[guscost]

Dying at home, many of them. Excess mortality is way up, and it’s not all COVID-19:

https://www.washingtonpost.com/health/patients-with-heart-at...

> The possibility that patients may be suffering — and even dying — at home rather than going to a hospital led the American College of Cardiology to launch a “Cardiosmart” campaign last week, attempting to reassure a wary population and encourage those with symptoms to call 911 for urgent care and to continue routine appointments, through telemedicine when practical: “Hospitals have safety measures to protect you from infection,” it reads.

> “The emphasis here is safety,” said Harlan Krumholz, a cardiologist and health care researcher at Yale University and Yale New Haven Hospital, who advised on the campaign. “We want to make sure preventable deaths aren’t happening.”

> There is no pill, no action, no behavior, he said, that could account for the almost 40 percent drop in STEMI patients. “We don’t have a means to cut your risk in half,” he said. “Not even primary angioplasty or stopping smoking.”

[mrfusion]

Should the media have some of the blame for these deaths by scaring people? Cherry picking young corona deaths, up playing tenuous studies saying corona causes diabetes and strokes, replaying stock footage of overloaded hospitals.

If they gave people accurate statistics they could make an informed decision whether they want to go to a hospital.

[yongjik]

Wow, you just jumped from an unexplained drop of ER vists straight to blaming the media for scaring people.

More than 70k have died in the US so far - are we also going to blame the media for not scaring people early enough, or is that too inconvenient?

[closeparen]

People are failing to seek treatment for the acute life-threatening emergencies they are almost certainly still having. It’s good that they’ve been convinced of the seriousness of COVID-19, but not that they view the threat of potential infection in the hospital as more serious than an actually-occurring heart attack or stroke.

[newacct583]

This is objectively wrong, just by numbers. Covid deaths alone, in areas where this has been studied, are routinely outnumbering deaths due to all other causes. Even granting the premise, there aren't enough heart attacks and strokes to make these deaths "not worth it".

[guscost]

Yes.

[mirimir]

Right, they're likely dying at home, and being counted as COVID-19 deaths. That's the safest guess, in the absence of epidemiologic data.

Even so, medical systems and coroners ought to be archiving samples for testing. Eventually there'll be adequate RNA and antibody testing capabilities. Without that data, we won't know what happened.

[zenexer]

They’re not being counted as COVID-19 deaths; they’re not being counted at all. A lot of people are living in isolation right now, often with no regular contact with the outside world. The sad truth is that there are probably a lot of people lying dead in their homes right now, and they could go unnoticed for months.

[mirimir]

Woah, I didn't think of that. I know that it happens, for those without close friends and family. But for many, the first clue has been failure to report for work. Which doesn't happen so much now. And it's eerie to think that it's become far more common.

[zenexer]

Indeed. People aren’t working, aren’t seeing friends/family, and don’t have regular appointments. For many of us, if we died tomorrow, it’d take a while before anyone noticed. I have no idea how many of my friends are still alive; I assume most are fine because they're young, but I’ve lost contact with most of the people I normally see on a daily or weekly basis.

When we come out of this, who will be left behind? And how many of those lives could’ve been saved if we weren’t in quarantine? That’s not to say the quarantine isn’t necessary, but it’s an important question to ask, as its a significant cost that isn’t obvious.

[wiether]

> I have no idea how many of my friends are still alive

Where do you live ? They don't have phone or Internet ?

I exchange daily with every people I call friend; I exchange daily with my close family; I exchange weekly with the rest of my family and people I don't consider friends but still care about.

I'm not a health worker nor someone working in something that matters and I have the luck to still be able to work from home so I've seen as my duty to make sure everyone I care about doesn't feel abandoned and is okay.

I'm not judging or anything but it seems odd to me to call someone a friend and still don't make anything possible to be sure they're safe in those dark times.

[zenexer]

I keep in touch with many of my friends online, but not all of them. There are plenty of friends I typically only see in person.

[belltaco]

Happened in Ecuador.

[BLKNSLVR]

My assumption is that cause of death wouldn't be blindly written off as COVID-19 though.

How thoroughly do deaths of the elderly and infirm get looked into as per the cause?

[Guest42]

Perhaps unemployment being up leads to people not wanting ER bills even more than usual.

[Fjolsvith]

Exactly. Unemployment doesn't have the employer benefit of health insurance.

[seibelj]

Could relaxing still home and cooking your own meals reduce activity-causing heart attacks? It’s a trope in the North-East that middle aged men die shoveling snow.

[WalterSear]

Most people don't have easy remote-ok-browse-hacker-news-at-4pm jobs.

They are at home, watching their debt grow and wondering how they will be able to find a new job to pay their bills.

[hombre_fatal]

Yeah, amazes me how many people think everyone is just relaxing at home playing Animal Crossing with paid time off wondering why we can't stay in quarantine indefinitely.

[WalterSear]

This country absolutely has the resources necessary to shelter in place as long as is required. However, it lacks the political will to do so.

[_y5hn]

No country avoids lockdown. It happens controlled or uncontrolled. When control is back, everyone open up again. Nobody wants these adverse side-effects, and that they may be worse than the virus is nothing new. Our plight as society is find ways to cope with it and prepare better.

[munk-a]

Possibly in the short term - in the long term the quarantine is likely going to increase heart disease due to people having more sedentary life styles... It's quite likely this is just a result of the math of going to a hospital shifting - a lot of folks decide not to go to the hospital with minor chest pain due to other obligations[1] and the addition of the outbreak likely adds to the reasons not to go to the hospital.

1. Don't do this, go to the hospital if you feel something different in your chest.

[benburleson]

This is anecdotal, but I've never seen more people out walking around town than the last couple months.

Is there research showing people are more sedentary now?

[indecisive_user]

Crime is down, while domestic violence is up. That's evidence people are staying inside more.

https://www.bbc.com/news/world-us-canada-52416330

As a counter anecdote, I know many people that only leave their house a few times per week, including for walks. They are definitely more sedentary now.

[guscost]

And you'd think deaths from auto accidents would be way down, but apparently not in Boston: https://boston.cbslocal.com/2020/05/04/coronavirus-covid-19-...

[wafn]

Anecdotally, around my town the lower number of drivers on the road seems to be causing those who remain to feel like traffic laws don't matter. I can't even count how many times I have seen blatant "it's red but there's no traffic so I'll just go" behaviors, along with ridiculous speeding and lane changing. Doesn't help that the police essentially announced that they won't be looking for crime anymore.

[harambaebae69]

I live in Boston and drive every day still. This is anecdotal - but I've seen the same amount of bad driving as ever (largely around merging, roundabouts, and turn signal usage) but now it's at a significantly higher speed because on I-95 and I-93 you can easily hit 85 mph instead of the customary 45 mph the whole way during rush hour.

I don't have any data, but I imagine that explains the similar serious accident rate.

[cat199]

> That's evidence people are staying inside more.

no, that's a big extrapolation..

one possible counterpoint: couples in healthy relationships could still be going out more, whereas those in dysfunctional ones might be fighting more due to more proximity or exascerbated economic hardship

[diego]

How many of those people would normally be walking in malls, stadiums or even gyms?

[jerzyt]

It would be nice for Fitbit to publish some research. They have the data.

[ravenstine]

That and I would suspect that people are eating more "junk", or carbs mixed with sugar and fat. I know I depression-ate out of my prepper stash for the first few weeks.

[yissp]

On the other hand, I think many folks are under a lot more stress in the current economic situation. That might have negative public health implications.

[onetimemanytime]

For the first few days maybe, but eventually you'll be throwing the frying pan at your others. Add lack of exercise, fresh air and there you have it. People also go nuts

[calibas]

Where's the source of "excess mortality is way up"? I didn't see it in the article, though it does suggest there may be fewer heart attacks and strokes because of "a decrease in air pollution and fewer high-fat restaurant meals".

[guscost]

https://www.nytimes.com/interactive/2020/04/21/world/coronav...

http://euromomo.eu

There's nothing for the USA as a whole, it will be compiled from states' records and estimates eventually. But it already seems obvious to me that the excess deaths in the next few years from secondary effects (avoiding hospitals, drug overdoses, suicides, stress/panic attacks, less traffic/police on roads, etc) will far outnumber the deaths where COVID-19 took away more than one year of life. I'm probably still in the minority with that belief.

[jaggederest]

I don't envy those who have to make these decisions. I think the public health impact from prolonged isolation could actually outweigh the direct effects of the virus. Just mental health alone is going to be rocked to the foundations.

[Fjolsvith]

And, people are going to be very angry when they learn that you can get the coronavirus when locked up at home. [1] They will wonder why they had to lose their job from the quarantine.

1. https://www.forbes.com/sites/lisettevoytko/2020/05/06/majori...

[henrikschroder]

The CDC has all-cause excess mortality tracking and graphs here: https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm

As far as I can tell the numbers are statistically computed estimates, based on real reported deaths, so it's not actual counted deaths, and there's still reporting lag skewing the last couple of weeks.

[guscost]

Thanks, yes it looks like recent weeks are weighted for under-reporting (how to figure out the weighting with so much chaos is another question), and they're estimating that a little over 60% of excess deaths in the past few weeks were caused by COVID-19.

[mrfusion]

They get counted as corona virus deaths as I have heard if.

[downerending]

Plus in other countries, they expect a massive uptick in polio, tuberculosis, etc., due to lack of vaccination and treatment.

Some of this is inevitable. Some of this is due to economic lockdown, which will simply crush third-world economies.

[pfdietz]

That makes little sense. If people are isolating for COVID, it's going to knock down transmission of the other infectious diseases too.

[downerending]

It's because they're not getting vaccinated, which makes a big difference.

Believe I also read that there's a vaccination window for TB--it doesn't work for adults. So each year of lowered vaccination coverage matters that much more. Globally a million people die of TB each year.