Excess Deaths in 2020 • Hacker News Board

Re: Excess Deaths in 2020

#141

Post by Retric » Thu, Apr 29, 2021, 5:07 PM UTC

HideousKojima wrote: post #82

Retric wrote: post #80

Earlier quoted context omitted.

That’s exactly the kind of paper you get when economists are publishing outside their specialty. Most interesting example was he excluded any data that was counter to his theory and used highly overfit data. “Whether Atkeson (February 2021) has correctly modeled the Covid-19 virus is not at issue.” They can’t exactly do cost benefit analysis without models to compare, but their cherry picking models to support their…

The point he's making in that section is that by accounting for voluntary changes in human behavior (or failing to account for it as many models did) will drastically affect the results of any model that attempts to predict the rate of spread.

Human behavior is also influenced by messaging. You can’t assume economically rational actors in the real world when modeling actual behavior as people don’t know actual risks etc.

In a non lockdown world where schools are open and attendance is mandatory... well it’s clear to the average person the government doesn’t think people need to stay home. Sure, old people are dying in hospitals but I am 40 so it’s nothing to worry about etc.

However, shut everything down and people get the message that this is serious irrespective of the actual dangers they personally face.

Re: Excess Deaths in 2020

#142

Post by JoeData » Thu, Apr 29, 2021, 5:11 PM UTC

DataDaoDe wrote: post #32

One thing I would like to know, and I don’t know enough about mortality measures so maybe someone who does could chip in, would be essentially what is the probability of observing a year like 2020 with respect to all cause mortality. Is it in 99th-percentile or are we looking at an observation within a standard deviation of the expected value,etc.

Short answer: In the U.S., 12 standard deviations.

In the U.S., deaths were 16%-17% higher than expected. The death rate was 17.8% higher than in 2019. Excess deaths were higher in 1918, but every other year since 1900 is lower.

Using 1946-2019 as our sample, the average yearly change in death rate is -0.2% with a standard deviation of about 1.47 (percentage points). The biggest increase in this year range was 3.1% (2.2σ).

If we go back before the antibiotic era, the biggest one-year increases are in 1918 (29.3%) and 1929 (7.2%). Note that statistics before 1933 don't include all states.

For some other ways of looking at the data, here's an economists blog post: https://economistwritingeveryday.com/2021/01/06/excess-morta...

(He was writing in January, so had less complete stats.)

Re: Excess Deaths in 2020

#143

Post by xxxxxxx12 » Thu, Apr 29, 2021, 5:32 PM UTC

Retric wrote: post #141

HideousKojima wrote: post #82

Earlier quoted context omitted.

The point he's making in that section is that by accounting for voluntary changes in human behavior (or failing to account for it as many models did) will drastically affect the results of any model that attempts to predict the rate of spread.

Human behavior is also influenced by messaging. You can’t assume economically rational actors in the real world when modeling actual behavior as people don’t know actual risks etc. In a non lockdown world where schools are open and attendance is mandatory... well it’s clear to the average person the government doesn’t think people need to stay home. Sure, old people are dying in hospitals but I am 40 so it’s nothing…

> shut everything down and people get the message that this is serious

the Pajama Class say this and then wonder why their "messaging" doesn't go over well with anyone who's not able to log into zoom and chat it up with their comfortable, salaried, urban-elitist compatriots

Re: Excess Deaths in 2020

#144

Post by BadInformatics » Thu, Apr 29, 2021, 5:38 PM UTC

petertodd wrote: post #118

viraptor wrote: post #60

Earlier quoted context omitted.

> caused by the lockdown (i.e. delayed elective medical procedures, suicides, etc.) That's a dangerous way to phrase it. People would delay the elective medical procedures due to covid, even without lockdown. Overwhelmed hospitals would enforce the same. The covid/lockdown split of excess deaths is very complicated in itself.

Since natural immunity is durable, an unmitigated pandemic would be over sooner. So in many circumstances the hospitals would be overloaded for less total time and thus lead to less non-covid excess deaths. Here in Canada, excess deaths in 2020 for the 15 to 64 age range has been abnormally high, starting in March. Yet, unlike older age groups, the level of excess does not follow the pattern of reported COVID infecti…

This analysis presumes that hospital emergency and critical care capacity is flexible (it's not), that we can expect medical professionals to keep on performing at 100% in the face of overwhelming stress (they will not), and that Canada would somehow succeed at what Italy did not back in the first half of 2020 by doing even less mitigation. An argument in favour of no mitigation would have to demonstrate:

1. covid-related mortality and morbidity would not make up for any drop in other excess deaths

2. short-term stops on all non-critical care would, on balance, result in a significant drop in excess deaths over longer-term stops on a smaller percentage of non-critical care

3. hospital systems and their staff would still be intact after such a large wave. This may sound crazy, but while we're trading anecdotes you may be surprised at how many ICU nurses considered quitting because of how hard the latest surge hit. These are the people who dictate how many "ICU beds" we have, not the physical beds themselves!

4. that we can make any kind of meaningful analytical statement on covid mortality vs excess mortality for a specific age group given the lack of reporting data on both. In particular, data from coroner's offices on covid deaths has a huge lag time at present. Looking at case counts only is a poor proxy given you have to model infection -> death/recovery/discharge lag times, geographical variations and healthcare capacity as well. The HMD link merely provides total counts and proportions with no additional commentary. You can find more specific discussions on the subject [1], but they don't cover demographic breakdowns over time and necessarily maintain a high degree of uncertainty.

I don't think it's controversial to say governmental policy here has been sub-optimal at best. But to say that one extreme approach or the other is what we ought to have done based on woefully incomplete data is a stretch too.

[1] https://health-infobase.canada.ca/covid-19/epidemiological-s...

Re: Excess Deaths in 2020

#145

Post by petertodd » Thu, Apr 29, 2021, 6:13 PM UTC

BadInformatics wrote: post #144

petertodd wrote: post #118

Earlier quoted context omitted.

Since natural immunity is durable, an unmitigated pandemic would be over sooner. So in many circumstances the hospitals would be overloaded for less total time and thus lead to less non-covid excess deaths. Here in Canada, excess deaths in 2020 for the 15 to 64 age range has been abnormally high, starting in March. Yet, unlike older age groups, the level of excess does not follow the pattern of reported COVID infecti…

This analysis presumes that hospital emergency and critical care capacity is flexible (it's not), that we can expect medical professionals to keep on performing at 100% in the face of overwhelming stress (they will not), and that Canada would somehow succeed at what Italy did not back in the first half of 2020 by doing even less mitigation. An argument in favour of no mitigation would have to demonstrate: 1. covid-re…

> This analysis presumes that hospital emergency and critical care capacity is flexible (it's not), that we can expect medical professionals to keep on performing at 100% in the face of overwhelming stress

No I'm not. Remember, what I said was: "So in many circumstances the hospitals would be overloaded for less total time and thus lead to less non-covid excess deaths."

Let's assume hospitals are severely overloaded, and are simply unable to treat COVID patients. The pedantic meaning of what I said will certainly be true: non-covid excess deaths will be less.

But the steel-manned version - less excess deaths in total - could still be true if lockdown drags on sufficiently long, and COVID-19 is sufficiently mild, and/or the marginal benefit of hospital care on survival is low enough.

> hospital systems and their staff would still be intact after such a large wave. This may sound crazy, but while we're trading anecdotes you may be surprised at how many ICU nurses considered quitting because of how hard the latest surge hit. These are the people who dictate how many "ICU beds" we have, not the physical beds themselves!

I'm well aware. Frankly, I suspect that problem is made worse by a long, dragged out, pandemic. People can often handle a short period of extreme stress better than they can handle a much longer period of high stress.

Re: Excess Deaths in 2020

#146

Post by orangecat » Thu, Apr 29, 2021, 6:17 PM UTC

xorfish wrote: post #59

HideousKojima wrote: post #40

I'm curious if there's a good way to breakdown how much is caused by COVID vs., say, caused by the lockdown (i.e. delayed elective medical procedures, suicides, etc.). For example the US suicide rate declined from 2018 to 2019, but went back up in 2020. Naively assuming that all of the increase was due to the effects of the lockdowns would attribute ~2,880 suicides to them (or more if in a counterfactual world the su…

You could compare the excess deaths for New Zealand, South Korea, Australia and other countries that were able to prevent Sars-CoV-2 from spreading with strict lockdowns. Diagnostic delays are not caused by lockdowns. They are caused by an overwhelmed health care system or the fear of infection, both of which are caused by high incidence. You also need to consider the damage that long covid possibly do over the next…

You also need to consider the damage that long covid possibly do over the next 30 years.

Yes, and also the long term damage of lockdowns. Some children will be permanently harmed by the loss of education, and many people will be dealing with the effects of social isolation for quite a while.

Re: Excess Deaths in 2020

#147

Post by melling » Thu, Apr 29, 2021, 6:19 PM UTC

petertodd wrote: post #130

chrisco255 wrote: post #123

Earlier quoted context omitted.

There's absolutely no correlation between lockdown policy and mortality. For example, click the link above and compare Florida to California. Florida has been wide open since last summer (over 9 months now) and has performed about the same as California. And you can cherry pick Hawaii, but New York and New Jersey have been among the most strict lockdowns and they find themselves in the top 3. It seems to help to be a…

> Florida has been wide open since last summer (over 9 months now) and has performed about the same as California. Remember that Florida has a significantly older population than California too. 2.1% of the population >85 years old vs 1.3%; 17.6% over 65 years old vs 10.6%. COVID deaths are very concentrated in the elderly. The CDC estimates that the 85+ age group has a 8700x higher chance an infection leading to dea…

How much other causation have you looked into? For example population density?

Miami is a small city of 500,000 people.

Re: Excess Deaths in 2020

#148

Post by gmiller123456 » Thu, Apr 29, 2021, 6:28 PM UTC

HideousKojima wrote: post #55

joshuahedlund wrote: post #48

Earlier quoted context omitted.

Suicides declined in 2020 [1] Cost benefit analysis is important. But it's pretty clear the vast majority of excess deaths were covid related, because there's a very strong correlation between excess deaths and reported covid cases/deaths, even when you look at different states that had different peaks at different times, and no such correlation to other responses like different types of lockdowns. More delayed / ind…

Weird, the first result when I did a search claimed it went up to 14.8 per 100,000 this year, from 13.9 per 100,000 last year according to the Google summary, but the actual page doesn't seem to actually have that data: https://www.americashealthrankings.org/explore/annual/measur... Looks like the CDC data is still preliminary? So I guess we'll have to wait and see what the actual number is. EDIT: Looking through the…

Likewise, you should cite a source for your statistics in your original post.

Re: Excess Deaths in 2020

#149

Post by Retric » Thu, Apr 29, 2021, 6:29 PM UTC

xxxxxxx12 wrote: post #143

Retric wrote: post #141

Earlier quoted context omitted.

Human behavior is also influenced by messaging. You can’t assume economically rational actors in the real world when modeling actual behavior as people don’t know actual risks etc. In a non lockdown world where schools are open and attendance is mandatory... well it’s clear to the average person the government doesn’t think people need to stay home. Sure, old people are dying in hospitals but I am 40 so it’s nothing…

> shut everything down and people get the message that this is serious the Pajama Class say this and then wonder why their "messaging" doesn't go over well with anyone who's not able to log into zoom and chat it up with their comfortable, salaried, urban-elitist compatriots

I am sorry that reality doesn’t line up with your preconceived notions so you feel the need to lash out with name calling etc.

Consider sitting, back taking a deep breath, and then stepping away from the computer to do something you enjoy.

Re: Excess Deaths in 2020

#150

Post by whizzter » Thu, Apr 29, 2021, 6:35 PM UTC

bjornsing wrote: post #109

HideousKojima wrote: post #40

I'm curious if there's a good way to breakdown how much is caused by COVID vs., say, caused by the lockdown (i.e. delayed elective medical procedures, suicides, etc.). For example the US suicide rate declined from 2018 to 2019, but went back up in 2020. Naively assuming that all of the increase was due to the effects of the lockdowns would attribute ~2,880 suicides to them (or more if in a counterfactual world the su…

> 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 reas…

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-... )