It would probably help to state the unexplained difference as a percentage of official C19 death count (and narrow the columns). I took the liberty:

             |   %   | excess  | official| unexplained
    Location | extra | death#  | C19 d#  | difference%
    --------------------------------------------------
    Spain    |  66%  | 19,700  | 12,401  |   59
    England  |  33%  | 16,700  | 10,335  |   61
    NYC      | 298%  | 17,200  | 13,240  |   30
    France   |  21%  | 10,500  |  8,059  |   31
    Holland  |  33%  |  4,000  |  2,116  |   90
    Istambul |  29%  |  2,100  |  1,006  |   109
    Jakarta  |  36%  |  1,000  |     84  |   1071
    Belgium  |  25%  |  2,300  |  1,632  |   43
    Switzer. |  21%  |  1,000  |    712  |   42
    Sweden   |  12%  |  1,100  |  1,160  |   -4

The spanish case is interesting. Must be noticed that the virus hit particularly hard in the retirement homes that contribute to 12.000 of the 20.000 deaths. Some elder in retirement homes weren't hospitalised. Some people say that their parents were "rejected" by hospitals (non belonging to a prioritary group). We breath a dense fake news atmosphere in any case, so this part can be wrong. Not all people that died in retirement homes this weeks died by coronavirus necessarily.

Retirement homes can not and are not designed to provide real medical care. This part has failed clearly. Some of this people could have been saved in normal circumstances. Specially if the retirement homes were more transparent about numbers and the people would had a clear protocol to follow.

Another special circumstance of Spain is that we are one of the countries with more life expectancy. We have lots of elder people, therefore much more people by million falling in a high-risk category. I don't see anybody explaining that in the news, but surely must have some statistical effect. Maybe we should start adding to the charts a category of people killed by million of people over 65yo.

This mean also than some countries in Africa (or Brazil) could go through this problem "relatively unscathed", just because they have lots of children and young adults. Same with poor US states that could behave different than rich states in this sense. Only time will tell us.

This table is missing Norway, Denmark, and Finland which would be the most interesting to compare Sweden to.

Sweden: 1,937 deaths. 50 fewer seasonal deaths than expected.

Norway: 187 deaths. No increase in seasonal deaths.

Denmark: 384 deaths. Seasonal deaths unknown to me.

Finand: 149 deaths. Seasonal deaths unknown to me.

Sweden has approximately twice the population of the other Nordic countries, so per capita they have between ~2.5x and ~6x the Covid19 mortality of their neighbors, who have stricter preventive measures.

Honestly, I can't see how Anders Tegnell and his colleagues can sleep at night with the uncertainties they are powering through. By rights they should be terrified that they've gotten one of their assumptions wrong.

Denmark has ~2.5x the per-capita covid-19 mortality of Finland, should Danish authorities be terrified that they've gotten their assumptions wrong?

The UK has ~2x the per-capita covid-19 mortality of Sweden, should English authorities be terrified that they've gotten their assumptions wrong?

You are cherry-picking like crazy!

There is clearly no evidence that stricter measures have any effect. If that was true, then there should at least be a linear correlation between strictness of measures vs. excess deaths, and that's simply not the case. You're extrapolating a linear correlation using a couple of data-points that happen to support your theory, i.e. Sweden vs other Nordic countries. Sweden vs. all of Europe paints a completely different picture, so you're not looking at that, because you're cherry-picking.

There are so many uncertainties around this whole situation, and I think the only thing we can say with certainty is that if a country has no or a low rate of excess deaths, that country is doing "ok". Not doing great, not doing shit, just doing ok.

> There is clearly no evidence that stricter measures have any effect

Working for us in NZ, although I think the timing of our national lockdown is strongly significant to our success, we managed to do so before it was widespread in the community.

Our new case rate is literally bottom of the FT Covid graph: https://www.ft.com/coronavirus-latest

And we have 50% the population of Sweden, and 0.72% the deaths. If we were to be per-capita equivalent with Sweden, we'd need about another 964 people to die.

Look, I agree with you that stricter measures probably have an effect. All countries have some forms of restrictions, all countries have flattened their curves, no-one is really seeing crazy exponential growth, common sense dictates that it's working.

But a lot of people in this thread are arguing that Sweden should have enforced stricter measures because that should have decreased the deaths further. And that position is unsupported, because there are comparable countries with stricter measures than Sweden that have a higher per-capita death count, for example the UK or Belgium. Looking at excess mortality the picture is similar. Sweden is absolutely not doing great, but it's not doing bad either.

If stricter measures always resulted in less deaths, as you argue, why are so many countries doing worse than Sweden? Why are more people dying in those countries? Is their population stupider? Unluckier? More defiant towards government? Clearly there are multiple other unknown factors at work here, which is why there's no evidence that stricter measures in Sweden would have an effect.

I perhaps didn't emphasise this enough in my original post, but I believe it answers your questions.

> I think the timing of our national lock down is strongly significant to our success, we managed to do so before it was widespread in the community.

> Why are more people dying in those countries?

Timing is a very significant factor, I believe - I couch that as a belief, because I haven't had the time to compare all lockdowns, but you'll note that on this FT graph[1], NZ's lockdown began near immediately by the metric being used, whereas the UK's took a full two weeks.

We know that the UK government dithered, initially focused on herd immunity (and worth noting that Johnson and his advisor Dominic Cummings who was hugely influential in pushing for it both went on to contract the illness), hired social media bots(?!)[2] to spin the party line, and only after all that, then went into lockdown. A veritable case of closing the barn door after the infectious horse has bolted.

Of course there's a bunch of other factors in death rates - the comparative proportion of your population which is especially vulnerable, medical care capacity, but it seems obvious to me that the largest factor will always be the number of infections in the first instance.

[1]: https://www.ft.com/__origami/service/image/v2/images/raw/htt...

[2]: https://www.thecanary.co/trending/2020/04/21/fake-nurses-pro...

> Timing is a very significant factor, I believe - I couch that as a belief, because I haven't had the time to compare all lockdowns

Fair enough, and I agree. It's clear that countries who clamped down super early have fared much better than everyone else.

But going by that FT graph, Spain went into lockdown a week before the UK, and still did worse? Germany later than the UK, and is doing better? There's a crazy amount of uncertainty about what good lockdowns are once you've passed a certain point of community spread.

Sweden obviously missed the point in time where lockdowns would have worked very well, while NZ, Australia, Norway didn't.

The UK obviously missed it as well, but while they were debating herd immunity, it might have been too late anyway? We might never know.

And with all that uncertainty, I think it's wrong for people to argue that Sweden "obviously" would have saved lives by going into a hard lockdown earlier. Maybe, probably, perhaps. Would a stricter lockdown now do anything in Sweden? Unlikely.

> Spain went into lockdown a week before the UK, and still did worse? Germany later than the UK, and is doing better?

Not relative to number of cases: Germany locked down later than UK, but a week earlier on the exponential growth curve.

I'll post this link again, because it's the best articulation of this point that I've found: https://medium.com/@tomaspueyo/coronavirus-act-today-or-peop...

Timing, with respect to where a country/region is on the exponential growth curve, is critical. In almost every place you see the same outcome, it's crazy.

Counterpoint: Santa Clara county locked down 3 days earlier than Los Angeles, but a week later on the epidemic curve. LA right now has had nearly twice the death rate per capita, and unlike Santa Clara which is almost at the end of the curve, may not even have peaked.

Lockdowns aren't everything..

Santa Clara’s official lockdown, and the tech world’s “work from home” mandates were separated by about a week, which could account for some of this.

Santa Clara has less population density and air pollution.

> Not relative to number of cases: Germany locked down later than UK, but a week earlier on the exponential growth curve.

Not according to the Financial Times graph in the post I was commenting on. Germany went into lockdown at 3000 cases per day, while the UK went into lockdown at 700 cases per day, and Spain at 600 cases per day, according to that.

Is the FT graph wrong? Do you have a better data source that proves your point?

You're missing an implicit assumption - that each country's testing regimes and levels and criteria were comparable - for an example from the top of my head, some countries only test if you show symptoms.

So if you'll allow me to rephrase:

> Germany went into lockdown at 3000 known cases per day, while the UK went into lockdown at 700 known cases per day, and Spain at 600 known cases per day.

As you said earlier, so many damn factors in this.

To add more data, Germany locked down on Mar 17 at 24 known deaths. The UK locked down on Mar 23 at 336 known deaths. Germany reached 342 known deaths on Mar 27. That's 10 days of lead time on the deaths metric.

Germany's new deaths per day (smoothed) stopped increasing at 215 per day on Apr 9 (2.5 weeks later). The UK's death rate stopped increasing at 850 on Apr 15 (2.5 weeks later).

https://91-divoc.com/pages/covid-visualization/?chart=countr...

Deaths tend to be more accurate than just confirmed cases.

One way to account for testing rates is to look at the test positive rate, and use that as a proxy. If the test positive rate is 50% (as it was in Spain at some point), you can be pretty sure you’re missing a lot of cases.

So if Spain has “600 cases” but only did 1200 tests, they probably have way more real cases than Germany’s “3000 cases” out of 30,000 tests.

FWIW, Germany had 9 deaths on March 17, while UK had 10 deaths on March 14. By that metric, the UK led Germany by 3 days. There’s more to it than just the one national lockdown date — in particular, Germany is federal and I think different states went into lockdown at different times, as in the US.

But meanwhile, South Korea and Taiwan have avoided lockdowns entirely, so it’s clearly not only about lockdown timing — availability of testing, as in Germany, helps a lot with keeping the sick isolated.

> and worth noting that Johnson and his advisor Dominic Cummings who was hugely influential in pushing for it both went on to contract the illness

Not really worth noting. It's an interesting anecdote, and I'm sure those who take the pro-lockdown position revel in the schadenfreude… but it has no relevance to the debate.

I does when Boris was going around boasting that he was "shaking hands with everyone" (in regards to a hospital visit). Then ends up in intensive care himself using up stretched resources.

I will give leaders who's job it is to meet lots of people to run a country a break, IF they take a reasonable position. Boris flaunting the risks to build up his public persona and then getting egg on his face is absolutely relevant. If you care in any way how a country is run.

Dominic is not so much in the public eye, but I bet he had a lot to do with Boris's early bravado.

It shows how widely it spread in the UK before they went into lockdown, which underlies my point that the efficacy of a lockdown is strongly tied to the timing thereof.

> for example the UK or Belgium

It depends when each country locked down relative to the number of cases and deaths at the time.

The UK is widely acknowledged (here anyway) to have acted too late in its lockdown as the were trying to pursue herd immunity.

Every country was widely acknowledged to be too late in its lockdown. In the ones that have seen disasters the accusation stuck, while in the ones that haven't it's been quietly forgotten.

> If stricter measures always resulted in less deaths, as you argue, why are so many countries doing worse than Sweden?

The UK acted too late. Compare Sweden to Australia. Australia has 2.5 times the population of Sweden (25.6 million versus 10.3 million). Sweden has had 1,937 COVID-19 deaths and Australia has had 74. Sweden's deaths per million population is 192 and Australia's deaths per million population is 3. Sweden's rate of testing is 9,357 tests per million population and Australia's is 17,743:

https://www.worldometers.info/coronavirus/

https://coronavirus.jhu.edu/map.html

Australia's had fewer cases, fewer deaths, and is doing more testing than Sweden.

> we have 50% the population of Sweden, and 0.72% the deaths

After google, the percentage of elder in Swedden is like 20% and in New Zealand like 12%. If you have half of population, you would have half of elder with the same percentage, but is minor. You should have like 6 elder people by each 20 elder in Swedden.

Even if the covid would perform exactly the same in all countries and the measures taken would be exactly the same, the deathcount by million of people would be different.

Okay, so, to tweak it based on that, our most vulnerable populaton is 30% the size of Sweden's most vulnerable population, and we have 0.72% the deaths.

Other difference can be that you have passed the problem in summer-fall so far, whereas europe passed it in winter-spring. This means, for example, that water droplets in the air will dry much faster in your case

You are about to enter in flu season and the next months can be complicated, so take care for yourself and your family. This is not over.

Sweden unfortunately got a rather large injection of cases from tourists visiting northern italy in just the wrong week. NZ doesn't have the same close traffic with any early covid hotspot.

I'm not sure where you got that impression about the NZ cases.

A bit over half of New Zealand's early confirmed cases were directly linked to recent overseas travel. Although the data [1] is a bit awkward to analyze, in weeks #12-14 (15 March .. 4 April) 451 cases out of the 883 total (51%) were classified as "overseas travel".

The data only includes the country of origin of the final leg of their international flight. Since there aren't any direct Europe-NZ flights, some of the cases with origins in Australia/USA/Asia could be due to passengers returning from Europe via an intermediate airport.

[1] https://www.health.govt.nz/our-work/diseases-and-conditions/...

The number of Swedes traveling in general and especially traveling to virus hotspots like Italy is far higher than the number of Kiwis doing it.

You know, maybe, just maybe, being a remote island so far away from the rest of the world it's often forgotten on world maps helps with reducing transmission vectors in pandemics.

The specific assertion was that "NZ doesn't have the same close traffic with any early covid hotspot", but that's demonstrably false.

Perhaps there were more Swedes traveling in general, but that is neither here nor there. [There were an average of 16,300 people arriving in NZ each day in early March.] NZ did in fact have plenty of overseas arrivals returning from various early hotspots (such as New York and Italy) and this is reflected in the confirmed case data showing that a whopping 39% of all of our cases were infected during their overseas travel.

Furthermore, every single significant cluster of cases was kickstarted by an index case that had recently returned from overseas.

It wasn't distance or being an island that protected NZ from experiencing an epidemic outbreak, but rather the rapid action from our government: travel restrictions, isolation/quarantine of arrivals, and strict lockdown of the entire country.

New York was not a particularly early hotspot, it was much later than Italy.

We shut down flights from China in February for that reason, and China is a masssive source of tourism for us - we also had the plague ship Royal Princess dock here and spawn a cluster, all of our largest clusters came from overseas contact - either from tourists or returning Kiwis.

Ummm...

> There is clearly no evidence that stricter measures have any effect. If that was true, then there should at least be a linear correlation between strictness of measures vs. excess deaths, and that's simply not the case.

What? No, timing of measures is critical here. [0] The same exact strictness of measures, implemented a week later, can cause 4x more deaths (total, and thus per capita too) merely because of the delay.

Yes, English and Danish authorities should absolutely be terrified that they waited to long to act, just as the Swedish authorities should be.

[0] https://medium.com/@tomaspueyo/coronavirus-act-today-or-peop...

It's not just that Sweden has a higher death rate but that Sweden's death shows a sharp exponential rise still. This effectively in the last few days, a week ago Sweden could be pointed to as a "miracle".

The other countries that have seen these exponential indeed effectively panic and impose any measure they can - social distancing and lock since that's all they have.

As people point out, there's no absolute evidence that quarantines, lock-downs or parachutes save lives yet common sense still dictates they do more than nothing and when a disaster is approaching, do you really want to say you failed to do that could have averted mass deaths?

Moreover, the Sweden versus the other Nordic countries does seem like a better comparison because these countries arguably have similar levels of relative isolation from the world, similar health care systems and similar cultures.

> Denmark has ~2.5x the per-capita covid-19 mortality of Finland

...and ~35% the per capita mortality of Sweden. Denmark is pretty much in the middle of the pack. That's clearly less reason for panic than if they were already in the top third and rising fast. And you accuse others of cherry-picking?

> Sweden vs. all of Europe paints a completely different picture

No, it really doesn't. Thanks for proving that this kind of jingoism isn't limited to the US.

> is that if a country has no or a low rate of excess deaths, that country is doing "ok".

Where are you getting figure for all cause mortality for Sweden please?

> should English authorities be terrified that they've gotten their assumptions wrong?

There is wide-spread condemnation about the UK approach - too little, too late.

Compare countries of similar population:

pop 10.7e6 https://covid.observer/gr/#daily

pop 10.7e6 https://covid.observer/cz/#daily

pop 10.3e6 https://covid.observer/se/#daily

pop 10.3e6 https://covid.observer/pt/#daily

pop 9.8e6 https://covid.observer/hu/#daily

pop 8.9e6 https://covid.observer/at/#daily

pop 8.6e6 https://covid.observer/ch/#daily

I want to point out the high absolute numbers of deaths, the deficient recovery, and that the curve shows no decline in Sweden.

I would be completely unsurprised that when this is over, an angry mob captures Tegnell and tears him limb from limb while alive.

Sweden has a higher rate. The theory is that the bulge in death rate is bigger up front vs a prolonged one that continues for months. It will be interesting to see long term results. Sweden also seems to have the same problem with long term care homes that many other nations (France, Canada, etc) are having.

Sad to say, I'm completely unsurprised that countries with rampant Covid19 spread have a lot of deaths in their retirement homes. It's practically deterministic.

People are contagious in the pre-symptomatic or asymptomatic case. So all that's needed is that one employee of the retirement home gets sick and goes to work before they know, and the game is up. Dead patients everywhere.

I'm sure this is discussed and considered on the highest levels of policy in the jurisdictions that have been the most proactive in getting a handle on the epidemic early, and missed in most others.

I'm sure a strict face mask policy could have helped slow things down, but that's sadly been a hotly contested topic.

Many retirement homes here in Czech Republic have had the care takers voluntarily locking themselves up together with the people living there. Some have been there like this for many weeks, only taking in supplies in a safe way & communicating electronically.

Thats some serious dedication & very prudent one, give all the tragic cases elsewhere.

I don’t think the up front deaths are in any way intentional. It’s very hard to compare strategies since there’s many other factors that control the outcome. Like Sweden had school holidays ending with a lot of people coming home from skiing in Italy just when the situation there exploded. And as you mentioned, the virus got into a lot of the nursing homes.

Just for reference, Norway's epidemic also started with a large influx of cases from Italy and Austria. But the countries have used different strategies from that point on.

This is one of the things I wondered when I saw the "flatten the curve" charts and simulations a few weeks ago.

Is there a valid statistical model for letting COVID-19 spread quickly, and "getting it over with", compared to flattening the curve and letting it create fewer mortalities over a longer time?

I suppose even if the total number of mortalities is projected over time, there's real hope that we could find more effective treatments over time.

The problem is that depending on your medical capacity, "getting it over with" overloads your medical system causing even MORE deaths. So the total number of deaths goes way, way up. Because in addition to the deaths from COVID-19, you get extra deaths from hospitals not having beds or able to handle other common injuries/sickness/accidents that are still happening every day but wouldn't normally lead to death because they could get full attention and care.

Now, if we had infinite medical capacity, then actually "getting it over with" could, from a number of deaths perspective, be advantageous. No lockdowns! No economic distress! However, you also overshoot a little. You would have deaths due to more of the population being exposed than required for herd immunity.

Of course, if you're a no lives lost at any cost, you'd still want to reduce deaths by slowing the spread until something like herd immunity or a vaccine. But most don't seem to have that sort of political or economic calculus.

The problem with not getting it over with is that the next wave is at extreme risk of colliding with the peak of the next flu season, which is a really great way of overloading your medical system and causing a bunch of deaths. This is something that's getting a bit of attention in the US now, but (of course) the UK government spotted it fairly early on and was pressured into ignoring it by our idiot press who think that paying attention to anything other countries aren't is a delusion of "British exceptionalism" that needs to be squashed.

I don't think it's a given that there'll be a next flu season. In my jurisdiction, I calculated that we've reduced the incidence of cold/flu symptoms by about an order of magnitude with social distancing measures. (Based on normal incidence of cold/flu symptoms, and rate of covid-19 testing which is open to anyone with cold/flu symptoms.)

Note also that the herculean effort to reduce all other cold/flu viruses by an order of magnitude only reduced R of covid-19 to around 1.

Where can I read more about early identification of this risk by the UK govt?

Not to mention effectively killing your mostly ireplecable medical personell - either directly by massive exposure to the virus, due to overworking or due to psychological issues caused by watching people die every day for weeks on end.

There will be an economic crisis if 2-3% of people lose their lives in a span of a few weeks.

Absolutely there would be.

On the other hand, the results from the recent antibody testing in California[1] (if they're accurate) would suggest a much lower death rate - around 0.1% - 0.2%.

I fully agree that social distancing is the right move with the current data, but I wonder if that will continue to be the case as we come to understand the virus and its actual infection-fatality-rate more.

[1] https://www.nature.com/articles/d41586-020-01095-0

0.1% is the current mortality of flu, this has killed twice the yearly number of flu victims in a month. Could be explained by the huge infection rate possibly but it’s definitely more deadly by a wide margin.

I agree totally. I haven't seemed much informed discussion along these lines, but the only two possabilities I see are:

1) The antibody studies are incorrect, and over-counting the infection rate.

2) COVID-19 spreads much more easily than influenza, and so a large percentage of the population has become infected much quicker than typical influenza spread patterns.

Neither option is great, though to me of the two, #2 seems more hopeful, since assumedly we'd get herd immunity relatively quickly.

And Germany is another outlier

It looks like Germany put lockdown measures in place about a week earlier than France, Belgium or the Netherlands, if you compare the number of deaths at the time the mesures were enforced.

Getting a lockdown in place a week earlier mathematically translates in a 4x reduction in deaths a few weeks later, which is more or less what we see when comparing France and Germany.

Likewise the UK enforced the lockdown a few days later than France (proportionally to the state of the pendemic at the time of the measures), more or less like Spain. Looks like they are both heading towards 30k or 40k deaths until the pendemic gets under control. A few days really matter when you're fighting a pendemic that double in size every 3 days.

Even before the lockdons went into effect the difference between Germany and France was puzzling.

Reddit user /u/Anaemix made a nice graph of the Swedish stats [1]. Döda per dag translates to deaths per day.

[1] https://i.imgur.com/oXyrncm.png

That chart is really hard to read. Am I supposed to take away that Sweden only has about 50 or 60 more COVID deaths than the official count? This seems hard to believe. These types of numbers don't tend to have that level of quality at this stage of a disaster. I guess time will tell.

The opposite. Sweden has counted 50 or 60 extra cases as COVID than can be accounted for simply by excess mortality. That sounds impossible, but the difference can come from a few places:

1) Excess mortality is only an estimate. There could be other reasons why non-covid mortality is lower/higher than previous years (e.g. less serious flu season)

2) The tests can have some false positives.

3) If the way you count deaths is "anyone who died and tested positive for Covid", it's possible that the people you're counting didn't die from Covid but happened to have the virus in their system (or would've died even if they didn't catch Covid).

All this is saying is: in past years, X people died in Sweden during this period on average. This year, Y people died. (Y - X) are the "extra deaths", so to speak, and so this is comparing extra deaths to reported Covid-19 deaths.

I think Covid is causing other causes of deaths to be reduced (less car accidents, flu etc. than usual), so the -50 on the chart implies that (1) all Covid deaths are being accurately counted) and (2) non-Covid mortality is slightly down.

No it's even weirder; the gap implies that there are 50-60 fewer non-COVID deaths in Sweden than there would be otherwise since the pandemic began.

Hospitals have seen a dramatic drop in visits that aren't coronavirus-related. You can bet that automobile accident deaths and injuries have dropped like a rock in the past month, for example.

Well spotted. I bet that work accidents also sinked

And probably people are getting lost on mountains less and less flu deaths too...

For flu deaths, perhaps people are so cautious/being sanitary that they are dropping, I know Japan has seen record drops in Flu diagnosis due to extreme caution from the populace due to covid.

Which isn't weird at all - if you trust that people avoiding crowds also lead to fewer having the accidents which would otherwise have gotten them dead.

Or prevents them from contracting any other disease that would have otherwise killed them. In fact even these numbers are undercounts of the "true" death total due to the pandemic, as we'd obviously expect baseline deaths to have dropped significantly over the short term. How much is for the next generation of epidemiologists to argue about.

But FWIW: Sweden is absolutely an outlier here, and given the choice between "Swedish reporting is fundamentally better" and "Swedish death counts are wrong in some banal way", I'll choose the latter.

Say it with me everyone: we don't make risk analysis decisions on the basis of outlier data.

Mortality data and excess mortality data goes back decades, it's not like we suddenly started counting these things yesterday because of the coronavirus.

For Sweden's death count to be wrong now, they would also have to have been wrong going back decades, without anyone noticing. Or, the total all-cause death count would have to start being wrong about now because of unspecified reasons.

That doesn't make sense.

Doesn't the logic go the other way around though? For Sweden's numbers to be unimpeachible now, they would have had to have never been wrong going back decades. But in fact public numbers get reported incorrectly all the time, they just get corrected.

This is happening everywhere right now, watch all the various numbers on Worldometer jump around like crazy.

What you're doing is pointing to this one, single number, as collated by the New York Times in one story, which doesn't match any other numbers in the same data set. And you'redemanding that we treat it as proof of your particular policy views on this one country.

And I'm saying: well, OK, that could be true. But it's probably just a mistake.

There's a huge difference between all-cause mortality numbers being wrong, and covid-19-attributed deaths being wrong.

The only way the all-cause mortality numbers can be significantly wrong is if you suddenly find piles of corpses and skeletons around, and that they belong to people who magically weren't being missed or noticed by friends, family, neighbours, etc. And the only way for governments to hide these numbers would be by digging mass graves, shoveling them full of dead bodies, and hoping no-one notices. This simply does not happen, modern countries do not get this number wrong. If there's any public statistic you can count on going back centuries, it would be the number of births and the number of deaths.

Excess mortality is simply graphing the number of deaths backwards through time, to find trend curves and spikes in the trend curves. Those numbers are as correct as the underlying numbers.

In comparison, correctly attributing a death to covid-19 is very difficult right now. Tests are in short supply, so a lot of countries aren't testing already dead people, because those tests can be better used elsewhere, to save lives. There might be political pressure to downplay the severity of covid-19, so cause of death gets fudged here and there. Cause of death is also not always straight-forward, a lot of people are dying with covid-19, not from covid-19, how should they be counted? Different countries have different rules here.

The NYTimes article is saying that a bunch of countries have unexplained excess mortality, quite a lot of it actually. And since the most likely cause of those deaths are in fact covid-19, it means that those countries are under-reporting, i.e. their numbers are garbage. In comparison to those countries, Sweden's covid-19 deaths align pretty well with Sweden's excess deaths. The official number is still probably wrong, but there's absolutely no way that Sweden's covid-19 numbers are more garbage than those other countries, and there's absolutely no way that Sweden is under-reporting to the same extent.

> The only way the all-cause mortality numbers can be significantly wrong is if you suddenly find piles of corpses and skeletons around

Or if someone types a number incorrectly; or the reporting deadline changes for a month causing a few offices miss it and get counted in the wrong month; or if the Times writers didn't understand the specific categories being reported and missed some data...

Again, I'm not saying you're wrong. I'm saying you're hanging your entire argument on one outlier number. And, statistically (see what I did there?) that doesn't tend to work out for you.

A likely explanation is that some of the people who died of Covid-19 would have died anyway.

I would chalk that up to people acting a little more conservatively because of COVID-19, even if there isn't a lockdown.

The excess mortality problem isn't about trust. No one has alleged that existing studied covid death numbers in Lombardy or New York or wherever are due to people lying.

It's just that some people, in every health care system, end up dying without a test being done. It's certainly plausible that Sweden has been far more conscientious about testing unknown deaths (or testing at-risk people before symptoms, etc...). That doesn't say anything about their trustworthyness.

FWIW, my money is on a bunch of these cases being discovered in Sweden too, they just didn't show up in the check the Times did. Epidemiology is just hard, and there are no magic tricks to play with the science.

Pretty hard to hide excess death. That's precisely the point of this chart. You can miscount Covid deaths, but it's pretty hard to miscount deaths overall unless there's a fraudulent cover-up. Deaths are all recorded and tracked. Bodies don't just disappear.

The excess UK deaths linked to coronavirus are likely to be currently around 43,100.

For an explanation see: https://www.ft.com/content/67e6a4ee-3d05-43bc-ba03-e239799fa...

For today's latest numbers see: https://twitter.com/ChrisGiles_/status/1252983884284821505

Super interesting, thanks. Do you know if anyone has graphed the excess mortality on a month by month basis? That data would be invaluable in understand the timelines of actual spikes in excess mortality, irrespective of covid-19 testing and diagnosis. For example, did it spike up in March in NYC compared to Jan or Feb?

The New York Times article mentioned has more complete data, including the graphs you want.

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

Could reduced deaths from driving etc. also be significant in this analysis?

> A chart published by the NYT:

Do you have a link to the source?

Do you have a link to this?

Couldn't you in fact make the opposite case?

Sweden as the outlier is not reporting accurately and others are?

The UK has seen huge excess mortality above the average which is being attributed to large numbers of undiagnosed deaths in care homes and in the community.

Its far too early to make any claims as to superior accuracy when almost every country is struggling with accurate testing across their entire population.

In which case you'd expect Swedens numbers to get revised strongly upwards.

Sweden also has no conclusive sign of flattening yet.

> Sweden as the outlier is not reporting accurately and others are?

Huh?

If a country is in lockdown, and still experiences excess mortality, but the official covid-19 deaths aren't enough to cover that excess, then.... what the hell did people die of?

The expectation is that because of lockdown, the excess mortality from non-covid-19 causes should be lower than previous years, and therefore all the actual excess, and probably more, is attributable to covid-19. Which means that countries where the official covid-19 number is lower than excess mortality, like the UK, are underreporting, while countries where the excess mortality matches the official covid-19 number, like Sweden, are not underreporting.

> The expectation is that because of lockdown, the excess mortality from non-covid-19 causes should be lower than previous years

It is hard to say whether this is true. There are two reasons why there could be excess mortality caused only indirectly by covid-19 (so not part of covid-19 mortality):

1) Overwhelmed hospitals cannot offer proper healthcare to some patients with non-covid-19 illnesses. This might happen in Italy or Spain.

2) People are too frightened by covid-19 to visit doctor even in acute cases of other illnesses (e.g. minor stroke) and sometimes visit them too late. This was reported by doctors in Czechia.

Your underlying assumption is a) Sweden is reporting correctly and b) won't in future find excess deaths in the community - as other countries have:

https://www.independent.co.uk/news/health/coronavirus-care-h...

UK coronavirus deaths more than double official figure, according to FT study:

https://www.ft.com/content/67e6a4ee-3d05-43bc-ba03-e239799fa...

> Your underlying assumption is a) Sweden is reporting correctly and b) won't in future find excess deaths in the community

Yes.

I don't think you can assume that non-covid-19 causes should be lower than previous years. For example, the main cause of deaths in normal years is cardiac problems. If Covid-19 is discouraging people from seeking help, and especially from going to the emergency room when they they think something might just possibly be wrong, then you can get a big increase in cardiac deaths.

> I don't think you can assume that non-covid-19 causes should be lower than previous years.

Sure, I agree that it's very uncertain.

However, if that's the case, then that just furthers my point, because it means that Sweden is overreporting covid-19 cases, and is actually doing even better than official stats say they are.

There's a very definite possibility that what people died of is lockdown and fear. More specifically, there have been some really worrying alarm bells going off in multiple countries about people not seeking medical attention for really serious conditions, or not receiving it when they did.

A close relative of mine had cancer surgery delayed by 1.5 months because the treating hospital refused to host the surgery. After they realized their hospital had been empty for many weeks, they called him and asked, "do you want to get your surgery three days from now?". He is recovering, but for him it would have been better to have had his surgery when it was originally scheduled.

The total number of people that have died on a certain date is not going to be revised, why would it be?

The excess is that number minus a historical average which will also not be revised.

Because of the huge amount of excess deaths that get assigned as probable covid cases. This is happening right now in the UK.