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Comment by walterbell | Hacker News Reader

These numbers can be further separated by "with Covid" and "from Covid" causality, as well as co-morbidities and expected lifetime. E.g. if someone was soon to die from illness A, but died 3 months earlier from complications induced by Covid, and the hospital received a financial payment for classifying this as Covid-related treatment, that should be broken out into a separate reporting category. Such deaths would not much change all-cause mortality for the year.

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Excess mortality is higher than reported COVID deaths. Australia contained the virus in 2020 and saw negative excess mortality. Official COVID deaths understate the true toll.

...of lockdowns?

COVID denialists often attribute excess deaths to lockdowns as opposed to undercounting of deaths from COVID. I was just preempting that line by pointing out Australia had severe lockdowns but negative excess deaths.

COVID what-ists? You mean all manner of people who have all manner of opinions and reasons for them that just so happen to differ from the views presented as scientific consensus by government, media and celebrities?

Here is a summary of over 400 studies demonstrating lockdowns are ineffective or harmful:

https://brownstone.org/articles/more-than-400-studies-on-the...

Prepare a sufficiently convincing argument against each and every one of them, and against the credentials of each and every author, before using the term "denialist" in application to anyone other than yourself.

Ok. I don’t care what the purported “studies” say. China, Taiwan, Australia had hard lockdowns. Taiwan and Australia have accurate statistics — they had virtually no COVID deaths and no excess deaths.

Sweden is 62nd on a list of 180 countries on deaths per capita. We can argue back and forth like this but why bother? If you don't care what the studies say, your mind is made up, making discussion with you valueless - for you.

I’m not saying there’s a huge difference between light and lighter lockdowns (ie, Denmark/Norway/Germany vs Sweden). I’m saying lockdowns themselves don’t produce excess deaths vs baseline (as evidenced by Australia and Taiwan). Therefore, the excess deaths that occurred in the US, which are greater than official COVID deaths, indicate COVID deaths are being under counted, not over counted

Doesn't basing your conclusion on the two countries that support it, out of a pool of ~200 that exist, seem a bit tentative?

It's at about the same level as the counter argument regarding Sweden (which is one reason I made it).

Have a look through the studies I linked, you'll find several that perform rigorous analysis on a large number of countries, including in some cases specifically regarding excess mortality.

For example, have a look at Figures 2A and 2B from the following study. 38 countries compared by length of initial lockdown measures, versus per capita excess mortality for the period, and then the same measure compared across all states of the US:

https://www.nber.org/system/files/working_papers/w28930/w289...

This doesn't support the hypothesis that lockdowns reduce excess deaths.

As I recall the basis of the argument against lockdowns (which yes was made by legitimate epidemeologists before covid made everything so politicized and tribal) is that the disease eventually comes right back and infects everyone once the lockdown ends. I do think there is a good argument about allowing vaccines to be developed and delivered though. But benefits like preventing hospitals from being overwhelmed were believed to already be achievable with social distancing alone. So one must be careful to not give to much credit to the lockdowns alone.

As for excess deaths, it presumably depends on how well the country can endure the self-inflicted downsides (such as a recession) that comes with it. Countries where it causes severe problems probably are the very ones who didn't have the political will to maintain the lockdowns, leading to some biased conclusions. We also have lots of other issues caused by covid response such as shortages and spiking prices all over. Being outright dodged by pointing blame at some indermediate actor like "corporate supply chains" or "hoarders" or whatever.

The point is there are arguments that can be made on all sides. No need to insult and dismiss people.

Leading cause of death in the US, 2015-2020: https://jamanetwork.com/journals/jama/fullarticle/2778234 (see table a few paragraphs down)

Heart disease, unintentional injuries, Alzheimer disease, and diabetes all jumped more than the expected trend.

2021 numbers I don't think will be finalized for another month or so.

Yes so it seems if anything COVID deaths are being misclassified as Alzheimer’s, diabetes, etc

One thing I've heard multiple doctors comment on is that they are seeing more patients who were successfully managing a condition have significant declines after a bout of COVID, even a mild one. That's definitely a bit of a philosophical question trying to assign fractional responsibility but you can also side-step this to some extent by looking at it as years of life lost — e.g. if someone with a manageable heart disease where patients tend to die 10 years older dies after having COVID, that's something like a decade where they could have been around their friends and family.

In places with good nationwide data like the UK and national level lockdowns, the excess mortality spikes also line up very well with the case outbreaks (especially pre vaccination), and considerably less well with other plausible causes of excess mortality (lockdown and unemployment induced stress, [long term effects of] reductions in access to treatment for chronic conditions)

> the hospital received a financial payment for classifying this as Covid-related treatment

Can you explain this more? Surely a hospital doesn't just get money for simply classifying it. How does a hospital benefit from classifying someone's treatment as Covid related other than being paid for the necessary treatment?

There are probably better sources, https://www.washingtonexaminer.com/news/cdc-director-acknowl... (Aug 2020)

> U.S. Centers for Disease Control and Prevention Director Robert Redfield agreed that some hospitals have a monetary incentive to overcount coronavirus deaths as they do deaths for other diseases. “I think you’re correct in that we’ve seen this in other disease processes, too. Really, in the HIV epidemic, somebody may have a heart attack but also have HIV — the hospital would prefer the [classification] for HIV because there’s greater reimbursement,” Redfield said during a House panel hearing Friday when asked by Rep. Blaine Luetkemeyer about potential “perverse incentives.”

For families, Covid classification for a death enabled up to $9000 for funeral expenses, https://www.cnet.com/personal-finance/covid-funeral-reimburs...

There is very little substance on that page plus it's 18 months old and the other fact you posted isn't an incentive for hospitals. I really wonder if that's actually a thing.

U.S. Congressional testimony by a CDC Director is not substantive?

The 2nd point offers a financial incentive for families to agree with hospital (mis)classification, i.e. it aligns the financial incentives of family and hospital towards Covid attribution.

Hospitals do receive extra payments for treating COVID-19 patients.

https://www.usatoday.com/story/news/factcheck/2020/04/24/fac...

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