COVID19 mini-update, October 29, 2020: Excess mortality; second lockdowns in Europe

(1) There is a lot of discussion whether the 220,000+ “official” COVID19 dead are an underestimate or an overestimate (due to counting “died with COVID19” as “died of COVID19”). What however cannot be fudged easily is the all-cause mortality in a given time period (say, a week, a month,…). Unless a country has a very rapidly growing or declining population, this can then be compared to the 5-year average of deaths in the corresponding weeks/months of the previous 5 years. In order to enable comparisons between countries, one can then express the difference as a percentage of average mortality, the P-value. Ourworldindata.org has great interactive graphs for this: let me include a static screenshot of one example below:

Click here for the original dynamic graph

What does this mean in absolute numbers for the USA?

The excess mortality is then the sum of the differences between the red and black lines. This actually will add up to more than the official number: the difference could be due to collateral mortality, e.g., as consequences of deferred care for the “Big Three killers”, cardiovascular diseases, cancer, and cerebrovascular diseases. Or from “deaths of despair”. Indeed, if (as I suspect) the official COVID19 toll is highballed by about 30-50%, I would not rule out that collateral mortality rivals direct mortality.

(2) As Israel is gradually exiting a second lockdown, European countries are either instating them (France) or are about to (Belgium, Germany,…). Allister Heath in the Daily Telegraph tells British PM Boris Johnson this should not be done without a full cost-benefit analysis, and transparency to the public.

UPDATE from the increasingly slapdash Jerusalem Post:

The coronavirus cabinet met late into the night on Thursday [to discuss the 2nd stage of lockdown exit, starting this coming Sunday. It] approved opening classes for grades one through four, allowing one-on-one activities and services (driving lessons or personal training) to resume […] and for [hair] salons and bed and breakfasts to open. It also agreed to allow up to 10 people to pray in synagogues. […]  In addition, the ministers agreed to [compress] the nine-stage exit strategy originally outlined by the Health Ministry [in]to six stages […] presented earlier in the week by the National Security Council.

Small business owners took to the streets on Thursday as the cabinet convened, begging the government to allow them to operate. However, ultimately, the cabinet decided to push off opening street shops another week, until November 8, unless there was a significant drop in infection. 

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