Let me add one data point: Hungary has currently the highest mortality for covid-19 in the world, and still currently higher than India, for apparently the same reason, healthcare over capacity.

(The trend is different though, there's hope)

I would not believe any numbers coming out of India right now. I have family in the medical field and they all agree that deaths are underreported by a factor of 5-10 based on where you are located. The FT did a story on it as well that showed the deaths were grossly undereeported

Yes, correct. The govt reporting of every figure is less by a factor anywhere from 10-50, or maybe even more as well. The ground reality in India is way worse than what even the media is able to show. And, at present no light in the tunnel. Heart cries at this but it is us at fault only for putting such incompetent people at the helm.

The cases are being under-reported too. The question is whether deaths are being under-reported to a greater degree than cases. Even the test-positivity rates vary from state to state not only because of the extent of infection in different states but also because some states contact-trace and test while others don't. Its a mess. And to see people try to fit models to this data and fight amongst each other is darkly hilarious.

Plus, at least in the first wave in Bangalore (where I grew up), there were no instances of crematoriums melting down and such. So the under-reporting of deaths was likely not as bad in the first wave as it is right now, but the under-reporting of cases was certainly quite large as testing capacity took a while to come online.

India reports 155 deaths per million. Hungary is at 2,874.

NYC didn't have a healthcare breakdown, it did send covid positive people to nursing homes.

WSJ, March 26 2020: https://www.wsj.com/articles/hospital-capacity-crosses-tippi...

> New York, home to the nation’s largest outbreak of Covid-19, the illness caused by the new coronavirus, is rushing to build a temporary hospital in a Manhattan conference center in the hope of staying ahead of the fast-spreading disease.

> Hospitals in parts of New York City have become so full of critically ill patients that they have steered ambulances elsewhere. The full-to-capacity morgue at Elmhurst Hospital in Queens is using a refrigerated truck to hold some of the dead. Thirteen people died in the hospital in the last 24 hours, said NYC Health + Hospitals, which operates Elmhurst.

Having some hospitals be full is not a system-wide breakdown. Even before COVID emergency rooms would be "on diversion" when particularly busy, and ambulances would go elsewhere.

For about 4-5 hours at a time,max, and believe you me it wreaked utter hell on my nights in the back of the ambulance when it happened.

Mine too!

No patients were ever turned away at NYC hospitals. There is a highly sophisticated patient transfer system in NYC.

Morgue capacity makes sense simply because of the population who was coming down with COVID at the time.

This makes it seem like not the case: https://www.nytimes.com/2020/04/19/nyregion/new-york-new-jer...

It very much depends on the definition of breakdown. Some people see a breakdown if hospitals run out of beds, others will pretty much never accept there is a breakdown in health care because it’s contrary to their conviction that COVID-19 is ‘just a flu’. To be fair, it’s a continuum, there’s not going to be an easily agreed fine line between broken down and not broken down. So the real question is, what constitutes the health care system breaking down, and did that happen in NY.

Without agreement on that though, we’re just shouting at each other.

NYC sent the elderly, covid positive people to nursing homes, where they died. Is that not a breakdown?

The order by Governor Cuomo sending infected patients into nursing homes was preemptive, which then led to strain on the health care system.

https://en.m.wikipedia.org/wiki/New_York_COVID-19_nursing_ho...

It’s worse because then they go and infect the rest of that vulnerable group.

I can understand not being able to treat them but at least isolate them…

This is the first I’ve heard of this. If it’s true they were sending known-covid positive cases into nursing homes, whoever gave the order should be tried for mass murder.

Unbelievable!

It is true, and Cuomo ordered it. Fully agreed that he should be tried for some serious crime. https://www.empirecenter.org/publications/the-hospital-lobby...

According to...well, everyone, that was a NYS thing, not NYC specifically.

More broadly it was a nationwide CDC advisory and not only that, the same shuffling of elderly infected back into nursing facilities happened in countries across the (mostly western) world. Probably based on shared implementations of policy briefing/ pandemic planning documents.