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Estimation of total mortality due to COVID-19

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Re: Estimation of total mortality due to COVID-19

#361

Earlier quoted context omitted.

Yes, it's considered downplaying to try and attribute these people's deaths to something that didn't kill them. If the answer to the question of, "Would this person be alive were it not for COVID?" is "Yes", then COVID killed that person. You should be able to be fragile and still survive, that isn't an excuse to let someone die.

That's... exactly the point? Dying with COVID does not mean you would be alive today if you hadn't contracted COVID.

Just wait till you hear about 'eggshell client' in a court of law.

Re: Estimation of total mortality due to COVID-19

#362
post #234

Earlier quoted context omitted.

>Something to consider if you see anyone trying to downplay this. Most of the downplaying I've seen has revolved around the idea that those who died would have, "died anyway" from some other ailment or that hospitals are finding any reason they can to attribute deaths to covid. So, while you have a great argument, I doubt you'll change any minds because those who disagree flat out reject your premise.

The "well they had comorbidities" argument does rather miss that after middle age that's true of pretty much everyone. Or to take me as an example: I have asthma. That probably counts as a comorbidity, so if I die of covid, should that count as a covid death or not? I'm 42, I can reasonably expect another 42 years of life. Most chronic illnesses don't kill you.

> I have asthma. That probably counts as a comorbidity, so if I die of covid, should that count as a covid death or not?

I've actually seen some people with Asthma may have possibly survived because of certain Asthma medications that may do something to block covid, I can't remember the study, but if you're on that specific med, maybe that helped?

I'm > 400 lbs (690 in 2012), I'm 41, I survived having it. Except for long-covid which was a bitch.

Re: Estimation of total mortality due to COVID-19

#363
post #89

Earlier quoted context omitted.

No, because without tests, doctors didn’t uniformly attribute deaths correctly to covid, and often the official causes of death even in cases of cancer are often “pneumonia” or sepsis, or organ failure — the literal thing that killed them at the moment of death, not the cause of the symptom that overwhelmed the body.

You are making an assumption that all (or even just the majority) of excess deaths are because of this. Moreover, we know that there are examples of the opposite: deaths where Covid was on the certificate as a contributing factor, but not the primary cause. These aren't hard to find. An 85 year-old with congestive heart failure and late-stage cancer and Covid reflects the modal situation here. It isn't some theoretic…

Right, and those happen at a pretty regular rate every year. If we suddenly have 50k+ more congestive heart failure cases, or 50k less, we can tell that in the statistics.

Re: Estimation of total mortality due to COVID-19

#364
We changed the title from "True U.S. death toll from Covid is more than 900k, study finds". That was editorialized, which breaks the site guidelines. It was also arguably both misleading and baity, which means that it broke the site guidelines on all three points:

"Please use the original title, unless it is misleading or linkbait; don't editorialize."

Please don't do that!

https://news.ycombinator.com/newsguidelines.html

Re: Estimation of total mortality due to COVID-19

#365

Earlier quoted context omitted.

The linked article seems to be including suicide as a death resulting from COVID, when the increase in suicides is far more likely to be caused by our response to COVID , not having COVID. It is definitely not only looking at whether people would have died sans covid in their system .

You think there were a half million excess suicides in the US due to our response to covid? Again, this is just nitpicking at an article that supports a (very obvious) conclusion you find politically inconvenient. As to whether a suicide due to pandemic-induced depression "counts" as being "caused by the pandemic" or not, isn't exactly the kind of confounding effect you railed against above? Isn't the solution, again…

A conclusion I find politically inconvenient? You have no idea what my politics are, please stop projecting.

To answer your question though, no, they should not be lumped together because they are not the same thing and so the mitigations would've/could've/should've been different. In other words, lumping all these things together as "caused by COVID" is the opposite of useful. For example, you do better next time with deaths due to COVID in your system (category "a") by ramping up vaccination faster/better facemask policy/earlier lockdowns/etc. You can decrease category "b" by having more hospital beds / more healthcare capacity. You can reduce the deaths in category "c" (seemingly suicides) by having lockdowns that aren't up-and-down rollercoasters / better mental healthcare / etc. All of these, though being "due to COVID" should be handled very differently so it is counterproductive to lump them all together.

Again, I think you might be projecting a bit here, because the only reason I can think of that you would want to lump them together is to push a political agenda. Not for any utilitarian reason.

Re: Estimation of total mortality due to COVID-19

#366
post #363
post #89

Earlier quoted context omitted.

You are making an assumption that all (or even just the majority) of excess deaths are because of this. Moreover, we know that there are examples of the opposite: deaths where Covid was on the certificate as a contributing factor, but not the primary cause. These aren't hard to find. An 85 year-old with congestive heart failure and late-stage cancer and Covid reflects the modal situation here. It isn't some theoretic…

Right, and those happen at a pretty regular rate every year. If we suddenly have 50k+ more congestive heart failure cases, or 50k less, we can tell that in the statistics.

Well, sure. It will be good to get the actual data, and then we'll know.

Right now, what we have is aggregate death counts (which we know are high), and people speculating that they're elevated because of Covid (or in this case, making models based on speculation).

Re: Estimation of total mortality due to COVID-19

#367
post #323

Earlier quoted context omitted.

> testing against a holdout set Not just a holdout set -- a holdout set of prospective data , where you actually predict the future, blindly, and see how you do. Obviously, you have to wait a little while to gather such data before you make big claims with your model. Doesn't mean you get to skip it. It's not even clear to me that the authors did a cross-validation here, or even bothered to fit the free parameters of…

What is the mathematical difference between testing against a holdout set of data collected at the same time as the data used to fit the model, and a holdout set collected in the future? I'm in total agreement that avoiding, e.g., overfitting is a good thing – but what work is prospectivity doing here? Also, if I understand correctly, none of the modeling done in standard texts such as Gelman et al.'s Bayesian Data A…

A prospective test is blind. You don't know what the data looks like, so you can't cheat.

> Also, if I understand correctly, none of the modeling done in standard texts such as Gelman et al.'s Bayesian Data Analysis involves prospective validation under your definition. Should we then classify the examples in that book as "mathematical fairy tales"? This seems like a fairly strict standard!

It's surprisingly common for models to pass all of the cross-validation you want to throw at them, and fail in the real world. I don't care what statistical techniques you've applied, if you don't conduct blind tests, you don't know how your model performs.

Setting this aside: TFA did nothing you're talking about. Let's be clear about that.

Re: Estimation of total mortality due to COVID-19

#368
post #288

Earlier quoted context omitted.

Sure, here's a much better treatment of the same subject: https://ourworldindata.org/covid-excess-mortality

Which is an excellent article. I just fail to see how you think it's inconsistent with the numbers in the IHME story above or their methodology. Lots of these confounding factors are expressly enumerated. I mean, do experts like the authors of that OWiD article find the same fault with IHME that you do? Can you cite some making similar criticisms? Again, I get the distinct feeling that you're arguing with methodology…

> I mean, do experts like the authors of that OWiD article find the same fault with IHME that you do? Can you cite some making similar criticisms?

I don't know. I don't cross-check my thoughts with every "expert" in the world before I express them. I have expertise in this field; I can think for myself.

> Again, I get the distinct feeling that you're arguing with methodology here not because there's anything particularly suspicious with IHME at all, but because the conclusion (that the US is approaching 1M covid deaths, something that should surprise no one) is politically inconvenient.

You have no idea what my politics are. I am saying that this model reflects the assumptions used to create it. Nothing more, nothing less. It is not a validation of the assumptions -- it is a regurgitation of the assumptions.

Re: Estimation of total mortality due to COVID-19

#369
post #364

We changed the title from "True U.S. death toll from Covid is more than 900k, study finds". That was editorialized, which breaks the site guidelines. It was also arguably both misleading and baity, which means that it broke the site guidelines on all three points: " Please use the original title, unless it is misleading or linkbait; don't editorialize. " Please don't do that! https://news.ycombinator.com/newsguidelin…

Original source was this: https://www.mediaite.com/news/true-u-s-death-toll-from-covid...

Which is where the title came from.

At the last minute I remembered there was an actual scientific paper so I changed the URL to that.

Re: Estimation of total mortality due to COVID-19

#370
post #367

Earlier quoted context omitted.

What is the mathematical difference between testing against a holdout set of data collected at the same time as the data used to fit the model, and a holdout set collected in the future? I'm in total agreement that avoiding, e.g., overfitting is a good thing – but what work is prospectivity doing here? Also, if I understand correctly, none of the modeling done in standard texts such as Gelman et al.'s Bayesian Data A…

A prospective test is blind. You don't know what the data looks like, so you can't cheat. > Also, if I understand correctly, none of the modeling done in standard texts such as Gelman et al.'s Bayesian Data Analysis involves prospective validation under your definition. Should we then classify the examples in that book as "mathematical fairy tales"? This seems like a fairly strict standard! It's surprisingly common f…

> A prospective test is blind. You don't know what the data looks like, so you can't cheat.

Suppose I blind myself to the holdout set. What's the difference?

> It's surprisingly common for models to pass all of the cross-validation you want to throw at them, and fail in the real world. I don't care what statistical techniques you've applied, if you don't conduct blind tests, you don't know how your model performs.

What exact failure mode is such that a) prospective testing guards against it, and b) traditional validation methods do not?

Take for example distribution shift. Suppose I'm worried the underlying data generating process is going to change between training and deployment. You propose, I guess, that this is fixed by collecting more data prospectively. OK, suppose and I do that and everything checks out. Now what guarantees there is no distribution shift between the time I do the prospective testing and subsequently deploy the model?

To be more direct: one eventually has to make assumptions of statistical regularity and distributional constancy somewhere, at some point, in order to do any statistical inference at all. If you have good reasons to make such an assumption, I don't see why prospective data collection is any different from a regular holdout set. And if you don't, then you're screwed no matter what you do.

> Setting this aside: TFA did nothing you're talking about. Let's be clear about that.

Sure, but strongly held, unorthodox opinions about statistical practice are more interesting to me than tearing down some mediocre article.

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