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Excess mortality

Just read this thread by David Wallace Wells about what we are able to see now about the death toll of COVID 19. It will sober you up fast:

“Live long enough in a pandemic and you will see the entire narrative landscape shift, even flip, sometimes more than once.” Excess mortality data isn’t new, but the stories it tells about the global pandemic will probably surprise you. A thread.

https://nymag.com/intelligencer/2022/03/covid-excess-mortality.html

“The idea is simple: You look at the recent past to find an average for how many people die in a given country in a typical year, count the number of people who died during the pandemic years, and subtract one from the other.”

“The basic math yields some striking results. A remarkable excess-mortality database maintained by The Economist estimates global excess mortality at above 20 million—well more than three times the official estimate.”

https://www.economist.com/graphic-detail/coronavirus-excess-deaths-estimates

“As a measure of pandemic brutality, excess mortality has its limitations — but probably fewer than the conventional data we’ve used for the last two years.”

“That’s because it isn’t biased by testing levels — in places like the U.S. and the U.K., a much higher percentage of COVID deaths were identified as such than in places like Belarus or Djibouti, making our pandemics appear considerably worse by comparison.”

“By measuring against a baseline of expected death, excess mortality helps — though only somewhat — account for huge differences in the age structures of different countries, some of which may have many times more mortality risk than others because their populations are older.”

“And to the extent that the impact of the pandemic isn’t just about COVID-19 but also our responses to it — lockdowns and unemployment, suspended medical care and higher rates of alcoholism and automobile accidents — excess mortality accounts for all that, too.”

“In some places, like the U.S., excess-mortality figures are close to the official COVID data. In other places, the numbers are so different that accounting for them changes the picture of not just the experience of individual nations but the whole world…”

“…scrambling everything we think we know about who did best and who did worst, which countries were hit hardest and which managed to evade catastrophe.”

“If you had to pick a single metric by which to measure the ultimate impact of the pandemic, excess mortality is as good as we’re probably going to get.”

“So what does it say? A year ago, it seemed easy enough to divide pandemic outcomes into three groups — with Europe and the Americas performing far worse than East Asia and much of the Global South, especially sub-Saharan Africa.”

https://nymag.com/intelligencer/2021/03/how-the-west-lost-covid-19.html

“Today, a crude count of official deaths, not excess mortality, suggests the same grouping: North America and Europe have almost identical death counts with official per capita totals eight times as high as Asia, as a whole, and 12 times as high as Africa.”

“South America’s death toll is higher still — ten times as high as Asia and 15 times as high as Africa.”

“The excess-mortality data tells a different story. There is still a clear continent-by-continent pattern, but the gaps are much smaller, making the experiences of different parts of the world seem less distinct and giving a more universal picture of pandemic suffering.”

“According to The Economist, Europe, Latin America, and North America have all registered excess deaths ranging from 270 to 370 per 100,000 inhabitants; excess mortality in Asia is estimated between 130 to 330; in Africa, the range is 79 to 220.”

“These numbers are not identical, but, all things considered, they are remarkably close together. The highest of the low-end estimates is barely three times the lowest; the highest of the high-end estimates is not even twice as high as the lowest.”

“If you adjust for age, as the Economist database does separately, the differences among continents grow more dramatic — suggesting a reversal of outcomes, rather than a convergence.”

“Outside of Oceania, Europe and North America were among the best in the world at preventing deaths among the old—several times better at protecting their elderly, of whom they had many more, than Africa and South Asia. East Asia performed better, but only slightly.”

“On per capita excess morality among the elderly, Canada is in line with China, Germany just marginally worse than South Korea, Iceland in the range of Japan.”

“By almost any metric, Oceania remains an outlier: The Economist gives the whole region an excess-mortality range of negative 31 to positive 37 per 100,000, meaning it’s possible fewer people died there than would’ve had we never even heard of SARS-CoV-2.”

(For those who may find this figure astonishing, keep in mind that for several weeks now the U.K. has been posting negative excess mortality data, as well.)

“In the country-by-country data, the divergences grow even bigger.”

Perhaps most striking is that the worst-hit large country in the world was not the U.S., which registered the most official deaths of any country but ranks 47th in per capita excess mortality, or Britain, which ranks 85th, or even India, which ranks 36th. It is Russia.”

The country that recently launched a needless war of nationalist aggression and expansion “has lost, during the pandemic, between 1.2 million and 1.3 million citizens over the course of the pandemic, a mortality rate more than twice as high as the American one.”

“Russia is not an outlier. While we have heard again and again in the U.S. about the experience of the pandemic in western Europe — sometimes in admiration, sometimes to mock — it has been eastern Europe that, of any region in the world, has the ugliest excess-mortality data.”

“This, then, is where the pandemic hit hardest — in the countries of the old Warsaw Pact and formerly of the Soviet bloc. In fact, of the ten worst-performing countries, only one is outside eastern Europe.”

“The world’s worst pandemic, according to the data, has been in Bulgaria, followed by Serbia, North Macedonia, and Russia, then Lithuania, Bosnia, Belarus, Georgia, Romania, and Sudan. (Have you read much about pandemic policy in any of these countries?)”

“Peru, which had what is often described as the most brutal pandemic in the world, ranks 11th — with the smallest gap, among those countries with the most devastating pandemics, between the official COVID data and the estimated excess mortality.”

“(You probably haven’t read much about Peru, either, but its lockdowns were severe — for months, only one member of each household was allowed out once a week.)”

“Because The Economist allows you to explore how excess mortality evolved over time, country by country, the data also clearly showcases the pandemic as a tale of two years — a mitigation year, 2020, and a vaccination year, 2021.”

“Early in the vaccine-distribution phase, with the U.K. and U.S. moving fastest, it was striking how so few of the countries that had done well in preventing spread in 2020 were doing well in providing vaccines quickly. Over the course of 2021, many of those gaps disappeared.”

“But the U.S. took the opposite course. In 2020, the U.S. had done a bit worse than average among its OECD peers. In 2021, when pandemic outcomes were often determined by the relative uptake of American-made vaccines, the U.S. did much, much worse than that.”

“In country after country in Europe, the pandemic killed a fraction as many last year as it had the year before. In the U.S., it killed more.”

“A year ago, you could defend the American record as merely below average. Today, it is cataclysmically bad, which is both outrageous and ironic, given that American vaccine innovation so helped changed the landscape for the rest of the world—the rich world, at least.”

“How did this happen? The answer is screamingly obvious, if also, in its way, confusing: The U.S. drove an unprecedented vaccine-innovation campaign in 2020, and then, in 2021, utterly failed to take advantage of its power itself.”

“But what is perhaps even more striking is that American vaccination coverage isn’t just bad, by the standards of its peers, but getting worse.”

“About two-thirds of Americans have received two shots of vaccine, a level that is in line with Israel and not far off from the U.K., though below many other wealthy countries. (And even in the U.K., vaccination was more effectively directed toward the old.)”

“But over the last six months, the country has had an opportunity to make up that gap with boosters and has simply not taken it.”

“Only 29 percent of Americans have had a booster shot of vaccine, which puts us behind Slovenia, Slovakia, and Poland and means that less than half of those people happy to be vaccinated a year ago have chosen to get a third shot through Delta and Omicron.”

“Booster campaigns seem like an obvious opportunity for easy public-health gains, yet remarkably few Americans seem to think it’s worth the trouble. Why? For everything we think we know about the pandemic and how people have responded, that one remains a maddening mystery.” (x/x)

Originally tweeted by David Wallace-Wells (@dwallacewells) on March 26, 2022.

Published inUncategorized