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by acqq 2274 days ago
> or where severity mix and/or mortality are strongly out of line with expectations.

Yes, that was the only conclusion I was able to make based on Germany's data being so different in the proportion of known cases against reported deaths. Some arguments from there like to explain their results as "superior" hospitals and the "lack of hygiene" as the cause of the results of Italy, Spain, France etc. and I just don't buy it.

It seems to me rather a result of a combination of more factors: my explanation at the moment is that they already had more old people in hospitals, and that they had for a lot of such people already "diagnosed" what brought them there, not changing it now when they die. As we see from the user nathell reporting from Poland, they are not the only land with such an idea.

It earns them short term prestige for "superior" health system, but it obscures what's going on. If they manage to keep doing this with the newly admitted cases remains at the moment unknown.

The real story behind all the graphs, anyway, is not in the numbers which we can see from the statistics of "reported cases" or "deaths", but those that are only to read between the lines, and which are the actual causes for all the measures introduced by all the countries, and that is for the countries at the start:

- how far are they from the health system being overflown

and for the countries where it progressed:

- how many people are without necessary medical care due to the health system not being able to handle, and how many people die due to that.

Both of those are something that the countries would rather not directly report. So that's why, from some point on, the only conclusion we will be able to reliably have would be possible if we'd be able to have the actual death statistics (including the cases not claimed to be Covid-19 cases) and compare these statistics with the statistics in the "normal times." All surges are then surely indirectly (due to the disruption of all the country's systems) and directly caused by Covid-19, even if they aren't reported as such.

Back to the data we have now, I also find the ft.com graphics the best on the web at the moment.

https://www.ft.com/coronavirus-latest

The log-log graph from this title is only useful post-factum and I don't agree with its current advantages claimed in the video at the moment. It is obscuring the current severe issues in most of the countries:

Contrary to the claims of the video, at the moment, most of the countries indeed should look at the charts of log of whatever on the y axis against the linear time on the x axis. With the doubling time of around 3 days, that means that whichever capacities you manage to provide, like hospital beds, or more health workers, whenever you double them, that "advantage" disappears in just three more days.

Linear time on x axis is the only sensible choice. The charts should allow us having some idea what the future brings.

2 comments

> Some arguments from there like to explain their results as "superior" hospitals and the "lack of hygiene" as the cause of the results of Italy, Spain, France etc. and I just don't buy it.

That sounds pretty wrong, and it's not what I've been hearing here in Germany. The "official" story is that testing ramped up earlier relative to when the outbreak started, and that through luck so far the virus hasn't infected many retirement homes and old people in general. [0]

If you break down cases / deaths in Germany by state and by district, you find that the districts that had big outbreaks the earliest also have the highest death rate now.

Heinsberg, the original hotspot, is now at something around 2.5% [1]. So I think it really is consistent with the story that testing started relatively earlier so fewer cases were missed, at least initially (there are reports now that non-symptomatic contact persons of confirmed cases are not getting tested anymore due to test shortages). This would imply that the death rate would converge to the world-wide average over time, which seems to be happening.

[0] https://www.deutschlandfunk.de/covid-19-warum-die-todesrate-...

[1] https://interaktiv.tagesspiegel.de/lab/karte-sars-cov-2-in-d...

> That sounds pretty wrong, and it's not what I've been hearing here in Germany.

Depends on who passes you the news. My quotes are from what "Dr. Stefan Hockertz" an "immunologist" directly claimed, and there are some other German-speaking claimed experts that wrote or made similar statements, including "it's not worse than flu" even as there were so many dead in Italy and Spain -- then their argument for why it's not happening in Germany is the said "superiority" and the reason for happening in Italy their "lack of hygiene". Some of these were than repeated in some articles written in French, which I've happened to read. French were actually interested to find what is Germany doing "better." What can be seen is however, German "doctors" criticizing Italians for "reporting those who died with coronavirus as dying from coronavirus" totally ignoring the scale and speed at which that happened in Italy, Spain and France.

The said distinction was apparently often used in Germany (or not? maybe you can investigate more? I'd be very interested in what you find!) but I do believe it's misleading, I think the sudden order of magnitude surges can have only a single cause, or some equivalent. If they claim it's not this coronavirus, and the surge factually exists, then there must be some additional new illness that otherwise wasn't recognized.

I think there are some people everywhere who like to find confirmation for their nationalist prejudice in this crisis. It's wrong, but it's also just way too early to draw any conclusions. You shouldn't be proud of your achievment when you don't know what's yet to come.

For what it's worth, I just searched for "why is the mortality rate lower in germany" in french on Google [0] and I've briefly looked at most of the hits on the first page, many of them cite German experts noting exactly the points that I mentioned.

[0] https://www.google.com/search?q=pourquoi+le+taux+de+mortalit...

Edit: Hockertz specifically seems to be something of a Coronavirus "denialist" [1], I don't think he's expressing a view that many share.

[1] https://www.br.de/nachrichten/wissen/faktenfuchs-aussagen-de...

> I don't think he's expressing a view that many share.

"Many" is hard to estimate, but my impression is that there was, at least at some points of time, obvious political motivation to downplay the seriousness of the epidemics. Apparently, at the moment when even the Netherlands, also being even more "pro market" and having publicly stated "herd immunity" goal (by their prime minister), already closed the restaurants, there were still open places across the border in Germany, and at least some parts of Germany were still reluctant to admit the seriousness of the issue. By the way, I still can't find some useful timeline of the measures introduced in Germany in the

https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_G...

I am aware that many decisions are up to the regional institutions there, and that's why generalizing and equalizing any statement to whole Germany is by definition wrong. But we can recognize, at least, different "interests" influencing what is happening and how it is covered in the media.

In that sense, as the impact of the epidemics to Germany potentially increases, I expect the climate to be always more similar to the one in the countries which are already more seriously affected.

However blaming first southern people for being "inferior" to Germans and having "less hygiene" fails to the fertile ground there, one other relatively recent reaction was "the Spanish cucumbers are guilty" affair where the cucumbers from Spain were destroyed but eventually the cause turned out to completely originate in Germany:

https://en.wikipedia.org/wiki/2011_Germany_E._coli_O104:H4_o...

"Spain consequently expressed anger about having its produce linked with the deadly E. coli outbreak, which cost Spanish exporters US$200 million per week"

Eventually it was established that the origin was "an organic farm[1] in Bienenbüttel, Lower Saxony, Germany."

> However blaming first southern people for being "inferior" to Germans and having "less hygiene" fails to the fertile ground there

I understand that you find that offensive, I do as well. But please don't generalize from statements made by fringe conspiracy theorists. That's almost as divisive as the original statement.

> please don't generalize

I don't, I specifically point exactly against the generalization:

> I am aware that many decisions are up to the regional institutions there, and that's why generalizing and equalizing any statement to whole Germany is by definition wrong.

and additionally give an example of one older affair where exactly the same prejudices that I mentioned resulted in measurable consequences.

> "Spain consequently expressed anger about having its produce linked with the deadly E. coli outbreak, which cost Spanish exporters US$200 million per week"

Is there anything that you dispute in what I've written?

If you want me to additionally support my claim that there was downplaying of the seriousness of the coronavirus epidemics, I have also:

"Of course, people will still die, but I lean out of the window and say: It could well be that in 2020 we won't have more deaths than in any other year."

https://www.faz.net/aktuell/gesellschaft/gesundheit/coronavi...

"Virologe Hendrik Streeck : „Wir haben neue Symptome entdeckt“ 16.03.2020"

A virologist, less than 2 weeks ago. Two doctors openly downplaying is already a symptom to me. I can imagine that slipping to the educated politicians, but the doctors...

Regarding which deaths are reported Covid-19 in Germany, my initial observation, please see other comments in this whole topics, e.g:

https://news.ycombinator.com/item?id=22720011

or

https://news.ycombinator.com/item?id=22719448

linking to the Guardian explaining:

"Unlike in Italy, there is currently no widespread postmortem testing for the novel coronavirus in Germany. The RKI says those who were not tested for Covid-19 in their lifetime but are suspected to have been infected with the virus “can” be tested after death, but in Germany’s decentralised health system this is not yet a routine practice."

As I also already mentioned, Germany is big with a lot of local policies which aren't unified across the federation, so let me stress it again, all that should be taken with grain of salt.

EDIT: it also appears to me that even the "debunking" of that first doctor guy didn't even try to address that he's misusing prejudices against "the southern people" etc. I haven't tied to analyze the "debunking" too carefully (not enough time) but my general impression is "oh, it's too early to tell if he is right."

Germany tested more and tested earlier. This allowed Germany to look into the future, nothing more.

If you look at the increase in deaths it’s pretty obvious that Germany is now catching up fast.

Testing alone obviously doesn’t do anything against the epidemic so it still remains to be seen whether everything that happened besides testing helped and whether the time won through being able to look into the future was used well.