How many needless Covid-19 deaths were caused by delays in responding? | Hacker News Reader

How many needless Covid-19 deaths were caused by delays in responding?

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46 pointsdoener40 comments

Depends on your base-line. Take Taiwan.

Taiwan was masked up and implemented international quarantine in January along with full contract/tracing. Yes, they have characteristics and infrastructure we cannot perfectly replicate like a homogeneous population with relatively even socio-economic status, social cohesions and a strong societal memory of SARs with infrastructure to go along with it and a complete mistrust of information coming from WHO and China.

But even if we did 80% as well as Taiwan we are talking about almost 100,000 deaths. I think the excess mortality is around 2x what we are seeing in the official death figures so more like 200,000 deaths.

Add in the trillions in the bailout and economic damage, this might be the worst decision ever.

Taleb et.al issued a warning on Jan 26 about this. As he said - governments “did not want to spend pennies in January; now they are going to spend trillions.” [1]

[1] https://www.newyorker.com/news/daily-comment/the-pandemic-is...

> Add in the trillions in the bailout and economic damage, this might be the worst decision ever.

This was caused by the pandemic itself, not by the reaction to it. There's no scenario in which a pandemic ravaging unchecked through the populace does not create massive economic damage.

States are reopening based on the rate of infection. If there was more testing and better contact tracing earlier, these reopenings would've happened earlier. Which means less money needed to keep the economy from crashing.

It didn't have to be unchecked. That's the thing. Taiwan never closed down.

We would have needed a better president in the White House at the very minimum to have had a better response. And that's enough of a counterfactual that I'm just taking the current situation as a given. Given the president we do have, the current result seems to have been inevitable one way or another. We could've had fewer deaths here in NYC with a better governor and mayor who acted more quickly, but again, this is a hell of a counterfactual.

Had we reacted better, it's reasonable to believe that we could have contained it properly and not spent as many trillions.

The worse we let the pandemic get, the more expensive it will be.

The countries that took early measures i.e. Taiwan and South Korea have not had anywhere near the economic shutdown we have had. Economic damage and the need for gargantuan bailouts has been greatly curtailed.

We are now perenially in a wave of shutdowns and loosenings as the virus ripples through the population till we have a vaccine or herd immunity or it is reduced to a manageable chronic problem.

Why do you believe the excess mortality is higher than reported?

I known firsthand cases where hospitals were writing "covid related" on death certificates for deaths that had absolutely fuck-all to do with covid (in my case, I had to get the coroner involved to fight the hospital to get it changed).

Thats not to say that a point is a pattern, but my case isn't the only one.

Expected deaths per month (averaged over the last 30 years) compared to to actual deaths per month for 2020. We are seeing a lot more death in general, specifically not directly attributed to COVID.

US can’t pull these numbers yet but they are available for many parts of Europe and those countries show way higher “non-COVID” deaths than expected.

On mobile and can’t find the source atm

> US can’t pull these numbers yet

They're available on the CDC website, about 1/3 down the page: https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm

The data I saw for the Northern Provinces (Lombardy?) showed that they had 3x the normal mortality. 1x of that is the baseline that includes workplace accidents, sports, auto accidents many of which are not happening now. The rest 2x can be reasonably attributed to Covid. But only half of the 2x (1x) was being attributed to Covid. There was similar data from rest of Europe. I believe the FT had a very good piece on it [?].

I am not factoring in reduced life expectancy of the Covid recovery cohort. Someone who recovers from Covid after a few weeks/months on a ventilator will have residual effects which will lower expectancy for that cohort. They are now finding long term lung damage among Covid recoveries.

Please, please wear a mask especially in indoor spaces and take precautions till we have a vaccine.

In places with smaller outbreaks, excess deaths aren’t elevated, so whatever factor it is can’t be entirely unrelated to the local prevalence.

Part of the problem is that as human beings, we are awful at assigning credit and blame for hypothetical scenarios.

When in the best-case scenario nothing happens, politicians aren't incentivized to take strong action at the expense of harming the economy. They'll be blamed for the unemployment and harsh actions when "the disease wasn't that bad" – even though it "wasn't that bad" due to the prevention measures taken in the first place.

Look at Seattle vs. NYC. NY's Governor Andrew Cuomo has been largely praised for his leadership, but that's purely optics. Had he acted sooner, lives would have been saved. [1]

[1] https://www.newyorker.com/magazine/2020/05/04/seattles-leade...

Is there anyone doing research on the irrational aspects of human nature (the inability to reason about large numbers and small probabilities, the fixation on outliers, hindsight bias, etc) and their intersection with social media? I would be interested to see an analysis of this kind of stuff from a systemic point of view.

The pandemic may also require us to conclude that a free market in health care, and individuals making purportedly rational decisions about the value of their own lives in the context of their economic status is not what should happen in a modern society.

That would make sense but no, there is no alternative to our healthcare system. Our institutions, public and private, are unable to change in response to anything, unable to improve in any capacity that's good.

“Our government response to the pandemic was terrible!”

...

“If the pandemic may also require us to conclude that we need more government!”

I’ll never understand this line of thinking.

Okay, let me take a stab at it.

Linking health care directly to employment means that people CANNOT take off work if they're sick. This is dangerous in normal times. In a pandemic, this means that businesses shutting down isn't just an economic crisis, it's also a health care crisis.

The idea of individual responsibility for group problems, like a pandemic, leads to actors predictably behaving selfishly (staying open, no masks, going to work) -- it's predictable and preventable by socializing the responsibility.

And secondarily, because the US government is incompetent and has been for years does not mean that government, in general, is a failure.

The people currently running the government had a terrible response to the pandemic.

I want to replace them with better people.

It doesn't mean we shouldn't invest more in local governments and private organizations from this lesson. But I won't resign myself to thinking we can't do better than this administration.

The response to the plague was terrible because apparently the government is unable to do anything useful.

"The way we've arranged our society means we have been unable to cope with a plague."

...

"We need to arrange our society differently."

I'll never understand this line of thinking, because i can't imagine our siciety ever getting better.

I agree that, based on their pandemic response (among other things), I wouldn't want the people currently running the executive branch to design a new healthcare system for the country.

But how does it follow that because one group of people are incompetent, the very concept of government cannot work?

In another thread I commented that because of our knowledge of how the US government handled coronavirus and disasters such as Katrina, it's vitally important that individuals and families cast out any thought or hope of aid, assistance, or rescue from the US fed government in a disaster and instead work to prepare themselves and their community for events like this.

This article is demonstrating that this isn't a political position - it's just a fact of life in the USA.

What you've described is a political position, and the result of political policy - that of American conservatives, Republicans and libertarians.

It doesn't have to be a fact of life in the US, but it is because half of the country believes taxation is theft and "the government that governs least, governs best."

It's very political. The fact that wearing a mask is political says it all.

Scaling up the population of one country and comparing to the US is not going to be a valid comparison. Korea is comparable in size and population to California, but you would not judge the timing of the response of California against the response of, say, Kentucky.

Singapore is a bit smaller in population than the SF Bay Area, but you wouldn't judge the timing of the response of Bay Area measures vs., say, Miami.

There are 3 very good comparisons to make in Europe. Three different approaches and 3 different outcomes, in terms of peak cases, peak deaths, and timing of implementing various measures. Italy, Germany and Sweden would be better comparison/contrasts than Singapore vs. the USA. For the USA, compare on a regional basis versus the countries in the study.

Exaggerating to make the point, It's valid to do this type of analysis, but comparing the attributes of a scaled up mouse to an elephant isn't going to be of much value.

Or by not having masks freely available and required for public space? A couple billion dollars worth handed out as needed, with a social contract that wearing a mask is patriotic.

> a social contract that wearing a mask is patriotic.

I don't know when it happened exactly, but I feel like the general public has completely lost any sense of patriotism. I remember it being a big deal when I was a kid in the 90s. These days, there just isn't really any national pride. I guess probably related to 9/11, Iraq, Afghanistan,etc.

Americans are rabidly patriotic.

To the point where it's all about symbols and not even about shared values.

If patriotic is declaring oneself to be a patriot, than your first statement is true.

And do they love their symbolism, to the point where they declare that they would die for a fucking flag.

It's been severely deemphasized in popular narratives, and there's been a bit of a real downturn, but most Americans still report in polls that they feel a strong sense of national pride.

A majority report national pride but at the same time it's at a record low:

https://news.gallup.com/poll/312644/national-pride-falls-rec...

As a matter of preference America values commerce over life. The slow response is because in general America is trading lives for liberty. Essentially life is cheap. You might disagree with assessment and chalk up the bungled response to incompetence, but I don't think that makes sense in light of the reopening of public life as the virus spreading accelerates. We're still opting for this strategy now. And it might be the right decision for America. We'll just have to accept the loss of life as collateral damage. I don't agree, but I'm not making the decisions.

Life is not cheap in the USA. However, liberty is of greater value. Liberty is possibly what Americans value above all else, life being a close second.

Hence: "Give me Liberty or give me death.", Patrick Henry, 1775

And: "Life, Liberty and the Pursuit of Happiness.", Declaration of Independence, 1776

You're right about the US valuing "commerce over life", but equating business with liberty is fallacious. The pandemic spreading uncontrolled has been and will continue to be disastrous for individual liberty.

Here in FL we just added 4000+ more cases. Every day we break our own record. Our governor seems to think he can blame it on "Hispanics". Sigh.

Where did we go so wrong in this country? Why do people not care about each other?

How many mental health issues are caused by excessive lockdown measures?

Effectively all of them... A decent response would have detected a new disease before it got past 30 cases, and a good lockdown or tracing campaign at that point would have eliminated it entirely.

The experiences of China and Korea strongly suggest that good lockdown and tracing campaigns cannot eliminate it entirely.

Both cases likely failed due to imports from other countries.

If action was prompt before the virus spread to other countries, that wouldn't happen.

It's easy to say "we should have locked down sooner." Monday morning QB'ing; it's what humans do.

This is not hypothetical: Approx 50% of deaths are nursing homes related

However, allowing the ongoing attacks (i.e., we're at war) on nursing homes was, and often still is, very real. Before we get districted by what could have been, let's stay focused on reality.

Had nursing homes been hardened and protected - as they should have been - the whole story changes.

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