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Comment by bjornsing | Hacker News Reader

> In the UK a study predicts a 7.9-9.6% increase in breast cancer deaths within 5 years of diagnosis due to diagnostic delays caused by COVID. [...] Basically I guess what I'm really trying to get at is that while COVID is certainly a terrible disease, there seems to have been little to no cost-benefit analysis performed by policy makers regarding the lockdowns and other attempts to combat it.

I see this line of reasoning a lot, even in mainstream media here in Sweden, but it seems flawed to me. As I see it diagnostic delays and delayed elective care is caused by a lack of lockdown or other stringent decease control measures. It’s when hospitals are overrun by people infected with SARS-CoV-2 that they have to delay other care. This happens due to rapid spread of the virus, which happens when lockdown is not imposed.

What’s the argument for the parents opposite line of reasoning?

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As a datapoint on Sweden, we have a normally pretty well functioning breast cancer screening system where women between 40-74 are to be offered a screening opportunity every other year.

In 2019 more than 800 000 screenings were done (with 8288 cancer cases discovered in the country that year) and this system has been credited for pushing down the yearly cancer deaths due to earlier discoveries.

In 2020 there was 160 000 less screenings so we can probably expect an increase in number of deadly cases in the coming years.

(Source, https://www.dn.se/sverige/en-av-fem-kvinnor-screenades-inte-... )

Ok, but again: The primary reason for this is the significant spread of SARS-CoV-2 which has overwhelmed hospitals. This in turn could have been prevented with lockdown(s). Right?

The hospitals weren't (all) overwhelmed but were focused on managing the pandemic. Fewer appointments scheduled, procedures pushed back, no weekend services, that kind of thing. Perhaps an element of patients huddling at home and being less proactive in their own care.

(Btw I'm not in healthcare. If anything my point is a logical alternative to the idea that overwhelmed covid wards could be the only thing affecting other services. But it's my impression of how things seemed to be, at least in the UK).

>overwhelmed hospitals

Something that has never been properly explained to me is how "overwhelmed" the hospitals were in relation to their normally "overwhelmed" state.

I wrote a script which extracted time series data from one of the hospital bed data APIs in my country around April last year and ran it for a couple of months. I wasn't able to make any useful conclusions from the data other than more patients were coming than going for a certain time periods and some wards had beds reassigned to other wards. It would have been a lot better if I had access to historical data to compare it to previous years.

In Lithuania health care barely functioned in mid-2020 purely because of the anti-pandemic measures and restrictions not because of being overwhelmed. It's only by the end of the year when the big second wave hit they were stressed. Yet many months lost because of lockdowns and bad decisions.

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