They're still higher than usual, and so any 'even at the peak' appeal to curves acknowledges that epidemiologists were probably correct and numbers of cases rose very rapidly from near-negligible levels, before slowing due to social distancing measures. If the disease was widespread much earlier, excess hospitalisations and deaths during that period ought to be much higher than they are now with aggressive social distancing having been place for nearly two months. It's not like France has limited access to healthcare or was more likely to chalk a surge of hospital inpatients with severe respiratory symptoms off as something else in late Feb or early March than in late April, when despite lockdown they were much higher...
Viral pneumonia is among the most common cases of death among the elderly.
Influenza cases vary significantly between years.
There is a lag of infection to death of two to three weeks.
It would have been invisible for a long time, spreading uncontrolled.
Except that if it really was 'spreading uncontrolled' and giving everyone 'the worst flu', as opposed to a handful of isolated cases which became more than a handful shortly after people started to panic about it, there wouldn't still be more vastly people being hospitalised for respiratory symptoms weeks after measures were taken to halt the spread than in late February. There might not have been much community testing going on then, but hospitals were certainly keeping records of who was coming in with respiratory problems; the well-established fact that comparatively few people were is strong evidence against the hypothesis it had already become widespread by then.
You're also more likely to develop pneumonia from Influenza than from COVID-19, especially if you're young. If you presented to a doctor oblivious of COVID-19 (or SARS), they would assume it is Influenza.
BTW, that 50% is for national level and with a shutdown in place.
Regions hardly hit by the virus have a much higher excess mortality (Bergamo province 450%, NYC 390%, Madrid 250%, Manaus 250%) [1]
[1] https://twitter.com/jburnmurdoch/status/1256312094334619648
It simply would not have registered among the usual deaths from viral pneumonia, which has a year over year variance of a similar magnitude.
The actual death numbers are also highly dependent on the age groups affected, in Germany for instance there is no discernible excess mortality because most of the infected are below the age of 65.
This is why I believe it's just a bad flu after all - the spread pattern matches the usual seasonal flu/cold; and we would have noticed an elevated mortality.
If we adjust for years of life lost, as opposed to just lives lost, COVID-19 may be less severe than seasonal H1N1 Influenza, which kills a lot of young people. On the other hand, COVID-19 also seems to be far more infectious.
https://www.euromomo.eu/graphs-and-maps/
Outside of NY/NJ, the excess mortality in the US is within 20% of the normal rate, no different than the variance expected from a bad/mild flu season.
If you were to transpose those cases back to February, what would you have seen in the death statistics? Nothing suspicious at all. There could have been hundreds of thousands of cases that have gone unnoticed, because there wasn't any testing - and that's assuming a mortality rate of over 2%. If the mortality rate is lower than 0.4%, as some studies suggest, it could've been millions of cases.
Edit: actual calc i did is 13k confirmed deaths in nyc / 70% herd immunity magic number of 8.4 mil
Let's look at Germany from that EUROMOMO map. Despite all the measures, they have had over 150k cases and over 6k deaths (a death rate of over 2%), but it doesn't show up on the graph.
All the deaths that have happened in Germany in the past weeks could've happened months earlier and it wouldn't have shown up either.
This disproves the idea that there couldn't have been any mass infections earlier, because we would've seen that from excess deaths. That's the point I am making. The only way to know would've been through testing, but there wasn't any testing then.
You can't really disprove the idea that "without measures excess mortality will always happen".
Let me reiterate:
Hypothesis: "If there had been mass spread outside of Asia as soon as January or February, we would have been able to tell because of unusually high excess deaths"
Contradicted by: "There are known cases of mass spread that didn't result in unusually high excess deaths"
Therefore, excess death is an insufficient metric to reveal a mass spread of COVID-19 - it could have been spreading undetected.
Whether there have been any measures to limit the spread is irrelevant to that conclusion.
You used Germany as an example.
Here's the situation in Germany:
Since 13 March, the pandemic has been managed in the protection stage as per the RKI plan, with German states mandating school and kindergarten closures, postponing academic semesters and prohibiting visits to nursing homes to protect the elderly. Two days later, borders to five neighbouring countries were closed. By 22 March, all regional governments had announced curfews or restrictions in public spaces. Throughout Germany, domestic travelling is only authorised in groups not exceeding two people unless they are from the same household. Some German states imposed further restrictions authorising people to leave their homes only for certain activities including commuting to workplaces, exercising or purchasing groceries.[10]
https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Germany
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Tell me, please, how does this support the idea that mass spread without extreme protective measures (as was the case in January or February) can result in no excess death?
I'm not saying it can result in "no excess death", I'm saying if there had been mass spread back then, even on the order of hundreds of thousands of cases, it could've gone unnoticed, because the excess death would've been within the seasonal variance.
If there are really 10x as many actual cases as reported - which is what antibody studies suggest - then the virus has either been spreading much faster than we assumed, or has been spreading for longer than we assumed.
The fact that somebody who died in France in December appears to have been infected with COVID-19 strongly suggests that there has been community spread far earlier than we assumed.
This is because there are lags in the data. You need to wait a few more weeks (and for some countries it'll be months) for the data to come in and be reported.
In the case of Germany, there would be 12,000 weekly deaths on average, versus about 2000 weekly deaths due to COVID-19 at the peak - that is within the variance caused by the seasonal flu. It would not have been a suspicious rise.
It's very easy to search for this information. Here's one link: https://blog.ons.gov.uk/2020/03/31/counting-deaths-involving...
> In the case of Germany, there would be 12,000 weekly deaths on average, versus about 2000 weekly deaths due to COVID-19 at the peak - that is within the variance caused by the seasonal flu. It would not have been a suspicious rise.
If you're comparing covid-19 to flu you must count them using the same method, and you're not doing that here. Here, for covid-19 you're using "deaths after confirmed positive" but for flu you're using "all cause mortality". When you use the same method to count covid-19 and flu deaths you see much higher rates of death for covid-19.
Your claim is that the lack in excess mortality is solely due to lag. Your link doesn't say anything about the extent of the delay regarding countries like Germany.
> If you're comparing covid-19 to flu you must count them using the same method, and you're not doing that here. Here, for covid-19 you're using "deaths after confirmed positive" but for flu you're using "all cause mortality".
The hypothesis is "If there had been mass spread back then, we would've seen it from excess deaths", which implies all-cause mortality. Of course I'm mentioning Influenza because it causes some of the seasonal variance and some of the same symptoms.
> When you use the same method to count covid-19 and flu deaths you see much higher rates of death for covid-19.
Yes, but that's in hindsight. That's not the way you would have looked at the cases at the time.
There are about 20,000 pneumonia deaths per year in Germany where the cause is never determined[1]. That's over 300 per week average, more in the winter years. Now suppose an old person comes in and dies of pneumonia. There's nothing suspicious about this. Suppose a few more come in this year than the last year. Again, nothing suspicious, some flu seasons are worse than others.
I'm not saying there have been 2000 undetected cases of COVID-19 deaths per week in Germany back in January/February, but there could have easily been 100-200.
[1] http://www.gbe-bund.de/oowa921-install/servlet/oowa/aw92/dbo...
The only way to know would have been to perform tests, which we did not do.
All the antibody studies so far suggested infection numbers that were massively higher than confirmed cases.
Furthermore the PCR tests used for initial diagnosis have high false negative rates and most people with only mild or no symptoms never got tested in the first place.