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Comment by davedx | Hacker News Reader

> There is always the slowest country to act, and its citizens would feel entitled to the kind of far-fetched speculation the author posted.

Sounds about right. Belgium and the Netherlands aren't doing very much yet.

One interesting fact I discovered when discussing with my wife last night that I think does shape the discussion here: In the Netherlands, seasonal influenza has ~1% mortality rate -- in the U.S. it's more like 0.1%. This leads to different framings of the comparative severity of Coronavirus in the Netherlands.

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>In the Netherlands, seasonal influenza has ~1% mortality rate -- in the U.S. it's more like 0.1% Completely false, it seems 0.1% also in the Netherlands. "In the Netherlands, our closest comparisons are the Mexican flu of 2009/2010, with a mortality rate of just 0.02%, and the regular flu epidemics, with an average mortality rate of 0.1%" from: https://healthcare-in-europe.com/en/news/on-the-implications...

>In the Netherlands, seasonal influenza has ~1% mortality rate -- in the U.S. it's more like 0.1%.

(I'm not a healthcare professional nor actuarian; the following is freehand speculation)

There are two key factors. Firstly, USA is much less densely populated, with various additional compounding aspects: social stratification, with many segments of society living mostly in their own areas, and lesser dependence on mass transport. Modern technology and abundance of land allows maintaining a degree of isolation when needed.

Secondly, the healthcare system in USA vs Netherlands is tale of semi-private vs nationalized system. The former has more incentives to be proactive and minimize costs, vs the later having incentives to make a good showing, with payments being assured anyway.

> The former has more incentives to be proactive and minimize costs

On an individual basis perhaps in theory, but not on a population basis. See underinsured people afraid to go to a doctor until their condition is so bad it warrants an ER visit.

The actual numbers of the cost-effectiveness of US healthcare also shows the complete opposite of "minimizing costs" where it's twice as expensive as any other system

> In the Netherlands, seasonal influenza has ~1% mortality rate

Yikes! If true, do you know why that is?

I don't know, but I live in the Netherlands (as an expat) and their approach to healthcare is legendary for its sloppiness. The most common joke is about doctors responding to any health complaint by handing some paracetamol and saying "come back in two weeks if you don't feel better".

Three days ago the government held a special meeting about the coronavirus, in which they deliberated that people should stop shaking hands. That's all. They tell people who have come back from a high risk area and have flu symptoms NOT to call their gp and just stay home.

That's the generally accepted advice, unless you have shortness of breath.

Do you happen to be a dutch doctor?

No I just read the public guidance, e.g. from the CDC: https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/st...

The German perspective is, that their hospital system, especially regarding infections and diseases, is the best practice everyone should follow.

Nevertheless health care outcomes on average are pretty good, if you look at things like life expectancy...

I'm not saying healthcare is bad ("sloppiness" wasn't a good choice of a term). In fact it's very well organised.

It's more that the Dutch seem to be extremely... relaxed, maybe a bit fatalistic, about illness. It's a "suck it up" attitude. The fact that they're so slow in taking action now doesn't surprise me.

Maybe cultural. One of the reasons I love working with the Dutch is their calm professional approach to things. Not the worst trait to have in times of crisis.

In the 2018/2019 period there were approximately 400,000 cases of influenza and 2,900 extra deaths. Approximately 0.7%.

https://www.rivm.nl/sites/default/files/2019-09/TG_123539_01...

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