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Comment by toxik | Hacker News Reader

There is a similar confounder for deaths: old and multi diseased. Yes you may know the body count with corona but you do not know the body count due to corona.

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At population scales, anomalous excess mortality can be detected and shown actuarially, based on expected mortality rates.

Which raises another key point: in an epidemic, it's the population at large which is affected and diseased. Individual assessments (or treatment) are often of limited use or applicability.

I'm not sure if we will be able to separate the confounding factors such as economic impact at the population level. Do you have an idea how this can be done?

I have seen a few studies using this method to look at excess mortality during the great recession [1],[2], but there wasn't a pandemic at the same time.

https://www.thelancet.com/journals/lancet/article/PIIS0140-6...

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3070776/

To a certain extent the distinction is moot.

Deaths directly from an infectious agent, or due to society-wide institutional impacts ... are still deaths, and would have, at least in a statistical sense, have been avoided without the epidemic. Specific mechanism differs, but the ultimate avoidance measure is the same: avoid pandemic situations, as a society.

Don't forget the other direction: the people who die due to the shortage of ICU beds. There will be uninfected people who die that in normal times would have survived.

Only the excess deaths will allow us to have a true comparison, but sadly we only get those long after.

Those are confounded too by the reduction in other deaths such as traffic related ones.

Why is it a confounder? If people have less traffic accidents due to staying at home, that makes the virus a little less destructive in terms of lives (just remember to account for the economic cost).

Because you won't be able to break out Covid-19 caused deaths from the aggregate.

I disagree, as noted elsewhere in this thread. Pandemic effects should be consider society-wide. Specific causal and medical or other mechanisms will differ, but it's the net effect which matters.

Nonetheless, dead + coronavirus symptoms + positive coronavirus test is a pretty objective way of measuring things. People who will end up dead are more likely to be tested, so it’s also a more complete data set.

Some people would have died anyway of the existing condition they are having. An interesting question is how much their life expectancy had been affected by having also caught the coronavirus.

Here is one calculation that estimates the Equal Value Life Year Gained as 15 years. Then, if we do nothing to mitigate the pandemic and 1 out of 200 people die, then the average person looses 27 days. https://www.forbes.com/sites/theapothecary/2020/03/27/how-ec...

This article says it's 7.8 years on average and up to 13.26 million QALYs are at stake in the US. So it's expected that life expectancy for the whole population will decline by at most 14 days due to Covid 19. https://www.nationalreview.com/corner/another-covid-cost-ben...

"if we do nothing to mitigate the pandemic and 1 out of 200 people die,"

Where does that figure come from?

Edit: also, I think 1 in 200 is very, very roughly 5-10 times all other infectious diseases in a normal year. So maybe that would provide perspective.

Let me rephrase it: If governments does nothing, 1 out of 200 people will die.

This study expects 510,000 people to die in the UK (depending on the R0 value) and 2200000 in the US. That's 1 in 135. https://www.imperial.ac.uk/media/imperial-college/medicine/s...

It will be between 1 in 200 and 1 in 100.

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