• I like sushi
    4.8k
    Regardless, an above average number of deaths registered in the last official figures in the UK (50% above average) requires some kind of explanation. I imagine some of those deaths were due to people scared of visiting a hospital, but 6000 seems far too many for that to be the only reason.

    The problem is the politicking. The science is consistent but the models, because they’re models, are never ever 100% accurate and the very same computer model ran twice will never give out the same result.

    The general population’s mistrust of scientists, and politician’s lack of scientific understanding, are the main factors. The Iraq War wasn’t anything to do with science on the scale the pandemic does. People just want to be told when, why and how and certainly don’t like the honest scientific opinion of ‘we can only give you rough estimates, so we err on the side of caution or millions could die’.
  • Benkei
    7.7k


    It is crucially important that the NHS is not overwhelmed, but if COVID deaths can be kept in the order of say 20,000 by stringent suppression measures, as is now being suggested, there may end up being a minimal impact on overall mortality for 2020 (although background mortality could increase due to pressures on the health services and the side-effects of isolation). — Spiegelharter

    That reads to me as if he doesn't know one way or the other but that we shouldn't be surprised if the yearly deaths for 2020 despite covid-19 remains stable. That really depends, I think, what types of comorbities are in play and whether those world result in deaths this year or much later (like diabetis and overweight).
  • I like sushi
    4.8k
    What you’ll find is at the end of the year more people will have died from the common flu (hopefully). This will lead some people to imagine there was never a problem in the first place. The very same people would likely have been those dead without the restrictions being put in place.

    When a plan is put into place and works, those opposed to it can always turn around and say it wouldn’t have mattered if no plan was used.

    Peter Hitchens is one of these. He is worth listening to just to get an idea of how well articulated someone can be without any actual expertise in the field - by making comparisons with hie he was right about the Iraq War (which is mere rhetoric as that had no real scientific basis whatsoever).
  • Merkwurdichliebe
    2.6k
    an above average number of deaths registered in the last official figures in the UK (50% above average) requires some kind of explanationI like sushi

    Only the British can make US bullshit smell like Rose's. :kiss:

    The general population’s mistrust of scientists, and politician’s lack of scientific understanding, are the main factors.I like sushi

    Scientist are more full-of-shit than all the politicians and lawyers combined 8-fold. This pandemic has proven that medical science has no clue whatsoever. Otherwise, it would be written... and not a bunch of speculative hype, which you and I are currently guilty of. But I have a good time working out these ideas, and I appreciate you for assisting me in this quest. I hope it is reciprocal.

    The Iraq War wasn’t anything to do with science on the scale the pandemic does. People just want to be told when, why and how and certainly don’t like the honest scientific opinion of ‘we can only give you rough estimates, so we err on the side of caution or millions could die’. — I like sushi

    "so we err on the side of caution or millions could die"

    That's exactly what they said about "weapons of mass destruction"...wmd's mf'er!!!...yellow cake from Nigeria MF'er!!! We all gonna die from the terrorists in the sky.
  • I like sushi
    4.8k
    I can only assume you’ve not looked at the links I’ve provided.

    Here they are:

    https://m.youtube.com/watch?v=gxAaO2rsdIs

    https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/datasets/weeklyprovisionalfiguresondeathsregisteredinenglandandwales

    If you still don’t understand the nature of mathematical modeling I cannot take your comments seriously. If you refuse to believe the governments statistics regarding the number of registered deaths (for all causes) that just makes me think you’re part of the tinfoil hat brigade or here purely to troll, and therefore cannot take your comments seriously.
  • Punshhh
    2.6k
    Anyone else actually get the 'rona?

    Do you have it? I hope your symptoms are not to bad.
  • Isaac
    10.3k


    Yes. It depends entirely on the type and effect of comorbidities. The fact is that the overlap is unknown and will remain unknown until the end of the year (possibly even the following year, which I think is what Professor Spiegelhalter is referring to there).

    My argument with @boethius is mainly about his ridiculous assertion that the overlap will definitely be small because there's no significant overlap in factors. This despite the fact the the only recorded factors affecting prognosis thus far are exactly the same as the factors affecting prognosis in other conditions, as the four articles I cited demonstrate.

    I should add we already know a considerable amount about the effect of comorbidities from the death certificates. 91% in the UK and 98% in Italy. It should be stressed here as I think this has lead to some confusion these are not figures for "other things the patient had" which seems to be the prevailing opinion here. When we say comorbidity in this context we're not saying "Oh and he happend to have heart disease also, but that's irrelevant".

    As the ONS specify "we analyse deaths involving COVID-19 by the main pre-existing condition. This is defined as the one pre-existing condition that is, on average, mostly likely to be the underlying cause of death for a person of that age and sex had they not died from COVID-19."

    We're not talking about "and they also had..." we're talking about a condition that actually listed on the death certificate as a contributory cause of death and I stress - mostly likely to be the underlying cause of death for a person of that age and sex had they not died from COVID-19

    I just don't know what more I can say to get this across.
  • Punshhh
    2.6k
    It never ceases to amaze me the lengths people will go to to maintain their chosen narrative.

    I should never have started trying to have a reasonable discussion again.

    Please do stick around to discuss this, your contributions are valued. I think you unfortunately chose to dig a little deeper with the wrong interlocutor. Boethius is quite argumentative, he seems to enjoy it. But this might result in a failure to reach consensus.

    There are others following this crisis who will be more agreeable.

    I apologise for not following your comments, I have limited time for this at the moment. I think you will find that the various folk following the thread have their own position, or take on this crisis, which they have presented, the rest of us can then take what we want from it. I am not sure what your position is?

    Mine is that the health consequences are not the primary concern, that we won't have accurate statistical analysis at this point, but there is a substantial overlap, along with a significant number of healthy younger fatalities and a worrying mortality among vulnerable groups. Those who are immunosuppresed for medical reasons, for example, they are a significant constituency. But more importantly there is the economic, political and social consequences, these are the areas of interest for many. Because the consequences may, or may not be profound.
  • Isaac
    10.3k
    When a plan is put into place and works, those opposed to it can always turn around and say it wouldn’t have mattered if no plan was used.I like sushi

    This is a non-sequitur. When a plan is put into place and the threat it was intended to avoid does not materialise we can say it was the plan, or we can say the plan was not needed. Neither is true or false out of the box. It depends entirely on the posterior analysis.
  • Isaac
    10.3k
    Please do stick around to discuss this, your contributions are valued.Punshhh

    Thank you. That's kind of you to say so.

    I am not sure what you position is?Punshhh

    Not too far from you it seems. My main concern is the psychological impact in two major ways.

    1. We needed to have responded to this crisis much quicker and with more decisiveness - let's be absolutely clear, despite my efforts to explain the overlap in deaths from other conditions, even if the overlap was 100%, having a year's worth of deaths in the space of a few weeks is an absolute disaster and would undoubtedly have caused thousands (if not tens of thousands) of unnecessary deaths due to the overloading of the healthcare systems. We needed to have instigated social distancing, testing and tracing straight away and the fact that we didn't is bordering on criminal. The problem, psychologically, is that the more the threat is hyped up, the more people panic about it, the less rationally they respond and that is the opposite of what we need. It may be tempting to think that presenting the worst case scenario fires people into action, but the literature just does not support that position. People become either hyper or hypo aroused to the threat meaning that they will either see it everywhere (and so not focus on where it really is) or they will just 'block it out' because it's too big to handle. Both of these effects are well-documented (it's not just guesswork) and both of them could be disastrous for the next time something like this happens.

    2. I'm extremely concerned about the effect the media has been able to exert on the general psyche. Culture has always been able to generate collective affect, but it's becoming worryingly uniform the more social media grows (I won't derail the thread by going into it here, but imagine starlings murmuring - one or two and it's just a mess going every which way, thousands and it suddenly looks like a choreographed dance, but all it is is just thousands of birds all trying to respond to each other and making tiny errors in copying which then get magnified)

    It would be political suicide now for any government to act in a way which contradicted the media view (because it is so uniform) and any government which did want to lead (they're supposed to represent the population - not blindly follow it) simply don't have the means to spread information in the same way. It's not about political ideology anymore, it's about market-ready groups who can have focussed advertising delivered to them. Ideology has been subsumed into these groupings.

    2,195 children every day die from Diarrhoea, 88% of which is avoidable by supplying clean drinking water and washing facilities. A relatively cheap intervention which doesn't even impact on issues like economic independence as other development aid might. The money to solve that problem is easily available, ready to hand and it really should have been sorted decades ago. any rational assessment of spending priorities would have focussed on it. But we don't get rational assessments of spending priorities when we jump from one media-instigated panic to the next.
  • I like sushi
    4.8k
    Of course? That was the point.
  • Punshhh
    2.6k
    I saw the protests against lockdown in the US and Trump announcing premature opening up of lockdowns. Looks like it's going to get fruity over there.
  • Isaac
    10.3k


    You said...

    This will lead some people to imagine there was never a problem in the first place.I like sushi

    You can't say that they'd be imagining it without having done the analysis. Presuming here we're talking somewhat rhetorically. If you literally mean people imagining there was no problem - zero problem - then of course they're wrong already, but if that's what you mean, then you're straw-manning. No one is claiming there's no problem, even the worst right-wing rats are admitting that a problem exists.
  • I like sushi
    4.8k
    I understood what you meant the first time. It’s like me saying “I told you it’d rain today!” and trying to say because I was right about this I am therefore right about which horse will win the Grand National - there is a slight connection between the two given that the weather will determine the running, but neither hold any weight if we haven’t examined the facts.

    Clearly you haven’t examined the facts because you don’t understand how mathematical modeling works and use this as an excuse to dismiss the science behind the modeling (which is your uninformed choice). Dismissing the science because it is inconclusive is to dismiss science completely. It’s ridiculous.

    As fro WMD very few people believed the government. In the UK public opinion was against the war and parliament debated the point too.

    My agenda here has been announced several times! I am concerned about how this plays out in developing countries and whether or not lockdowns helps or hinders them in the long run.

    I’ve steered well clear of politicizing this or pointing to any particular leader/government to blame. Nature is worse than any government in terms of death counts.
  • I like sushi
    4.8k
    You appear to want me to be saying something you’re not saying to disagree with me and start a pointless argument. Find someone else to spit your dummy at because you’ve done this too many times to me already.

    No more replies from me so go at it and get it off your chest (whatever it is?)
  • Benkei
    7.7k
    My argument with boethius is mainly about his ridiculous assertion that the overlap will definitely be small because there's no significant overlap in factors. This despite the fact the the only recorded factors affecting prognosis thus far are exactly the same as the factors affecting prognosis in other conditions, as the four articles I cited demonstrate.Isaac

    The overlap is 100% given a long enough time period. I think we don't really know yet in the short term but I think there are some educated guesses.

    We have a number of old people who would've died this year anyways and a number who would've died later. Given sufficient infections we will see a statistically significant rise in deaths in the older age groups, where a lot of deaths will occur now instead of later due to a reduced immune system and no effective treatment at this time.

    Then there's the group of comorbidities. I don't know what the prevalence is of comorbidities resulting in deaths this year but since this apparently includes obesity and diabetis, here too I suspect a staristically significant increase in deaths this year from people who would've died much later under other circumstances.

    To what extent these will be practically significant increases depends on the infection rate and therefore the efficacy of policies.

    What is practically significant isn't precise and is a matter of opinion. It appears to me you and boethius might be discussing opinions at this point which is why you aren't reaching agreement.
  • Isaac
    10.3k
    What is practically significant isn't precise and is a matter of opinion. It appears to me you and boethius might be discussing opinions at this point which is why you aren't reaching agreement.Benkei

    You're right, and of course, the timescale matters. Thinking about overlap with deaths this year is a fairly arbitrary cut off point (why not the next two years or five). This is a problem with risk analysis in general and why people like Prof. Spiegelhalter tend to talk about Days of Life Lost rather than raw deaths, it's not because he doesn't care about the elderly and ill, it's just that there's no other way to account for effect of interventions statistically without skewing the results.

    The overlap in factors affecting prognosis, however, is not just opinion (or rather it's the opinion of virtually every expert who's written on the subject). This overlap does affect the predictions in ways which are then beyond mere opinion. In order for the overlap to be statistically small, for example, we would have to have a lack of overlap in factors affecting prognosis to a greater extent than there is overlap. In order to sustain such a position one would have to assume that factors as yet undiscovered turn out to be so significant that they outweigh the overlapping factors already discovered. That seems quite a stretch.

    What we know is that the vast majority of fatalities (over 90%) had other comorbidities which were "mostly likely to be the underlying cause of death for a person of that age and sex had they not died from COVID-19". so this is referring to cause of death at the time of death. Not cause of death eventually, or some time in the distant future if they're unlucky enough. It is the other factor which the doctor or coroner thought serious enough to contribute to the actual death at the time ie without Covid-19 they would quite likely have died from that condition alone.

    I agree that the complicating factors of system overloading and long-term lung damage make the figures difficult to say with certainty, but there is not any evidential support for the position that the overlap with those who would have died anyway will be statistically very small. As Professor Ferguson says, this is primarily a condition which causes death in those who are already very ill.
  • Isaac
    10.3k
    since this apparently includes obesity and diabetisBenkei

    Just noticed this. The risk group (those who are significantly more at risk than average) include the overweight and those with diabetes. The comorbidities registered on death certificates (where the overlap comes from) do not include any such vague categories. They are actual causes of death. They're far less vague and use either ICD-10 or WHO cause of death categories.
  • boethius
    2.3k
    You're right, and of course, the timescale matters. Thinking about overlap with deaths this year is a fairly arbitrary cut off point (why not the next two years or five).Isaac

    If you think we've been talking about some vague timeline and therefore, your position is correct given more time, you are wrong.

    3) 2000 cases from respiratory conditions is not far off normal. It's the amount of cases with underlying health problems being pushed over the edge that is the real problem here. The key thing there being that we don't know how many of them would have died anyway, nor will we until the year's figures are out.Isaac

    Yes, the reasoning is based on the empirical data that the virus seems to simply double your chances of death this year, whatever your risk group; that this is the best predictor for most people.boethius

    However, if long term injury increases the risk-of-death factor for survivors of Covid, then you may end up with more deaths in absolute terms next year due to lung injuries or other long term Covid treatment complications. (likewise for every other demographic cohort)boethius

    We know with great precision how many of those people were going to die this year anyway, its about 300,000 (the death rate minus deaths from accidents). So until the death rate from Covid-19 exceeds 300,000 you can't possibly say that the victims were not going to die anyway, simply on the basis of the numbers, you additionally need data on the overlap - or you need to wait for deaths occurring over a longer timescale - say a year, or you need a plausible mechanism of fatality which does no coincide with underlying health conditions.Isaac

    My argument is a counter-argument to the idea that Covid is shaving off a population from these risk groups that can be in some sense said to "about to die anyways"; I've been using a year as a baseline time frame for the meaning of "about to die".

    Covid doesn't kill enough people to have an obvious and noticeable statistical effect of this kind, such as non-respiratory disease going forward making up for, or nearly making up for, Covid deaths and arriving at some equilibrium.
    boethius

    We've been talking about a year.

    Obviously, if you make "die anyways" to mean any length of time then the overlap is 100 percent as @Benkei mentions. Since that's obvious it's necessary to discuss some specific time frame.

    We've been discussing the time frame of a year.
  • Isaac
    10.3k
    We've been discussing the time frame of a year.boethius

    I'm aware of that. I was simply making the point that what might be a 60% overlap in a year could be a 90% overlap in two years. Picking one year is quite arbitrary (although it does cover seasonal variations, so it's pretty much the minimum time scale it makes any sense to compare over). Professor Ferguson and Professor Spiegelhalter are referring to the yearly mortality in their comments, as have I been.
  • boethius
    2.3k
    My argument with boethius is mainly about his ridiculous assertion that the overlap will definitely be small because there's no significant overlap in factors. This despite the fact the the only recorded factors affecting prognosis thus far are exactly the same as the factors affecting prognosis in other conditions, as the four articles I cited demonstrate.Isaac

    By small, I have been clear that the effect is there, the effect is measurable, but the effect is not so large as to essentially balance out deaths over the year, or come anywhere close to that.

    Yes, people have problems that will likely kill them with time. We've been talking about a 1 year time frame. No where have you presented any evidence that most people dying of Covid would die within 1 year.

    Him saying the overlap 'is not the point' of the graph has somehow become him saying that there is no substantial overlap (oh, sorry I forgot 'substantial' now means 'very small' - I will have to get the hang of this newspeak)Isaac

    Substantial for a statistician can easily mean "a small but statistically significant effect".

    I have said the overlap is small in the context of your initial assertion that Covid deaths and "otherwise deaths" may completely balance out to have no, or hardly, and net increase in deaths. That's a big effect.

    I've been arguing that the effect is small, because we have enough information to know it's killing people in large risk groups. And furthermore, I've been arguing that the overlap maybe not only small but not as big as long term injury replenishing those risk groups.

    I agree that the complicating factors of system overloading and long-term lung damage make the figures difficult to say with certainty, but there is not any evidential support for the position that the overlap with those who would have died anyway will be statistically very small. As Professor Ferguson says, this is primarily a condition which causes death in those who are already very ill.Isaac

    You complain about me being a dishonest debater, and yet you don't mention that this has been one of my major points, that I said from the beginning.

    And now you say "very small" is what you've been disagreeing with, to give room for you to have the small v very small part of the debate. I never used there term very small.

    Yes, we know people that die of Covid are usually ill, maybe very ill, we've been discussing the overlap with people "who would otherwise die this year", not the overlap with "ill people".

    If you want to discuss 10 year, 20 year time frame, then I would agreeing with you. But we've been talking about a year.

    You've basically changed your position to my position, but you're so cranky about being wrong and citing evidence that supports my position, that you want to pretend my position was your position all along based on substituting meaning of words. But that ambiguity isn't there.

    1) A spike in the death rate is only a snapshot at a particular moment. The 6000 extra people who died last week are not now available to form the pool of people who will die next week. This would be irrelevant if Covid-19 did not preferentially target those with underlying problems, but it does.Isaac

    This is your initial position in your disagreement with @I like sushi. I like sushi and I have been saying such an effect, is there, but is not big.

    You've been arguing that Covid targets "the weakest" hearts and so on, to support your position that the effect is large, or at least likely large. So large as to change policy response or create narrative risks on the left of some sort.
  • boethius
    2.3k
    Professor Ferguson and Professor Spiegelhalter are referring to the yearly mortality in their comments, as have I been.Isaac

    Ok, so we're talking about a year.

    What evidence is there that the effect of overlap with people "who would otherwise die this year" is a big effect as opposed to a small effect?

    I.e. big enough to support the idea that:

    1. High overlap undermines certain arguments against social distancing measures because there should be little net excess in treatment requirement, focusing the main problem even more in the height of the spike of cases. Without overlap there is an argument that flattening the curve will not help because it pulls staff from other vulnerable cases in the long term so providing no net gain. In other words, with overlap we only need to re-assign resources (which everyone agrees is doable), without overlap we need to produce a net increase in resources (which many think is not doable, so why bother >> herd immunity bullshit).Isaac
  • Isaac
    10.3k
    the effect is not so large as to essentially balance out deaths over the year, or come anywhere close to that.boethius

    As I've said, take it up with the professionals who disagree with you, or present some counter-citations. Your personal 'rekon' that it won't be large doesn't amount to much on its own when contrasted with two experts who both think it will be between 50 and 100%.

    No where have you presented any evidence that most people dying of Covid would die within 1 year.boethius

    Right. And nowhere have you presented any evidence that they wouldn't. Hence my point to @Benkei that a year was a bit arbitrary. Professor Ferguson talks about people at "the end of their lives" and Professor Spiegelhalter talks about a "very short time". If you want to interpret those expression as meaning much more than a year, you can, but I'll not join you. Someone with 5 or more years left being described as at "the end of their lives" is ridiculous.

    Substantial for a statistician can easily mean "a small but statistically significant effect".boethius

    What about "many", does that now mean 'few'? Plus his recent comment is much clearer that he expects "there may end up being a minimal impact on overall mortality for 2020". Or does "minimal now mean 'massive'?

    What evidence is there that the effect of overlap with people "who would otherwise die this year" is a big effect as opposed to a small effect?boethius

    Over 90% of people who have died of Covid-19 had comorbid conditions that were "mostly likely to be the underlying cause of death for a person of that age and sex had they not died from Covid-19". These were not the assignation of broad risk groups. These are the additional conditions the doctors considered life-threatening enough to be listed as a cause of death.

    Prognosis for Covid-19 fatality is significantly worse for key factors which are identical to factors which also affect prognosis for the comorbid conditions listed. There are no non- overlapping factors listed in any of the studies.
  • boethius
    2.3k
    Please do stick around to discuss this, your contributions are valued. I think you unfortunately chose to dig a little deeper with the wrong interlocutor. Boethius is quite argumentative, he seems to enjoy it. But this might result in a failure to reach consensus.Punshhh

    Poor, poor @Isaac, comes to a debate forum, engages in a debate, get's served with a debate.

    None of the points I have made is motivated simply to disagree with Isaac.

    I genuinely believe the effect of overlap of deaths of Covid this year with "otherwise would have actually died" group this year is small and can be defended with reasoning. By small I mean the effect is there, but not big enough to change policy response.

    If you agree with my position, which you seem to, then why would it be unreasonable to defend a position you view as correct? If you disagree, then join the debate -- maybe I'm wrong and you can explain where and why -- instead of complaining about others debating on a debate forum.
  • boethius
    2.3k


    3 days ago, I made my position very clear:

    I'm not sure you're even arguing / implying something against what I emphasize above, or are just compiling all the statistical minutia of relations to consider.

    In terms of adding to the list, a big one that can not only nullify the affect of high-risk groups decreasing in absolute size (due to dying), but actually reverse that tendency, is that the virus may cause long term lung damage.

    So, if every 70 year old got the disease, all else being equal, we may expect that demographic cohort to have less deaths post-pandemic, simply due to their numbers being smaller or perhaps particularly weak breathers being culled from the heard. However, if long term injury increases the risk-of-death factor for survivors of Covid, then you may end up with more deaths in absolute terms next year due to lung injuries or other long term Covid treatment complications. (likewise for every other demographic cohort)

    Long story short, some Covid deaths would have died anyways, but expected overlap is small (extreme bias towards this group getting Covid would be needed for a significant overlap), and long-term injury may compensate, even significantly over-compensate, this overlap by increasing the risk-of-death factor for these risk groups (indeed all risk groups).
    boethius

    I gave you the benefit of the doubt that you were saying the same thing.

    If you're saying the same thing now, you've wasted your time and made yourself look like a fool. Though you haven't wasted my time fortunately, for it is true, as @Punshhh suggests, that I enjoy debating on a debate forum, which is why I come to a debate forum to debate.

    For instance if you mean by:

    What we know is that the vast majority of fatalities (over 90%) had other comorbidities which were "mostly likely to be the underlying cause of death for a person of that age and sex had they not died from COVID-19". so this is referring to cause of death at the time of death.Isaac

    That 90 percent of Covid deaths had comobidities, but that does not mean 90 percent will die within 1 year. Then you agree with my original position!

    If by:

    I agree that the complicating factors of system overloading and long-term lung damage make the figures difficult to say with certainty,Isaac

    You mean that regardless of overlap, long term lung damage may simply replenished those "at risk of dying within 1 year" then you agree with my original position!

    Maybe you aren't here to debate, which sometimes means recognizing a change in position and simply saying so. Maybe you just want to have pat you on the back all day. That can be done in private, why bother us about it?
  • Metaphysician Undercover
    13.2k
    2. I'm extremely concerned about the effect the media has been able to exert on the general psyche. Culture has always been able to generate collective affect, but it's becoming worryingly uniform the more social media grows (I won't derail the thread by going into it here, but imagine starlings murmuring - one or two and it's just a mess going every which way, thousands and it suddenly looks like a choreographed dance, but all it is is just thousands of birds all trying to respond to each other and making tiny errors in copying which then get magnified)Isaac

    This is not at all an accurate representation of herd mentality.

    What we know is that the vast majority of fatalities (over 90%) had other comorbidities which were "mostly likely to be the underlying cause of death for a person of that age and sex had they not died from COVID-19". so this is referring to cause of death at the time of death.Isaac

    I see this statement as blatant deception. The vast majority of covid-19 related deaths are pneumonia related, pneumonia caused by the virus. the cause of death is the virus.

    This seems to be the premise that you are trying to support, that something other than the virus causes these deaths, but it's not the case. And it's completely false to argue that the people would have died at that time anyway, because they already have an "underlying cause of death". Clearly they were still alive and could not have had a cause of death already. From your logic we might as well say that every living person has an underlying cause of death because we're all going to die. Life is an underlying cause of death. It's simply a nonsensical argument which you've been putting forth.

    Hardly any ancient farmers died of cancer. It's not because they were super-healthy, it's mostly because they died of something else first.Isaac

    Look at this analogy. It's pure nonsense. Ancient farmers ate produce directly from the farm, not highly processed food (a significant factor in some cancers) that today's city dwellers eat. Your entire argument, that people haven't died from A,B,C,D, or a bunch of other different conditions, because they died of X first, but we still ought to talk about all these conditions as is they are causes of death for these people, or even potential causes of death for these people, is complete nonsense. They have an actual cause of death, which is X.
  • Isaac
    10.3k
    That 90 percent of Covid deaths had comobidities, but that does not mean 90 percent will die within 1 year. Then you agree with my original position!boethius

    No. A comorbidity sufficient to be be mentioned on a death certificate is extremely likely to to cause death within the year. Doctors do not fill in death certificates with a list of "other stuff they also had", these are very serious conditions which are "mostly likely to be the underlying cause of death for a person of that age and sex had they not died from Covid-19". That is why Professor Ferguson described victims as being mostly "at the end of their lives"

    So I am not saying that it doesn't mean these people will most likely die within a year. It absolutely does mean that. Having a comorbidity listed on the death certificate as a cause of death is very serious and anyone in that condition is very likely to die within the year. That is why, again, both the experts who have spoken on this matter have reached the same conclusion, and why you've not managed to produce a single expert saying anything to the contrary.

    300,000 people die each year (from disease). These deaths are drawn, in the overwhelming majority, from the exact group of people who would have the comorbidities listed in the ONS figures as having a 90% overlap with Covid-19 fatality. I've supported that assertion for heart disease and cancer by providing studies of risk factors and prognosis.

    For your claim to be true, there would have to be little overlap with this group.

    We already know there is a massive overlap with Covid-19 fatality and these comorbidities (over 90%). We already know that there is a massive overlap in prognostic factors (I've cited the studies for you). So you'd have to present an argument which shows how, despite an overlap in prognostic factors, the 300,000 deaths this year are not largely drawn from the group of people ill enough with these comorbidities to have them recorded as a potential cause of death. This is, on the face of it, a ridiculous assertion for which you've yet to provide a shred of evidence.

    You mean that regardless of overlap, long term lung damage may simply replenished those "at risk of dying within 1 year" then you agree with my original position!boethius

    No. "Complicate the figures" is not anywhere near "replenish the entire cohort". Again, there is no evidence that lung damage will cause future deaths in these numbers. This is just your speculation and needs evidence to support it.
  • frank
    15.8k
    The reason you aren't seeing higher mortality among younger people with no underlying health issues is the availability of oxygen, the ability to resuscitate with saline, antibiotics, pressor drugs, and so on. So death is just one aspect of this pandemic, and in developing countries where the poor receive none of the help I just mentioned, death will be a more significant aspect than it is in core nations.

    I know you aren't disagreeing with that, I'm just saying that I think the cause of death listed on official documents probably isn't a big deal?
  • Baden
    16.3k
    I'm not going to allow @Merkwurdichliebe to troll here anymore and am deleting his posts. Replying to him is therefore probably a waste of time. Unless he comes up with a sincere contribution, which is unlikely.
  • boethius
    2.3k
    300,000 people die each year (from disease). These deaths are drawn, in the overwhelming majority, from the exact group of people who would have the comorbidities listed in the ONS figures as having a 90% overlap with Covid-19 fatality. I've supported that assertion for heart disease and cancer by providing studies of risk factors and prognosis.Isaac

    This is the error in your analysis I've pointed out like 5 times already.

    We're talking about deaths within 1 year, so talking about overlap with comorbidity in larger groups than "likely to die within 1 year" supports my position.

    The "heart disease" risk group is larger than "people going to die of heart disease within one year from heart disease".

    For your claim to be true, there would have to be little overlap with this group.Isaac

    No, my claim is completely compatible with these facts.

    Lot's of deaths (most deaths) each year are not predictable at the individual level.

    At the start of the year, we cannot predict with any degree of certainly in the sense of individual identification who will be dead by the end of the year.

    Most deaths within 1 year do not come from groups with 90% chance of death this year. There are such groups, but they are small and so even 90% of such people dying within the year is not a big number.

    Lot's of effort has gone into this, as doctors and life insurers would like to know, but they don't know. What we know is that everyone has a chance of dying, that chance varies and can be statistically investigated, our understanding always improved, but the pure element of chance (relative our knowledge at the start of year as well as just the nature of reality) is also at work.

    If statisticians put someone in a group of 1% risk of death due to heart disease this year, they are not saying that they were just too lazy to analyse further and see which of these people with heart disease have actually quite strong hearts (and so many 0.1% of dying) and which have "the weakest heart" (and so 90% of dying); they are saying "of 100 people in this group we expect 1 to be dead by the end of the year, but we don't know which one". Further analysis can make some progress, but does not fundamentally change the fact that most deaths are from groups with small chance of death within the year, but they are large groups and so result in lot's of deaths.

    Statisticians of these sorts of things are constantly doing analysis to see if there are other predictors, and sometimes new predictors are found and new risk-groups created, but things are no where close to predicting "who's going to die within 1 year".

    That's why your argument depends (depended) on some hidden variable we do not know, such as assuming the people who would die from heart disease this year have "the weakest heart" and the people with heart disease who die from Covid too have "the weakest heart". This is not what statisticians believe. Certainly, such a hidden variable is there that might be uncovered by better medical tools or perhaps is fundamentally hidden for ever, but there is also a large amount of random chance that goes into who dies or doesn't within a year of heart disease.

    No. "Complicate the figures" is not anywhere near "replenish the entire cohort". Again, there is no evidence that lung damage will cause future deaths in these numbers. This is just your speculation and needs evidence to support it.Isaac

    You have not bothered to understand my argument.

    It's you that has been claiming that the overlap is big, so big that Covid maybe just a problem of reallocating resources and does not require new net-resources.

    I have been arguing that the overlap is small with "people who would die this year anyways"; small in the sense that Covid is not just a resource allocation problem even if you could reallocate without friction from other health resources that having nothing to do with respiratory disease (which you can't), and even if you could reallocate from the future to the present (which you can't, even with loans).

    I have also mentioned, that even if you are right about overlap, the risk group might be replenished due to long term lung injury.

    No where have I said it's guaranteed or I know it to be true. It is, however, a risk, a big risk, and therefore no reason to change policy even if your overlap hypothesis was true (which it isn't).

    Furthermore, the effect of replenishing the risk group can be very small but still result in replenishing the risk group (a small thing that affects a large amount of people). If a risk group is 1% risk of death of heart disease and 1% risk of death of Covid (if infected with Covid), and they all get Covid and 1 person dies of Covid, then there's a decrease in expected deaths in absolute terms within the year based only this, due to that 1 person no longer in the group, so now there's 1% risk of death for 99 people, so 0.9 expected deaths from this group within the year.

    Long term lung injury only has to increase the risk of death in this group by ~0.1% to replenish the risk group back to resulting in 1 expected death within the year; so 2 deaths within the year (1 from Covid and one from the other risk, such as heart disease) instead of 1.9 deaths due to the slight culling effect Covid had on this group.

    This is why overlap has to be with small groups that have super high chance of death to not only see a culling effect but also for the long-term injury effect to also need to be very large. 0.1% increase of death in a group that has 90% chance of death within the year changes little in absolute terms.

    If everyone, or most people, gets Covid, and most deaths arise within large risk-groups, then a very slight increase in chances of death due to surviving Covid can easily replenish all the risk groups to result in the same amount of deaths in absolute terms within the year.

    You've been basically wrong at every level of your argument, and now that you're beginning to realize this, you are trying re-interpret things to arrive at my position.

    Welcome to my position.
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