[HN Gopher] Covid-19 may have killed nearly 3M in India, far mor...
       ___________________________________________________________________
        
       Covid-19 may have killed nearly 3M in India, far more than official
       counts show
        
       Author : pseudolus
       Score  : 354 points
       Date   : 2022-01-10 11:40 UTC (11 hours ago)
        
 (HTM) web link (www.science.org)
 (TXT) w3m dump (www.science.org)
        
       | m33k44 wrote:
       | India desperately needs a public institution like the NHS of the
       | UK!
       | 
       | Few years ago my father died of ILD(Interstitial Lung Disease),
       | as per the doctors. I had my doubts about the diagnosis, but I
       | had no where to go to for second opinion. There is a private
       | hospital syndicate in every city of India; no hospital goes
       | against other hospitals in the same city; they will cover each
       | others back because most of the hospitals have the same
       | "consulting doctors". They just loot the patient's relatives by
       | prescribing same drug but from different manufacturer. And if
       | they realise that the patient is going to die, then the family
       | members are pressured to take the patient home or elsewhere, this
       | is to avoid "death count" on their register. I was literally
       | asked to take my father home the day he died suggesting that
       | "take him home, we will provide the ambulance and he will die on
       | the way home so it won't be on anyone of us!"
       | 
       | The medicine profession in India is not just joke, it is inhumane
       | and lacks any value for humanity.
       | 
       | India should have looked at some of the European countries when
       | setting up it's healthcare, education and news media policy.
       | Unfortunately the country has copied verbatim everything in this
       | regard from the US!
        
         | llampx wrote:
         | The value of life is negative in India, unfortunately.
        
       | evancoop wrote:
       | Excess deaths will need to become the standard statistic used to
       | compare nations. Otherwise, we'll be debating "deaths FROM vs.
       | deaths WITH COVID" and the differing statistical definitions from
       | nation to nation. Moreover, is a death from lack of access to
       | medical care due to the collapse of a medical system a COVID
       | death? Is a death of despair from isolation and unemployment a
       | COVID death?
       | 
       | My sense is, when the pandemic is analyzed historically, "excess
       | deaths" will be the only salient statistic in the literature.
        
         | robertoandred wrote:
         | Excess deaths per capita, please.
        
         | ekianjo wrote:
         | > Excess deaths
         | 
         | Excess deaths are not just due to COVID.
        
           | Jedd wrote:
           | > Excess deaths are not just due to COVID.
           | 
           | Can you clarify what you mean by this?
           | 
           | What kinds of things might excess deaths be attributable to,
           | and to what rate / ratio would you expect?
        
             | kansface wrote:
             | People are now skipping routine cancer screenings, check
             | ups, and altogether avoiding any health care out of fear of
             | catching covid. Its not hard to find stories of people with
             | heart attacks not going to the hospital! Kids are missing
             | routine vaccinations, etc. Drug overdoses are up - more
             | deaths in SF are from ODs than Covid last time I looked.
             | Dementia patients and those in nursing homes truly took a
             | nose dive by completely separating them from human contact
             | (they deteriorate rapidly with no stimulation). I imagine
             | lots of people stopped exercising and put on loads of
             | weight.
        
             | zo1 wrote:
             | Not OP. But it's becoming increasingly clear (to me, at
             | least) that data about reality has been lost. And no amount
             | of "statistics", "modelling" and accounting for confounding
             | variables will get that data back. This applies to masks,
             | lockdowns, vaccine effectiveness and treatment
             | effectiveness.
             | 
             | Even if we do get a reasonable set of that data back via
             | statistical means, I personally wouldn't trust it. Too many
             | things weren't tracked, people had incentives to fudge
             | numbers, data-integrity and duplication issues, etc. As
             | much as I know there are lots of incredibly smart and
             | educated people working on this, I see most of this as
             | people running around throwing spaghetti at a wall to see
             | what sticks, some hoping to get paid for it, others hoping
             | to save lives.
             | 
             | Likewise for your question. We simply don't have data or
             | knowledge about what people did or how they behaved
             | differently that might have caused a non-covid death to be
             | reasonably attributed to covid. Suicide rates, anti-social
             | behavior of children not seeing people's faces, people
             | hiding pro-active tests, dentists visits, hiding from
             | leaving the house and getting depression, the list is huge
             | and specifically _unconstrained_.
        
               | oblio wrote:
               | You can complain about everything in the world, but not
               | about masks. Masks work, we've known they work since at
               | least 1919. When worn correctly by large groups of people
               | in risky environments (indoors, poor airflow), they
               | greatly reduce transmission rates.
               | 
               | Everything else, you can say stuff about, vaccines have
               | side effects, we don't know if and how much they reduce
               | transmission, treatments are in flux, but masks are a
               | simple and obvious solution with almost 0 side effects.
        
               | swader999 wrote:
               | Masks with a decent seal work and studies with mannequins
               | show this. But in real life, an airborne disease, massive
               | gaps by the side of your nose, wet cloth, rules such as
               | wear it to your restaurant table then take off to eat,
               | it's a pathetic exercise at best.
        
               | oblio wrote:
               | Gee, I wonder if anyone thought of testing conditions
               | similar to real life. Nah, nobody did, because everyone
               | is stupid.
               | 
               | https://www.mpg.de/17916867/coronavirus-masks-risk-
               | protectio...
               | 
               | https://www.nature.com/articles/d41586-020-02801-8
               | 
               | Even bad masks poorly worn are better than no masks, and
               | the effect is statistically significant.
               | 
               | Also reducing the areas in which there is unmitigated
               | exposure is a good thing, not a bad thing.
        
               | brigandish wrote:
               | > Gee, I wonder if anyone thought of testing conditions
               | similar to real life. Nah, nobody did, because everyone
               | is stupid.
               | 
               | No need for that, at all.
               | 
               | From [1]:
               | 
               | > A recent British Medical Journal review looked at six,
               | fairly porcine, studies concerning mask-wearing and
               | estimated an impressive 53% reduction in risk. But the
               | single randomised controlled trial estimated the smallest
               | effect: a reduction of about 18% (-23% to 46%) in Sars-
               | CoV-2 infections. The "heaviest" studies, an analysis of
               | US states and a survey of about 8,000 Chinese adults in
               | early 2020, observed rather than experimented and its
               | editorial highlights the risks of confounding variables
               | influencing both wearing masks and infections and the
               | impossibility of disentangling the effects of measures
               | fluctuating simultaneously. Indeed, this review found an
               | identical 53% reduction from handwashing.
               | 
               | There is an introduction of Spiegelhalther and Masters
               | given here[2]. It's well worth reading that BMJ article,
               | btw.
               | 
               | [1] https://www.theguardian.com/theobserver/2021/nov/28/i
               | vermect...
               | 
               | [2] https://statsandstories.net/media1/covid-by-the-
               | numbers
        
               | swader999 wrote:
               | These are all muted by omicron that has an R7-R10.
               | 
               | Sure, wearing a Helmut is safer but if you hit something
               | at 90 km/hr does it matter?
        
               | swader999 wrote:
               | That study proves exactly what I said.
               | 
               | It describes an ideal situation where people are wearing
               | well fitting medical grade or better masks with a virus
               | as transmissible as Delta.
        
               | irthomasthomas wrote:
               | From the only randomised controlled study of masks...
               | https://bmjopen.bmj.com/content/5/4/e006577.long
               | 
               | "The rates of all infection outcomes were highest in the
               | cloth mask arm, with the rate of ILI statistically
               | significantly higher in the cloth mask arm (relative risk
               | (RR)=13.00, 95% CI 1.69 to 100.07) compared with the
               | medical mask arm. Cloth masks also had significantly
               | higher rates of ILI compared with the control arm. An
               | analysis by mask use showed ILI (RR=6.64, 95% CI 1.45 to
               | 28.65) and laboratory-confirmed virus (RR=1.72, 95% CI
               | 1.01 to 2.94) were significantly higher in the cloth
               | masks group compared with the medical masks group.
               | Penetration of cloth masks by particles was almost 97%
               | and medical masks 44%."
        
               | oblio wrote:
               | Things vary wildly across the world but in most of Europe
               | people aren't allowed to use cloth masks anymore, and
               | haven't been for at least half a year.
               | 
               | They have to wear either surgical masks or FFP2.
        
               | Jedd wrote:
               | > We simply don't have data or knowledge about what
               | people did or how they behaved differently that might
               | have caused a non-covid death to be reasonably attributed
               | to covid.
               | 
               | Which is somewhat tangential to my question.
               | 
               | Disregard any formal attribution to COVID 19 as a cause
               | of death - direct or indirect.
               | 
               | Parent was suggesting _all excess deaths_ are not _just_
               | due to COVID (directly or indirectly).
               | 
               | Sensibly allocating excess deaths to different categories
               | is really the question here, and I'm wondering what
               | caveats we should be careful about.
               | 
               | From a terribly abstract perspective, total excess deaths
               | within a population, year on year, prior and then during
               | a global pandemic, _should_ give us some useful
               | baselines.
        
               | Ensorceled wrote:
               | > Not OP. But it's becoming increasingly clear (to me, at
               | least) that data about reality has been lost.
               | 
               | Are you claiming that death counts are incorrect and data
               | about deaths have been lost?
        
               | zo1 wrote:
               | Not death-counts, but definitely data _about_ the deaths
               | yes. So detailed reasons for the death, specifics about
               | the death that may be pertinent, their covid history
               | prior to the death, how covid did or didn 't affect their
               | behavior that may have caused the death, etc.
               | 
               | Example: Are we keeping track of all the people that
               | skipped a routine test because of covid lockdowns? And
               | then, is there a subsequent record of that fact linked to
               | every covid case of death? Or are we stuck modelling the
               | correlation/overlap of those two data points because we
               | track those statistics across populations separately?
        
               | saalweachter wrote:
               | Eh, I think we have enough variation in local responses
               | that we'll be able to tease a lot of the data out with a
               | reasonable degree of confidence.
               | 
               | We're living in a world full of counterfactuals, with
               | some places mandating -- and enforcing -- mandates on
               | various public health measures rigorously, and other
               | places not.
               | 
               | The pandemic also has a time dimension. To the extent
               | that excess deaths are from deferred treatment and missed
               | testing, we expect them to get worse over time -- people
               | missing a cancer screening in March 2020 shouldn't have
               | resulted in excess deaths in April 2020, in the extreme.
               | "Real" COVID deaths meanwhile we'd expect to follow the
               | peaks and valleys of the infections.
               | 
               | It will be a lot of work, but that's what grad students
               | are for.
        
           | bena wrote:
           | But the vast majority would be.
        
           | csours wrote:
           | Sure. It doesn't matter at a national population level.
           | 
           | ---
           | 
           | Excess deaths is an epidemiological measure and should be
           | used for epidemiological purposes - targeting a public health
           | response.
           | 
           | It seems like quite a few people have confused epidemiology,
           | clinical care, and virology. Each of these fields can suggest
           | data for the others, but can't speak definitively until the
           | studies are actually done.
           | 
           | For example, some have said that omicron is more mild than
           | other variants; but it would be more correct to say that the
           | average experience of omicron in the population is more mild
           | AT THIS TIME.
           | 
           | At this time, many people have been vaccinated or recovered
           | from a previous infection, so without some very particular
           | data, you cannot say that omicron is more mild.
           | 
           | Edit:
           | 
           | > you cannot say that omicron is more mild than another
           | variant to any particular person in a clinical context.
        
             | renewiltord wrote:
             | The theory of the matter is that you take what's working
             | and you apply it and discard what's not working. The
             | practice of the matter is that if excess deaths goes up due
             | to drug use increasing during lockdowns, the public health
             | reaction is to increase lockdowns.
        
         | naasking wrote:
         | > Is a death of despair from isolation and unemployment a COVID
         | death?
         | 
         | Since that's driven by the response to COVID, I certainly don't
         | think it should be, because the response is a choice which
         | differs meaningful from a death by COVID infection or
         | comorbidity. Teasing apart the deaths directly caused by COVID
         | from those that indirectly led from our response to COVID is
         | important for making these decisions in the future.
        
         | donkeyd wrote:
         | Unfortunately, it's still not a great comparison. Countries
         | with lockdowns had less deaths from things like other
         | illnesses, traffic accidents, et cetera.
        
           | mohanmcgeek wrote:
           | It's still a better metric than some guy on science.com
           | effectively saying "I feel this number should be much higher"
        
           | lordnacho wrote:
           | The point is to capture all those effects together. People
           | who died in car crashes after 9/11 grounded all the planes
           | have in some sense died from the terrorist attack, even
           | though nothing at the scene suggests it.
           | 
           | Same with covid, if someone dies from undiagnosed cancer due
           | to lockdowns, they have been affected by covid in one way or
           | another. That's what the "with or from" comment is about, we
           | get past it by looking at the total effect.
        
             | josephcsible wrote:
             | > Same with covid, if someone dies from undiagnosed cancer
             | due to lockdowns, they have been affected by covid in one
             | way or another.
             | 
             | If a death would have been prevented by just not having
             | lockdowns, then tallies that it's included in being high
             | shouldn't be used to justify having lockdowns.
        
         | saalweachter wrote:
         | Excess deaths - and maybe a QALY-loss estimate - are the only
         | way to "score" the pandemic and different countries' response
         | to it, but I suspect there will be a lot of writing on "actual
         | COVID deaths" versus "deaths from hospitals deferring treatment
         | due to COVID surges" versus knock-on deaths attributable to the
         | pandemic, lockdowns, unemployment.
         | 
         | We're getting so much interesting data out of this pandemic,
         | both biological and sociological. Which public health measures
         | were effective? Which ones were acceptable to different
         | populations, and why? How does misinformation flow? How well
         | can governments control the narrative?
         | 
         | There are going to be PhD theses built on this for the next
         | ten, twenty years.
        
           | jeromegv wrote:
           | Deaths from hospitals differing treatment are also a great
           | assessment of COVID impact on society. If COVID hardly hit a
           | region, then they didn't need to delay surgeries. If COVID
           | ravaged through the country, likely the hospitals were
           | impacted and had to delay surgeries. All excess death is
           | relevant.
        
             | q1w2 wrote:
             | Right, but it's important to distinguish excess deaths
             | caused by covid and covid hostpital impacts vs excess
             | deaths caused by lockdown behavioral changes.
             | 
             | Lockdowns and mandates are something a region can
             | instrument independently, and we now have lots of data to
             | assess the benefits/impact of different degrees and types
             | of lockdowns and mandates in jurisdictions that were
             | impacted by the same number of new covid cases.
        
           | [deleted]
        
         | DanHulton wrote:
         | I've taken to calling them "Pandemic Deaths", ie deaths caused
         | by the pandemic, regardless of specific source. Makes it a
         | little harder to split hairs.
        
           | the_doctah wrote:
           | Then that should include suicides from lockdown inflicted
           | mental distress
        
             | jeffbee wrote:
             | You mean it should include a negative adjustment for the
             | fact that suicides fell in 2020 in the U.S.?
             | 
             | https://www.cdc.gov/nchs/data/vsrr/VSRR016.pdf
        
               | the_doctah wrote:
               | >Rates for persons aged 10-34 were higher in 2020 than in
               | 2019, whereas rates for persons aged 35 and over were
               | lower.
               | 
               | I highlighted the important part.
        
               | jeffbee wrote:
               | > only the 5% increase for those aged 25-34 (from 17.5 to
               | 18.3) was significant.
               | 
               | Hope that helps.
               | 
               | It's _super_ weird that people try to focus on this when
               | the larger failure of policy is that car crash deaths
               | were up more than 18%, resulting in far more absolute
               | deaths. You are talking about a change of 320 deaths
               | while the car crash increment was 3140 additional deaths.
        
             | xadhominemx wrote:
             | Australia had a severe nationwide lockdown and suffered
             | negative excess mortality in 2020
        
             | flerchin wrote:
             | It does
        
         | tinus_hn wrote:
         | And then if it turns out that lockdowns actually cause deaths
         | due to youth suicides, they'll be swept under the rug and be
         | used to excuse more lockdowns.
        
           | tinus_hn wrote:
           | An inconvenient truth.
           | 
           | https://www.nbcnews.com/news/us-news/youth-suicide-
           | attempts-...
        
         | loudmax wrote:
         | The Economist's excess death tracker is online here:
         | https://www.economist.com/graphic-detail/coronavirus-excess-...
         | 
         | The article was last updated in October 2021, but the data in
         | the charts is current insofar as it's available.
         | 
         | Their methodology is posted on Github here:
         | https://github.com/TheEconomist/covid-19-excess-deaths-track...
         | 
         | They get their data from the World Mortality Dataset
         | (https://github.com/akarlinsky/world_mortality). They claim
         | their modeled baselines fit a linear trend for year, to account
         | for long-term increases or decreases in mortality, and a fixed
         | effect for each week or month up to February 2020.
         | 
         | I haven't dug into the details of the methodology but it
         | appears very sensible. Of course it's very dependent on overall
         | mortality rates having been accurately reported to begin with.
         | 
         | If the Economist keeps this this chart going long enough, we
         | should expect that in countries worst affected by covid, future
         | mortality rates will fall below the expected baseline. The
         | simple (if somewhat morbid) logic being that in those places
         | the most vulnerable people will have already died.
        
           | xeromal wrote:
           | I find it strange China isn't in this list.
        
           | jeffbee wrote:
           | It doesn't sound like anyone really knows how many people
           | exist or are born or die in India, so it's not clear that the
           | Economist's attractive presentation of the data could have
           | any real basis in India, without a primary data source.
        
           | nonethewiser wrote:
           | Evidently the underlying dataset doesn't include China.
        
           | tersers wrote:
           | You are in luck, they just updated it today.
        
           | tarunupaday wrote:
           | I do not see any data about India
        
             | quietbritishjim wrote:
             | It's not in the table but there is a mention in the text
             | below:
             | 
             | > In India, for example, our estimates suggest that perhaps
             | 2.3m people had died from covid-19 by the start of May
             | 2021, compared with about 200,000 official deaths.
        
       | hnbad wrote:
       | I remember when I saw the first reports about Covid in India in
       | 2020 locals on social media were suggesting that despite the
       | reported mass deaths the unofficial numbers would likely be
       | significantly higher because only people who actually made it to
       | hospitals were counted and many people dying in rural/poorer
       | areas (where tests or even medical care weren't widely available)
       | were cremated without a diagnosis.
       | 
       | I'm not at all surprised to see that this may still be the case
       | now a year an a half later.
        
       | bigodbiel wrote:
       | For >70% seroprevalence, with IFR 0.5 (best estimates pre-
       | vaccination), and a population of 1.4 billion would still give
       | around 5 million deaths. I would expect India's IFR baseline to
       | be lower than average western (younger population, low obesity),
       | but surges would lead to healthcare collapse raising it.
        
         | [deleted]
        
       | Aldipower wrote:
       | India: 3,000,000 / 1,300,000,000 = 0.002307692307692308
       | 
       | Of course a lot and too much.
       | 
       | Germany: 120000 / 83000000 = 0.0014457831325301205
       | 
       | But why arguing with absolute non-comparable numbers without
       | context? Click rate?
        
         | 2-718-281-828 wrote:
         | I would argue this is neither a lot nor too much. That's my
         | personal opinion. But I would use this statistic as an argument
         | to relax a little and allow for controlled spread of Omicron
         | and have the pandemic become endemic finally.
        
           | [deleted]
        
         | cosenal wrote:
         | The point of the article is how India cases are very under-
         | reported. If it was just about officially reported death rate
         | of the country normalized by population, as you did in your
         | math, there wouldn't be an article at all.
        
           | Aldipower wrote:
           | Yes, I understand, my point is, why putting this absolute
           | number into the article title?
        
             | shagie wrote:
             | Germany has reported 114K deaths. India has only reported
             | 484K deaths.
             | 
             | There are other aspects to the underreporting of deaths -
             | https://www.science.org/doi/10.1126/science.abm5154
             | 
             | > The analyses find that India's cumulative COVID deaths by
             | September 2021 were 6-7 times higher than reported
             | officially.
             | 
             | From back in June - https://www.npr.org/sections/goatsandso
             | da/2021/07/20/1018438...
             | 
             | > The analysis, from the Center for Global Development, a
             | think tank in Washington, D.C., looks at the number of
             | "excess deaths" that occurred in India between January 2020
             | and June 2021 -- in other words, how many more people died
             | during that period than during a similar period of time in
             | 2019 or other recent years.
             | 
             | > Drawing death data from civil registries and other
             | sources, the report came up with three estimates for
             | undercounts. The conclusion is that between 3.4 and 4.7
             | million more people died in that pandemic period than would
             | have been predicted. That's up to 10 times higher than the
             | Indian government's official death toll of 414,482.
             | 
             | The story isn't about the number of deaths itself but
             | rather the underreporting of deaths. Another possible title
             | would be "Covid-19 believed to be underreported by 6-10x in
             | India" - though that fails to capture the sheer toll of the
             | death and isn't as eye catching.
             | 
             | There is nothing to compare it with in Germany (for
             | example) because the number of unreported covid-19 deaths
             | is likely very small in comparison to the totals.
        
               | taeric wrote:
               | I think the question is fair on "why isn't the headline
               | that actual deaths are over 6 times reported deaths?"
               | 
               | That is, the absolute number is big, but it is not that
               | that is the story. The story is how that big number
               | relates to another number.
        
             | birksherty wrote:
             | Because people died and it's data.
        
             | tgv wrote:
             | Because it's a pretty high number. It shows that if an
             | epidemic breaks out in an where it cannot be controlled,
             | the toll is high. If Andorra would have denied the
             | existence of COVID and refused to take measures, the
             | numbers would be a bit lower.
        
       | rep_movsd wrote:
       | Wow Look at China! 1000 people died on April 15th, 2020 and then
       | not a single death.
       | 
       | Imagine such an advanced country, we should all move there or
       | adopt their form of government!
       | 
       | https://news.ycombinator.com/item?id=29873938
        
         | ceejayoz wrote:
         | Enough information leaks out of China that we can be fairly
         | confident they at least don't have massive waves of deaths and
         | overwhelmed hospitals.
         | 
         | Totalitarian governments _can_ do better in this sort of
         | scenario, for a while. It 's not a great trade-off 99.9% of the
         | time, but there's a reason wars, disaster recovery, etc. tend
         | to be fought by executive fiat rather than democratic decision
         | making.
        
           | codeflow2202 wrote:
           | The only source of their stats is the party. It's part of
           | their politics to downplay the bad and show off the good.
           | They have nothing to gain by showing to their population that
           | they are weak in front of this pandemic.
        
             | tzs wrote:
             | There are only 22 countries that do not have diplomatic
             | missions to China.
             | 
             | The remaining countries have embassies, counsel general
             | offices, and similar throughout China. Beijing has 172
             | embassies plus missions from the EU, African Union, Arab
             | League, and the UN.
             | 
             | 24 other cities throughout China have counsel general
             | offices [1].
             | 
             | All of these have extensive contact with the local
             | populations, and all of them have secure means of
             | communication back to the home governments.
             | 
             | There are a large number of foreigners from a wide variety
             | of countries living in China for business reasons, or
             | visiting China for business reasons, who have extensive
             | contact with the local populations.
             | 
             | The party might be able to control the domestic flow of
             | information sufficiently to keep their own people in the
             | dark, but for events with wide impact such as epidemics and
             | pandemics they can't stop other governments from finding
             | out through reports from all those foreigners.
             | 
             | Conclusion: either China's death rates _are_ actually quite
             | low from COVID, or they are not and the other governments
             | (including the US, all of the EU, Japan, Australia, Korea)
             | know this but are keeping it secret themselves as are the
             | numerous non-government workers who regular are in China.
             | 
             | [1] https://en.wikipedia.org/wiki/List_of_diplomatic_missio
             | ns_in...
        
             | ceejayoz wrote:
             | The only source of _statistics_ is the party, but that 's
             | not the only source of _information_. If the healthcare
             | system was collapsing in China due to COVID megadeaths, we
             | 'd know.
        
               | bagacrap wrote:
               | Whether the healthcare system "collapses" has to do with
               | how hard it actually tries. We did get reports early on
               | that the crematoriums were working far more than usual.
        
               | ceejayoz wrote:
               | > We did get reports early on that the crematoriums were
               | working far more than usual.
               | 
               | That's precisely what I'm talking about, right? That
               | information got out; the world was able to see
               | information indicating a higher death toll that official
               | numbers implied, despite attempts to keep it quiet.
        
         | rei_ayanami wrote:
         | Yeah, communism for the win, we want more Tienanmen square
         | stuff and concentration camps for certain minority groups.
        
           | glogla wrote:
           | I think you missed the sarcasm.
        
       | godmode2019 wrote:
       | "He also focused on the large cities, where death rates may have
       | been lower than in the countryside"
       | 
       | Didn't the WHO estimate 120 million people would die in
       | developing countries of hunger brought on by economic conditions
       | of the pandemic.
       | 
       | This seems to meet the criteria. They also said delta was much
       | more deadly than alpha, 2021 being more deadly than 2020, ie
       | hunger, malnutrition, my guess is 2022 will be more deadly than
       | 2021. Due to the same reasons, mainly in the country side, poorer
       | communities.
       | 
       | The average age of registered people in India is 26, you should
       | expect a low IFR in such a population living in a warm climate,
       | with limited air conditioning - where you see summer spikes in
       | Texas for example.
        
       | hereforphone wrote:
       | Of course the daily stats aren't accurate. Not nearly so, I
       | believe. Some nations have better capability for testing. Some
       | nations have people wealthy enough to get tested or provide free
       | testing, whereas others do not. In some places, knowledge of
       | COVID-19 does not exist.
       | 
       | Does / did anyone really believe that the USA is the leading the
       | death count, when countries with more questionable infrastructure
       | and huge populations like China and India exist?
        
         | rhino369 wrote:
         | I would never trust the Chinese government to publish accurate
         | numbers. But their society definitely kept pre-Omicron covid
         | cases really low. Their infrastructure to identify and
         | quarantine cases is much better than the US's or Europe's since
         | they are an authoritarian state.
        
         | seanmcdirmid wrote:
         | China has pretty good testing infrastructure that they use
         | aggressively when any cases are found. Surely the residents of
         | Xi'an are being swabbed every week now.
         | 
         | But China is much more developed than India.
        
           | makomk wrote:
           | China has pretty propaganda-heavy testing infrastructure -
           | they do heavily publicised one-off mass testing of entire
           | cities which the state media points to as proof of their
           | superiority over other countries which aren't doing that, but
           | outside of that testing appears to be extremely questionable.
           | They've had pretty astounding incidents like not testing
           | people hospitalized with Covid symptoms in the one province
           | which had known, uncontrolled community spread at the time at
           | a point when Western countries (or at least the UK) were
           | systematically testing anyone who went near a hospital. And
           | of course testing entire cities is going to miss recently
           | infected people and doesn't help find cases outside the city
           | boundary, which is likely more common than they let on...
        
             | seanmcdirmid wrote:
             | It's not just propaganda though. Anyone who has family or
             | friends in China has heard gripes about how much testing
             | they are being subject to. You can't really dismiss them as
             | being brainwashed with the party line or something. China
             | has a zero COVID policy, and they are extremely aggressive
             | about that. I guess you are arguing that these policies are
             | just applied to the cities and not the villages?
        
           | hereforphone wrote:
           | Does China have a motivation to be honest about their
           | figures? Did they a year ago, or two years ago? Even if
           | they're honest now, no doubt they were first hesitant once
           | the cat (COVID-19 in this case) got out of the bag?
        
             | seanmcdirmid wrote:
             | China isn't North Korea, there are plenty of information
             | paths between China and the rest of the world that doesn't
             | go through the party. The party has motivation to be honest
             | in so much that if they weren't honest, it would be obvious
             | very quickly that they weren't tame they'd lose face.
             | 
             | Back when COVID first came out, local officials on the
             | ground were hesitant to bring attention to what they
             | thought was a minor problem at the time. Even when the
             | deaths began piling up, they were still trying to hide from
             | the central government, and even then, plenty of
             | information was leaking to the outside, everyone knew
             | something was up even if they weren't sure what it was.
             | However, once the central government got involved, well,
             | any chance of deception at the local level was off the
             | table. The central government doesn't really have a boss to
             | hide things from, so in that case, things work out for
             | transparency (but, ya, if they thought they could hide
             | something, they would be tempted to for face reasons).
        
         | pradn wrote:
         | In Egypt the minimum wage for public sector workers is EGP
         | 2,400 per month. A rapid test costs about EGP 700. Are the case
         | numbers accurate when even a rapid test costs as much as a
         | third of one's monthly salary?
        
       | geodel wrote:
       | Yeah, but is it surprising? Government would like to put only
       | confirmed cases in covid death and non-confirmed ones in 'other'
       | category. Media would like to put unconfirmed cause of death in
       | covid category and hence the higher number.
       | 
       | Somehow there is this assumption that higher number would lead to
       | outrage and cause changes for the better healthcare
       | infrastructure. I for one can't not agree that with current per
       | capita income level and tax revenues an order of magnitude
       | improvement in healthcare infra is possible.
        
       | mohanmcgeek wrote:
       | We have a post like this every month.
       | 
       | What incentive does the country have to under report COVID
       | deaths? Get some glorious trophy from the west on its stellar
       | COVID management?
       | 
       | Save face with people and continue winning elections? The people
       | don't blame the government for covid.
       | 
       | Not to mention, the numbers are reported independently by the
       | states, ruled by very different political parties.
        
         | Jedd wrote:
         | > We have a post like this every month.
         | 
         | I'm not sure that's true. And if it were to be true, I'm not
         | sure how it speaks against the claims made in this article?
         | 
         | > What incentive does the country have to under report COVID
         | deaths? Get some glorious trophy from the west on its stellar
         | COVID management?
         | 
         | I don't think TFA is trying to establish what incentives an
         | administration may have to try to demonstrate their
         | administration was more effective than it actually was.
         | (Though, having written that out loud ...)
         | 
         | > Save face with people and continue winning elections? The
         | people don't blame the government for covid.
         | 
         | I admire your optimism regarding the passive objectivity of
         | 'the people'.
         | 
         | Generally, I'd expect a population (within any ersatz
         | democracy) to evaluate the quality of its administrators based
         | on their performance during a pandemic, and subsequently vote
         | accordingly.
         | 
         | > Not to mention, the numbers are reported independently by the
         | states, ruled by very different political parties.
         | 
         | How would you expect this to play out if every incumbent
         | politician / political party in each state, was incentivised to
         | downplay mortality rates from COVID19?
        
           | mohanmcgeek wrote:
           | > And if it were to be true, I'm not sure how it speaks
           | against the claims made in this article?
           | 
           | I'm not sure how this somehow, every month, is "hacker"
           | "news"
        
         | toast0 wrote:
         | > What incentive does the country have to under report COVID
         | deaths? Get some glorious trophy from the west on its stellar
         | COVID management?
         | 
         | It's about incentives and costs at every level. If the person
         | filling out the death paperwork writes covid, does that require
         | more work than not writing covid (paperwork, cleaning, testing,
         | etc)? Does it bring shame to their work, their colleagues or
         | facility or community?
        
           | mohanmcgeek wrote:
           | What about the incentives of the "scientists" doing this
           | study?
        
             | BhavdeepSethi wrote:
             | Why don't you elaborate on that rather than posting a
             | leading question. I don't understand what a supposedly bias
             | scientist living in Canada has to gain from his analysis
             | about India?
        
         | herendin2 wrote:
         | This pandemic literally started with local politicians and
         | bureaucrats, in Wuhan, lying to their central government and to
         | the media about its effects, and grossly under-reporting
         | deaths. This accelerated the spread, or may even mean they
         | missed a window of opportunity to stop the spread.
         | 
         | It's obvious that officials have many incentives to downplay
         | the impact, and dodge and shift blame. When local officials
         | lie, their national government will probably repeat the lies,
         | perhaps unknowingly
        
         | mschuster91 wrote:
         | > What incentive does the country have to under report COVID
         | deaths? Get some glorious trophy from the west on its stellar
         | COVID management?
         | 
         | Local politicians may have other motives - there have been
         | close links of COVID prevalence among the extreme poor / in
         | slums [1], for example. Concealing COVID deaths may be an
         | attempt to hide the fact that the government has failed to
         | serve that community.
         | 
         | Additionally, there may be fiscal impacts based on COVID
         | classification - not sure what India in specific is doing, but
         | for example, the US covers funeral costs for COVID deaths.
         | Three million COVID funerals are _a lot_ of money.
         | 
         | > Save face with people and continue winning elections? The
         | people don't blame the government for covid.
         | 
         | Oh yes they do. A large part of why Germany's Conservative-led
         | coalition was shot down in last year's election was the
         | handling of the coronavirus pandemic - incompetence on all
         | levels of government as well as some conservative backbenchers
         | taking nearly 50 million euros in sketchy mask deals [2].
         | 
         | In contrast, _factually good_ management politics can earn
         | historic landslide wins [3].
         | 
         | [1]: https://arxiv.org/abs/2010.06958
         | 
         | [2]: https://www.sueddeutsche.de/bayern/bayern-lobbyregister-
         | poli...
         | 
         | [3]: https://www.bbc.com/news/world-asia-54519628
        
           | mohanmcgeek wrote:
           | > Oh yes they do
           | 
           | I should have been clearer. Indians don't blame the
           | government for COVID as evidenced by election results
           | everywhere in the country irrespective of the political
           | spectrum. Even places where the incumbents lost, COVID was a
           | non issue.
        
         | 99_00 wrote:
         | The incentive is obvious. And by looking at partisan media
         | outlets you can see that the political machines take it
         | seriously.
         | 
         | When Trump was in power CNN had a covid death count being
         | displayed 24/7. America's ranking in deaths was constantly
         | mentioned.
         | 
         | When he lost the election it was removed.
         | 
         | 2021 saw more covid deaths in the US than 2020. Despite
         | vaccines being available. This received almost no coverage.
         | 
         | And now, in the US the cases and deatha in individual states is
         | used for political gain by both sides. Especially when the
         | states governor is seen as a possible political candidate.
        
           | tombert wrote:
           | > When Trump was in power CNN had a covid death count being
           | displayed 24/7. America's ranking in deaths was constantly
           | mentioned.
           | 
           | CNN might be partisan but I don't know that this is a good
           | example. In 2020 COVID was new, and people were all clamoring
           | to see new updates about it. Trump being in office was (I
           | think) somewhat incidental.
           | 
           | In 2021, I think people are tired of hearing about COVID as
           | much and as a result it didn't get the total 24/7 coverage as
           | often. I remember a similar thing happening shortly after
           | 9/11.
        
       | reacharavindh wrote:
       | Not very surprised.
       | 
       | An Indian expat living in NL, with parents living back home in
       | India. My (retired, old) parents are afraid to get tested for
       | COVID because they hear way too many incidents from their
       | neighbourhood about "hospitals faking COVID test results just so
       | that they can admit them for 4 days, administer expensive drugs,
       | charge them some hefty bill, and send home". As stupid as it
       | sounds, I could not force my parents to go and wait in the line
       | to get COVID test, after he says "I believe I don't have COVID
       | now. But if I go to the testing center that is so badly managed
       | and understaffed where only people with obvious high level of
       | COVID are brought to get official result, I will get COVID
       | there!".
       | 
       | Say what you will, but if the basic trust in doctors and
       | healthcare is lost, how would people get tested, and how can you
       | trust any statistics from there?!
       | 
       | I'm ashamed, stupefied and angry at the same time.
        
         | victor106 wrote:
         | Most Hospitals in India are a really big scam.
         | 
         | Many of my colleagues got sick in Hyderabad and from what I
         | hear the hospitals directly sell drugs in black.
         | 
         | Three of them got admitted to yashodahospitals
         | (https://www.yashodahospitals.com/) and all three of them had
         | to pay 5x the price for Remdesivir. The worst part is this was
         | sold to them by the hospital management.
         | 
         | Also, in India, when a doctor refers you to a diagnostic center
         | for a lab test, the diagnostic center pays the doctor money in
         | the form of a kickback.
         | 
         | It's pathetic.
         | 
         | I live in the US and the healthcare situation is bad but not as
         | bad as in India. You would never want to get sick in India and
         | visit a hospital there.
        
         | nonamechicken wrote:
         | If they are worried about hospitals, please request them to go
         | to any of the independent labs that does covid tests. These
         | labs are not connected to hospitals, they get paid only for the
         | test, so doesn't matter to them whether the patient is positive
         | or not. Many in my family did that.
         | 
         | Also, when one of my family members got positive during the
         | first peak, they went to a local government hospital (small
         | town). They got really great care (including 4-5 doses of some
         | injection worth ~10000 Rs per dose if I remember correctly,
         | free food etc), and paid absolutely nothing.
        
         | saimiam wrote:
         | Does their city have at home testing where someone comes home
         | to collect samples and results are emailed to the patient?
        
         | triceratops wrote:
         | If your parents don't have symptoms, or have manageable
         | symptoms and are self-isolating, why bother testing? As long as
         | they're fully vaccinated they've done their absolute best in
         | this situation.
        
           | nradov wrote:
           | There are additional outpatient therapies that can be
           | medically indicated depending on symptoms, risk factors, and
           | locally approved care protocols. Most physicians will only
           | prescribe those therapies based on a positive PCR test. Some
           | of those therapies include monoclonal antibodies (less
           | effective now with the Omicron variant) or a brief course of
           | fluvoxamine.
           | 
           | But for vaccinated patients with mild symptoms and no major
           | risk factors, staying home and avoiding public testing sites
           | is a reasonable approach.
        
           | kenjackson wrote:
           | I think the self-isolation part is key. If they're doing that
           | as if they have Covid then I agree with you. And honestly, I
           | think the commenters parents have a fair point about being in
           | line with other likely Covid infected people.
        
         | sabujp wrote:
         | my in laws ordered a covid test, paid via paytm, the person
         | came and took the sample, took the money and never returned
         | results.
        
           | programmer_dude wrote:
           | Did you order a Thyrocare test by any chance?
        
             | sabujp wrote:
             | no, it was not a thyrocare, might have been a local
             | contractor working for apollo. However, my mom went
             | recently and for the return booked an at home travel test
             | collection through
             | https://www.metropolisindia.com/covid-19-test and was able
             | to get an rt-pcr result in less than 24 hrs.
        
         | keewee7 wrote:
         | The anglophile Indian elite is surprisingly ignorant of what is
         | going on in their own country. The anglophile Indian elite also
         | controls many aspects of the country.
         | 
         | This out-of-touch anglophile elite is the reason India is so
         | dysfunctional, even more than other poor developing countries.
        
           | api wrote:
           | That's interesting because for a long time there's been this
           | right-wing narrative about how "India benefited from British
           | colonization."
           | 
           | I suppose the British did introduce some technology and civic
           | systems, but they also probably fractured the society and
           | created a new kind of caste system.
           | 
           | How much of today's seeming culture of corruption in India is
           | a legacy of colonialism vs. how much was there already? I'm
           | asking because I'm only looking from a distance.
           | 
           | Also makes me wonder if the Chinese cultural revolution,
           | while a disastrous failure on very many levels, might have
           | erased a lot of the legacy of past colonialism... for the
           | same reason that a gigantic natural disaster might lead to
           | shiny new infrastructure after everything gets rebuilt.
        
           | pratik661 wrote:
           | This is an empirically accurate assessment. The priorities of
           | the Anglophone elite (which dominate the IAS and other parts
           | of the admin) are divorced from the priorities of the rest of
           | the country. This manifests in issues akin to what they call
           | "structural racism " in the US.
           | 
           | Ie: budgeting priorities; India over budgets IITs and other
           | elite institutions over other colleges and primary education.
           | This results in a system with excellent top universities, but
           | a steep drop in educational quality in tier 2 institutions
           | (and very low educational outcomes in public primary and
           | secondary schools).
           | 
           | The government also focuses on agricultural price stability
           | over farm income (ie banning agricultural exports during high
           | prices).
           | 
           | One can argue that the popularity of Modi and the other
           | regional satraps (with language based sub nationalism) is a
           | result of this institutional bias. Imagine how you would vote
           | if you couldn't participate in the economy of your hometown
           | because all the street signs/store names were in a language
           | you couldn't read.
        
             | selimthegrim wrote:
             | >The government also focuses on agricultural price
             | stability over farm income (ie banning agricultural exports
             | during high prices).
             | 
             | Given the farm law protests I don't know if you can pin
             | that one on the anglophone elite.
        
         | hiyer wrote:
         | In my apartment complex in India, we have ~300 apartments and
         | ~1000 residents. There have been over 70 cases of Covid here
         | since the beginning of last year (including 15 as I type this)
         | and only one of them was hospitalized - a 3 year old boy. All
         | the others were quarantined and recovered at home. I don't know
         | where your parents live, but what I've seen in Delhi, Bangalore
         | and Chennai (I don't have first/second-hand knowledge of other
         | places) is that hospitals refuse to admit you unless you
         | absolutely need to be admitted.
         | 
         | Edit - just to add, the kid mentioned above also recovered, but
         | he was hospitalized for a couple of days with very high fever.
        
           | maccard wrote:
           | OPs point was that it doesn't matter what the hospitals are
           | actually doing, if people don't trust them.
        
             | hiyer wrote:
             | True, but what I'm saying is there's no reason to mistrust
             | the hospitals as I've not seen the alleged behaviour at
             | all. Add to that the fact that you don't even need to go to
             | a hospital to get yourself tested in the first place - in
             | most cities you can get it done by a professional at home
             | (though it's possible OP's parents live in a rural area
             | where this facility is not available).
        
               | genghizkhan wrote:
               | The situation is far worse in smaller towns and cities in
               | places like Bihar and UP. I remember hearing stories
               | during the second wave (some of which I was able to
               | confirm) about doctors not telling family members that
               | their loved ones had passed away so as to be able to keep
               | charging the family for continued hospital care. The loss
               | of trust in the medical profession is very real.
        
               | zabhi wrote:
               | Can confirm. Have personally seen this in Patna, Bihar.
        
               | foobarian wrote:
               | I'm not from India and for the longest time it was
               | tempting to think of India as one homogeneous place; but
               | that is not what it's like at all. Isn't India enormous,
               | with many quite different states and different levels of
               | development? And bottom line, what percent of the
               | population has access to good quality health services vs
               | what the GP described?
        
               | hannofcart wrote:
               | This is exactly right. The disparity in the level of
               | healthcare that you would get in an Indian state like
               | Bihar vs that in a state like Kerala is similar to the
               | difference you'd expect between Sub-Saharan Africa and a
               | second world Eastern European country.
        
               | MisterBastahrd wrote:
               | Even in the US, there's a segment of the population who
               | are getting themselves killed by not getting vaccinated
               | and then refusing to accept proper medical care at the
               | hospital because they believe that COVID is a conspiracy
               | and that medical practitioners are in on the scheme. They
               | roll in 5 days after they start showing symptoms with low
               | oxygen levels hoping to find a doctor who will prescribe
               | ivermectin and vitamins to become self-fulfilling
               | prophecies when doctors refuse to treat them with things
               | that aren't approved or helpful.
        
               | pvaldes wrote:
               | Also in Europe. Death by ozonotherapy is real.
        
               | maccard wrote:
               | > True, but what I'm saying is there's no reason to
               | mistrust the hospital
               | 
               | That doesn't matter _if people don't trust the
               | hospitals_. Whether or not there's a reason for it is
               | insignificant.
               | 
               | > as I've not seen the alleged behaviour at all
               | 
               | As an aside, one anecdote doesn't mean that there's no
               | reason to mistrust the hospital. I have elderly relatives
               | in care homes, and I've not seen them abused. That
               | doesn't mean there's not a problem with abuse in care
               | homes here in the UK
        
               | hiyer wrote:
               | Well, it's not one anecdote - it's 70+ in my apartment
               | complex and probably 100+ overall, but I get your point.
        
               | eldaisfish wrote:
               | it is one anecdote. Too many indians of privilege do not
               | appreciate the fact that the majority of the country does
               | not have that same privilege. Seventy people around you
               | are all in the same social strata as you.
        
               | hiyer wrote:
               | Are you saying not being admitted to a hospital is a
               | privilege? I would think that if a hospital did want to
               | fleece someone, gainfully employed and insured people
               | would be the best candidates rather than poor people who
               | may not be able to afford the treatment.
        
               | fragmede wrote:
               | Trusting hospitals is the privilege being referred to.
        
               | geodel wrote:
               | Exactly right!. Some people take their own example from a
               | privileged position and claim that everyone can get same
               | treatment/service.
        
           | bongoman37 wrote:
           | Depends on where you are and how connected you are. In my
           | locality (Bangalore) a bunch of people who tested positive
           | got admitted to hospitals on 'precaution' even though they
           | were all mild and advised to isolate at home.
        
           | wrycoder wrote:
           | Cumulative Deaths: Selected Countries and States (per 100K)
           | 
           | https://ig.ft.com/coronavirus-
           | chart/?areas=eur&areas=usa&are...
        
         | laxmin wrote:
         | I am a physician and my contribution to this conversation might
         | not be appreciated, but here it goes. I work at a medical
         | university with two medical colleges and a wide healthcare
         | system and we were involved in the clinical trials for Covaxin
         | (India's indigenous vaccine) as we as Covid care and
         | immunisation. As a foot soldier, I am tired of fighting stories
         | such as yours that raise doubt on statistics with anecdotes.
         | The statistics maybe flawed, but we need some scientific rigour
         | in decrying them. Not 'my parents said' stories.
         | 
         | The anecdote about faking covid test results is plainly wrong.
         | There is a mechanism for registering every PCR-RT test that is
         | done along with the Aadhaar Unique Identity Number. The results
         | need to be validated at different levels. These have been
         | digitised. You can access your parents records online and
         | verify and validate them too. All this is available on your
         | mobile apps. The digitisation and workflow management make
         | faking the results very difficult if not impossible.
         | 
         | Hospitals are specially licensed to treat Covid. Not all
         | hospitals can admit covid patients. It is not like every small
         | clinic or hospital at the corner can simply admit patients. The
         | total bill for ANY COVID RELATED ADMISSIONS are capped. The
         | test fees are capped. There simply is not much incentive to
         | fake results when the fees cannot be charged on whim.
         | 
         | Of course, common people like your parents are fed
         | misinformation by the social media (anti-vaxxers movement in
         | the US) and a lot of fear about corporate profiting, big
         | pharma, etc are the usual trope.
         | 
         | Big pharma sure profits, but they profit most off such staple
         | as baby powder and insulin. Their profits, data of efficiency
         | on vaccines etc are under glare of scientific scrutiny, while
         | their pain killers and opioids are where they don't get any
         | investigation.
         | 
         | The death rates on the other hand in India are under reported
         | and there is a huge backlog that is being cleared right now.
         | 
         | You may not believe it, but India's response to the pandemic
         | has been nothing less than fantastic, given the sorry affairs
         | of its health infrastructure. The mechanisms at every level
         | worked satisfactorily. Were they miraculous? no.
         | 
         | Efficient given the resources? Yep. It could have been worse.
         | Far far worse.
         | 
         | Edit. Oh I forgot to add... our hospitals lost a lot of money
         | and our entire budget. We had to borrow to keep things running
         | and are in the red for the next few years.
         | 
         | So all this 'profiteering'... try running a hospital.
         | 
         | Edit 2: The local administration commandeered our hospitals to
         | set up Covid wards. Admissions were made electronically for
         | hospital based observational wards. Food and medicines were
         | made free for all the admitted patients. Also, Oxygen. Did I
         | tell about the overtime payments to doctors, nurses and
         | paramedical staff? All from the hospital funds. Patients paid
         | nothing. Thats right. Nothing. Not a cent.
        
           | nonamechicken wrote:
           | I also appreciate your contribution. Unlike a lot of the so
           | called NRIs, at least you chose to stay and do your part to
           | make India better.
        
             | gadders wrote:
             | FYI for those wondering - NRI stands for Non-Resident
             | Indian/Not Really Indian depending on how pejorative you
             | want to be.
        
               | nonamechicken wrote:
        
               | [deleted]
        
           | justicezyx wrote:
           | Nicely explained.
           | 
           | India should be an example of underdeveloped nation managing
           | their covid situation. I'd like these policies to be
           | documented and shared with UN med and shared with the world.
        
           | eldaisfish wrote:
           | large parts of this comment are an appeal to authority.
           | India's response to the pandemic was an absolute disaster to
           | the poor who incidentally make up the majority of the country
           | and whose voices are rarely heard. This comment reeks of
           | privilege and a lack of information about just how bad the
           | indian medical situation is.
           | 
           | As just one example, india STILL does not have a good handle
           | on WHAT is killing people. Up until 2018, there were annual
           | death surveys to determine the cause of death. Think about
           | that - people go door to door and record verbal responses
           | about how people died. That is how poor data in india is.
           | 
           | These are not anecdotes and you should - respectfully - stop
           | taking anything the indian government says at face value.
        
           | obelix74 wrote:
           | I agree with almost everything you say. Hospitals saved my
           | MIL when she caught Covid in 2020 and had lungs affected. She
           | was treated by a Doctor via video and only a nurse (hired a
           | month ago, new to her job) doing the actual physical work.
           | 
           | My only gripe is the shame that is attached to testing
           | positive. The system kicks into extraordinary paranoia when
           | someone tests positive. That is the reason why people refuse
           | to be tested. My MIL did not test for weeks after she started
           | coughing. Thankfully, my SIL traveled from the US forced her
           | to test and admitted her.
           | 
           | I understand the reasons and the struggle of the hospitals,
           | but there is a bit of heavy handedness (nowhere near China, I
           | must admit) that is scaring people away.
           | 
           | I am thankful to the Doctors and nurses of India. They have
           | saved at least two lives in my immediate family.
        
           | reacharavindh wrote:
           | Hey. A lot to unpack here. But, first, THANKS!! for
           | everything you do and the care you have for doing things
           | right. Please don't take criticisms such as mine to mean that
           | "everything is wrong and everyone is wrong" instead of its
           | actuality where there is something wrong amidst several
           | right.
           | 
           | With that out of the way, I did try to explicitly say that my
           | experience is not first hand and that it is of that from my
           | parents and my frustration that they cannot get tested as
           | often as I can in the NL, and trust the local healthcare
           | setup as I do here.
           | 
           | I for one am a lot relieved to hear from you that the digital
           | systems are put to good use in verifying COVID tests,
           | administration of vaccines, treatment, bills etc.
           | Unfortunately, my parents concerns were still not addressed
           | by these re-assurances. One may still test positive for
           | COVID, but not really need the excessive medical procedures
           | that the private hospitals/doctors do with monetary aims.
           | Even worse, a doctor could simply admit someone for a couple
           | of days and run all the tests only to come up and say after 2
           | days and a bill of several thousand rupees, - "your covid
           | test was negative", please be careful about your other
           | problems we took care of.
           | 
           | Secondly, if the regional testing centers or doctor's offices
           | are as badly managed and under-staffed as my dad claims in
           | his region, it is hard to trust the rest of the system to
           | work, and not be scared of contracting covid just by visiting
           | the test centre. I realise that India is big, diverse and
           | unequal so it may not be the case where you are.
           | 
           | One of the reasons, I am stupefied, angry and scared is also
           | from your list...
           | 
           | > our hospitals lost a lot of money and our entire budget.
           | 
           | > Did I tell about the overtime payments to doctors, nurses
           | and paramedical staff? All from the hospital funds. Patients
           | paid nothing
           | 
           | At least from a sample size of two (in a country with a
           | couple billion people), it is not true. My uncle and aunt
           | were hospitalised. for "mild" covid late last year, and came
           | back home after 4 days with a fat bill, lot of frustration
           | from defending against what they perceived as needless tests,
           | and of course COVID. A private hospital could still keep the
           | COVID cost to whatever regulatory maximum is, and still do
           | absurd tests to milk the patient's insurance policies :-(
           | 
           | The only way for this system to gain trust is transparency.
           | For patients to take hospitals to court with trustworthy
           | judicial system. However, here we are where India reports a
           | few lakh people died, and researchers claim it is wrong by
           | several orders of magnitude :-(
           | 
           | I trust the sincere work of yours. But, we have a long way
           | before that can be applied to the majority.
        
           | steelstraw wrote:
           | > Big pharma sure profits, but they profit most off such
           | staple as baby powder and insulin. Their profits, data of
           | efficiency on vaccines etc are under glare of scientific
           | scrutiny, while their pain killers and opioids are where they
           | don't get any investigation.
           | 
           | Pfizer reported that earnings and sales more than doubled in
           | the past quarter, and it raised its outlook for results the
           | full year, thanks greatly to its Covid-19 vaccine.
           | 
           | The vaccine business alone was responsible for more than 60%
           | of the company's sales, as vaccine revenue rose to $14.6
           | billion from only $1.7 billion a year earlier. The company
           | said its Covid vaccine sales accounted for $13 billion of
           | that revenue. Revenue outside of its Covid vaccine business
           | was up a far more modest 7%.
           | 
           | https://www.cnn.com/2021/11/02/business/pfizer-
           | earnings/inde...
           | 
           | It's the largest part of the business now, and they are
           | protected from downside: Under the PREP Act, companies like
           | Pfizer and Moderna have total immunity from liability if
           | something unintentionally goes wrong with their vaccines.
           | 
           | https://www.cnbc.com/2020/12/16/covid-vaccine-side-
           | effects-c...
        
           | statguy wrote:
           | > You may not believe it, but India's response to the
           | pandemic has been nothing less than fantastic
           | 
           | Come on, India was probably the only country in the world
           | where there were dead bodies floating in rivers.
           | https://www.bbc.com/news/world-asia-india-57154564
           | 
           | During the second wave in April-May 2021, which India had
           | ample time to prepare for, hospitals just didn't have oxygen.
           | 
           | https://www.tribuneindia.com/news/haryana/ex-envoy-dies-
           | wait...
           | 
           | https://www.washingtonpost.com/world/2021/04/21/india-
           | hospit...
           | 
           | States purposely undercounted their death tolls by vast
           | amounts.
           | 
           | https://twitter.com/deepakpatel_91/status/139341986118379930.
           | ..
           | 
           | That said some states like Kerala and Maharashtra managed the
           | pandemic much better than others like UP and Bihar, so your
           | experience could be based on one of the better performing
           | states.
        
             | nonamechicken wrote:
             | The dead body floating thing happened in 1 or 2 states. My
             | understanding is that dumping the body in Ganges is a
             | cultural thing in some towns in those states. Someone from
             | there told me that the older generation wants their body to
             | be thrown in Ganges or buried on the shore so that they can
             | get 'moksha'.
        
               | statguy wrote:
               | > The dead body floating thing happened in 1 or 2 states.
               | 
               | Those were the worst hit states - UP and Bihar. What was
               | observed during the second wave was not normal, something
               | like that last happened in 1918 after the Spanish flu:
               | 
               | https://www.bbc.com/news/world-asia-india-57068503 "This
               | is not the first time bodies have floated up in rivers in
               | India during a pandemic.
               | 
               | "The River Ganga was swollen with dead bodies", the
               | famous Hindi language writer and poet, Suryakant
               | Tripathi, better known as Nirala, wrote about the 1918
               | outbreak of Spanish flu in his village in a province
               | which is now India's Uttar Pradesh state."
        
               | nonamechicken wrote:
               | While I agree that we shouldn't be seeing bodies in
               | rivers, I am not entirely convinced if Covid and Spanish
               | flu in India are comparable.
               | 
               | The below links say bodies were found in many rivers, not
               | just Ganga.
               | 
               | "A report released by the sanitary commissioner in 1918
               | later documented that it was not just Ganga that was
               | clogged up with bodies, but all rivers across India."
               | 
               | https://economictimes.indiatimes.com/news/politics-and-
               | natio...
               | 
               | https://en.wikipedia.org/wiki/1918_flu_pandemic_in_India
               | 
               | I don't think if scenarios such as below are happening in
               | India, the leftist Indian media would stay silent.
               | 
               | "India perhaps never saw such hard times before. There is
               | wailing on all sides. ... There is neither village nor
               | town throughout the length and breadth of the country
               | which has not paid a heavy toll.
               | 
               | Elsewhere, the Sanitary Commissioner of the Punjab noted,
               | "the streets and lanes of cities were littered with dead
               | and dying people ... nearly every household was lamenting
               | a death, and everywhere terror and confusion reigned."
               | 
               | https://theconversation.com/1918-flu-pandemic-
               | killed-12-mill...
        
               | nonamechicken wrote:
               | Just found out that there was a similar incident back in
               | 2015 where they found more than 100 dead bodies in Ganges
               | in the same region. It was also reported by BBC. Now I am
               | wondering if BBC conveniently forgot that and went far
               | back to 1918, just so that they can compare India's
               | current situation to Spanish flu?
               | 
               | https://www.bbc.com/news/world-asia-india-30808745
               | 
               | https://en.wikipedia.org/wiki/Unnao_dead_bodies_row
        
               | valarauko wrote:
               | It is NOT a cultural practice in either of these states
               | to simply "dump the body" in the Ganges. The tradition is
               | to scatter the ashes in the river. Wood burnig open air
               | cremations along the river bank is the norm, which takes
               | several hours to reduce a body to ashes & bone fragments.
               | Under usual conditions, a family member would remain with
               | the pyre till the end, and would collect the bone
               | fragments, mostly the next day. A lot of the leftover
               | material is wood ash, which would be deposited in the
               | river directly by the crematorium workers. Historically
               | when resources have been tight & crematoriums overwhelmed
               | by epidemics in the past, a family member would not be
               | present, and unscrupulous crematorium workers would
               | overturn partly cremated bodies in the river to ensure
               | fast turnover, which is what seems to have happened in
               | 2020. Desperate families might also inter the bodies
               | directly in the river.
        
               | nonamechicken wrote:
               | Unless I misunderstood, someone I know from one of these
               | 2 states recently told me their grandparent wanted to be
               | disposed of like that. They said their generation or
               | their parents don't believe in such practices.
               | 
               | According to the below article, some communities do
               | practice dumping body in Ganges.
               | 
               | "He further informed that the practise of dead body being
               | disposed in the rivers is prevalent in two particular
               | stretches in central/eastern U.P. and the epicentre of
               | which is in Kanpur Unnao region in central U.P and
               | Banaras-Ghazipur area in eastern U.P"
               | 
               | https://indianexpress.com/article/india/practice-of-
               | bodies-b...
               | 
               | There was also another incident in 2015 from the same
               | Unnao region where they found more than 100 bodies in
               | Ganges.
               | 
               | https://en.wikipedia.org/wiki/Unnao_dead_bodies_row
        
               | valarauko wrote:
               | Like I mentioned at the end of the initial comment, some
               | families do indeed inter the bodies directly in the
               | river, unable to afford the cost of cremation - this is
               | also mentioned at the end of the wiki article you linked.
               | This isn't new or surprising information. If there are
               | communities that do this as a matter of routine, it's
               | certainly not a significant source considering the 100s
               | of millions who live along the river, where these
               | community's dead mostly disappear without record into the
               | river. For what its worth, it's certainly not a standard
               | practice for the region. If bodies were present at
               | significantly larger numbers in 2020, it suggests that
               | either communities that do not traditionally practice
               | interring in the river were doing it out of desperation,
               | or that the traditional communities suffered
               | significantly more deaths in the Delta wave, both of
               | which are troubling concepts. The other possibility is
               | that these were unclaimed bodies unceremoniously
               | discarded by the civic administration, and the angle
               | perhaps most appealing to those opposed to the current
               | political dispensation.
               | 
               | EDIT: regarding the anecdote about a grandparent asking
               | for this, there's a lot of context we don't know. Rather
               | than a traditional practice, it might simply be a comment
               | based out of frustration about the expense & bother to
               | the family for a "standard" funeral. I also have family
               | from the region and I've never heard of this as a
               | standard routine widespread practice. For the most
               | disadvantaged communities, I can understand it.
        
               | srean wrote:
               | From the link that you pointed to
               | Police officials of Unnao have offered an explanation
               | that the bodies were         of "people who were dumped
               | in the river or buried on the banks after their
               | families could not afford a proper cremation."
               | 
               | You are trying hard to give the story a spin that dead
               | bodies in the river in such numbers is nothing notable.
               | 
               | Government contractors pressed into removing
               | commemorative burial markers less they be counted by
               | drones
               | 
               | https://www.youtube.com/watch?v=ZiLzIuMsnW0
               | 
               | Let me find something in English to give context on these
               | shallow graves
               | 
               | https://www.youtube.com/watch?v=6Q6hYu3EsC0 (will give
               | viewers an idea of the mindboggling scale of the
               | phenomenon)
               | 
               | The following videos are not in English but you should be
               | able to get a sense of the numbers by looking at them
               | 
               | https://www.youtube.com/watch?v=ALO0VjfxXDA (pardon the
               | annoying and unnecessary dramatization music)
               | 
               | https://www.youtube.com/watch?v=8DWWeOt4jWM
        
             | kaesar14 wrote:
             | To be fair, there is no country in the world operating with
             | as little resources for as many people as India. The scale
             | of administrating a pandemic response in India is mind-
             | boggling.
        
           | EngCanMan wrote:
           | Thanks for the comment. Are you able to elaborate on the big
           | pharma profits most on baby powder, insulin and pain killers?
           | In the world I live in, they pushed those markets to the
           | brink in the form of baby powder lawsuits, an epidemic of
           | obesity and the opioid crisis. Also, have you looked into
           | Pfizer's profits for 2021?
           | 
           | https://www.cnn.com/2021/11/02/business/pfizer-
           | earnings/inde...
           | 
           | Edit: Baby Powder Lawsuit -
           | https://www.nytimes.com/2020/06/23/health/baby-powder-
           | cancer...
           | 
           | Obesity Worldwide - https://www.who.int/news-room/fact-
           | sheets/detail/obesity-and...
           | 
           | Opioid deaths began with increased prescription -
           | https://www.cdc.gov/opioids/basics/epidemic.html
        
           | saurik wrote:
           | The way the comment you are responding to was written and
           | explicitly quoted, and yet said the commenter was still
           | trying to get their parents to go despite the multiple
           | objections, made it to me sound like they were not claiming
           | the things you are defending against but merely restarting
           | them as something the parents said.
        
           | jowdones wrote:
           | Well, I for once, appreciate your contribution :)
        
         | metb wrote:
         | As a caring child of old parents, you should get your parents
         | to NL where you can provide the best possible care for them,
         | instead of letting them die in a place where they can't even
         | get a COVID test done.
        
           | nonamechicken wrote:
           | > instead of letting them die in a place where they can't
           | even get a COVID test done.
           | 
           | I find it hard to believe that they are unable to get tests.
           | During the peaks, it may have been true. Outside of that,
           | there was no shortage. And we don't even need to go to
           | hospitals for covid tests, there are plenty of independent
           | labs. So, if their parents don't trust hospitals, they can go
           | to those testing centers instead. Many in my family did that,
           | that too 2-3 times (since they have to show negative RT PCR
           | result for travel).
        
             | rjv8 wrote:
             | > I find it hard to believe that they are unable to get
             | tests.
             | 
             | Yes, he is probably just dissing his country to earn some
             | "brownie points".
        
           | MandieD wrote:
           | If OP's parents are anything like my dad, they have zero
           | interest in trading their warm homeland with its familiar
           | language and culture for cold northern Europe. My dad would
           | rather die in Texas than live in Germany, much as he enjoyed
           | spending a week here this summer meeting his grandson.
           | 
           | Older people have attachments other than their grown-up
           | children.
        
             | reacharavindh wrote:
             | This. My parents have zero interest in spending their older
             | years in a region that doesn't speak the language they
             | know, colder, and has simply a different way of life than
             | theirs not to mention their social circle.
             | 
             | I wholeheartedly agree with their choice, and will do my
             | best to help them where they are.
        
               | rjv8 wrote:
               | When millions are dying around them helplessly for want
               | of good care, it seems cruel to let them fend for
               | themselves in their old age, where they are scared to
               | consult a doctor. If they are not willing to come to you,
               | shouldn't you visit, and take care of them in these
               | difficult times?
        
               | nonamechicken wrote:
               | I have been also wondering about this. My impression is
               | that Tamil Nadu is much better in terms of health care
               | compared to many Indian states. So, its strange that the
               | parents are refusing to get tested. I am thinking that
               | the parents are afraid to take public transport, and they
               | don't want to burden their NRI son/daughter, so are
               | making up excuses.
        
               | srean wrote:
               | Tamil Nadu, Kerala are significantly ahead in many key
               | social and public health metrics. Were they not been
               | compensated for by BIMARU (roughly, Bihar, MP, Rajasthan,
               | Uttar Pradesh) states India would be competitive with
               | first world standards. Unfortunately, the BIMARU states
               | are the most populous and consequently controls the
               | political fate of the rest of the country.
        
               | reacharavindh wrote:
               | The issue needs more context. It's not that they are
               | fending for themselves in their old age. They are
               | retiring in a village with a social circle they are
               | comfortable with, and near a temple that they consider as
               | pilgrimage, and have my sister who can reach them in
               | couple of hours should there be a dire need.
               | 
               | I'd visit if it would be of any help.
        
         | blocked_again wrote:
         | India compromises of 28 states. And all most all of them have a
         | population bigger than New Zeland and some of them even have
         | populations bigger than Brazil. Stop over generalizing your
         | experiences with one state in India with entire India. What one
         | experiences in Bihar or UP would be completely different from
         | what one experience in Kerala or Goa for example. Be specific
         | when talking about your experience in India.
        
           | selimthegrim wrote:
           | *is comprised of
           | 
           | e: Muphry's Law got me. Comprises or is composed of is fine.
        
             | blocked_again wrote:
             | The point of language is to communicate. As long as you
             | understand what the person is saying it's good enough. Once
             | you start cherry picking on the syntax itself you are
             | missing the actual point of why the language was invented
             | in the first place.
        
               | spiffistan wrote:
               | Not when what you write (compromises) literally mean
               | something radically different. That's not syntax.
        
               | blocked_again wrote:
               | You still understand the context right. What's the point
               | of cherry-picking then?
        
               | programmer_dude wrote:
               | I don't think you understand what cherry-picking means.
               | Also syntax, grammar and pronunciation are important.
               | Understanding the context is not enough.
        
               | nonamechicken wrote:
               | I am guessing 'blocked_again' is from India, which means
               | English is not their native language. Having to translate
               | ones thoughts to a foreign language itself is hard, so I
               | am with 'blocked_again' on this.
        
               | programmer_dude wrote:
               | I am from India too. People can learn.
        
               | selimthegrim wrote:
               | My mother is Pakistani if that makes people feel better.
        
         | agumonkey wrote:
         | It's not as bad but it's not too different from other
         | countries. Trust has evaporated in France, it didn't devolve
         | into full on medical scam like what you describe, but the
         | feeling is the same. People don't trust doctors or nurses and
         | can't go willingly there (hence the limited vaccination rate).
        
           | sofixa wrote:
           | > hence the limited vaccination rate).
           | 
           | Of _checks notes_ 73% of all eligible ( 5 years or older, all
           | doses required ( booster included), and it was 12 years or
           | older until yesterday, so there 's a huge drop since then).
           | Many were forced by restrictions on everyday life, but still,
           | that's certainly not "limited".
        
         | 2-718-281-828 wrote:
        
           | pps wrote:
           | > Germany is also infamous in EU for its antibiotic resistant
           | hospital bugs like MRSA.
           | 
           | Never heard that this is a problem in Germany. Maybe because
           | Poland is so much worse in regards to healthcare.
        
             | 2-718-281-828 wrote:
             | https://www.scinexx.de/news/medizin/deutschland-bis-
             | zu-20-00...
             | 
             | https://www.zdf.de/verbraucher/volle-kanne/studie-zu-
             | kranken...
             | 
             | https://www.zdf.de/nachrichten/politik/sepsis-deutschland-
             | kr...
             | 
             | > Never heard that this is a problem in Germany. Maybe
             | because Poland is so much worse in regards to healthcare.
             | 
             | Then you are not well informed.
        
           | raxxorrax wrote:
           | > Intubations which aren't required and actually harmful and
           | traumatizing.
           | 
           | If this happened you certainly need get it to a lawyer. It is
           | not much, but there are some way for recourse. You almost
           | certainly have permanent damage after intubation.
        
             | 2-718-281-828 wrote:
             | not me and not anybody I know. for what it's worth I don't
             | know anybody who got any health issues from corona much
             | less having to seek medical help.
             | 
             | https://www1.wdr.de/daserste/monitor/sendungen/gefaehrliche
             | -...
             | 
             | https://www.welt.de/politik/deutschland/article207311157/Co
             | r...
        
           | pfyra wrote:
           | > Recently went to the doc for a normal cold.
           | 
           | Why see a doctor for a regular cold? I've never heard anyone
           | do that here in Sweden.
        
             | 2-718-281-828 wrote:
             | because I need a doc's certificate to show my employer?
        
               | pfyra wrote:
               | Ok, I expected some kind of treatment. We do need the
               | same certificate in sweden too, but only from the 5th
               | sick day or so and I think they give certificates for
               | regular cold over the phone.
        
               | detaro wrote:
               | Exactly to avoid the thing you are complaining about
               | doctors are allowed to give those out over phone during
               | the pandemic.
        
               | 2-718-281-828 wrote:
               | they need the card at the beginning of a quarter. I was
               | sick few days ago.
        
               | detaro wrote:
               | That is not a legal requirement, no. (not just for AUs,
               | but a bunch of other things too it has been waived, again
               | so that people don't need to go visit their doctors in
               | person during the pandemic if it can be avoided. You can
               | call a doctor you never went to for a sick note or a
               | video consultation)
        
               | 2-718-281-828 wrote:
               | me ask woman on telephone of doctor that me coughing and
               | headache - me need coming or this fine? she - yes you
               | come must ... end of story
        
               | morsch wrote:
               | There has been an exemption to this rule for a while now.
               | If your doctor doesn't do it, find one who does.
               | 
               | As for hanging around in a waiting room, I agree it's
               | insane on many levels. I usually ask very directly if
               | it's okay to come back in a while instead of waiting
               | around. Though my primary health care provider has people
               | with a cold wait outside in their garden, which is much
               | better if you come prepared.
               | 
               | https://www.dak.de/dak/ihr-anliegen/corona-telefonisch-
               | krank...
        
             | skocznymroczny wrote:
             | Sometimes these days it feels like people forget cold
             | exists. They catch a cold, get mild symptoms, and their
             | first thought isn't "oh, I'm glad it was just a cold and I
             | quickly recovered" but "wow, good thing I got vaccinated,
             | these covid symptoms were really mild".
        
           | sparselogic wrote:
           | > We also have reports of systematic hospizalization where
           | ambulant treatment would be possible and recommended.
           | Intubations which aren't required and actually harmful and
           | traumatizing.
           | 
           | Source?
           | 
           | BTW - it's only an anecdote, but a coworker in DE had a very
           | different experience. After a week of significant symptoms
           | but self-administered rapid tests coming back positive, they
           | contacted the hospital for a checkup. Upon entry they
           | received another rapid test: as soon as it came back
           | positive, the hospital verified that their lungs were
           | functional and then sent them home as quickly as possible.
        
           | tonyjstark wrote:
           | > This sounds similar to what is going on in Germany. We also
           | have reports of systematic hospizalization where ambulant
           | treatment would be possible and recommended. Intubations
           | which aren't required and actually harmful and traumatizing.
           | Same reason - financial incentives.
           | 
           | Never heard of that in any of a variety of news sources I
           | consume, without a credible source I heavily doubt it.
           | Instead it seems like doctors currently urge people to take
           | precaution (like getting vaccinated) to keep them away from
           | hospital because of the work load.
           | 
           | > Recently went to the doc for a normal cold. Was standing in
           | a small unventilated corridor for half an hour with several
           | coughing people.
           | 
           | A lot of doctors now offer visits via video chat, if you need
           | a sick leave for work it's often enough just to call the
           | doctor and they send you the papers.
           | 
           | True, there are problems with resistant bugs in hospitals and
           | there are problems with testing facilities. The 'ashamed,
           | stupefied and angry' feeling in Germany however can't be
           | generalized like that: Some feel like they're living in a
           | dictatorship because they have to wear a mask, some are angry
           | because of the unclear and reactionary handling of the
           | pandemic on a political level, some don't believe in science
           | but follow alternative medicine or just think all of it is a
           | big hoax, and there probably many more reasons people have.
           | 
           | Overall, Germany still has a pretty good record on keeping
           | people alive while never using really hard measures. What we
           | really could use though is a more civil communication.
        
             | bonzini wrote:
             | > > We also have reports of systematic hospizalization
             | where ambulant treatment would be possible and recommended.
             | Intubations which aren't required and actually harmful
             | 
             | > Never heard of that in any of a variety of news sources I
             | consume,
             | 
             | And I heard exactly the same about Italy from news sources
             | that no one in their right mind would trust, which actually
             | corroborates your point.
        
             | 2-718-281-828 wrote:
             | https://www1.wdr.de/daserste/monitor/sendungen/gefaehrliche
             | -...
             | 
             | https://www.welt.de/politik/deutschland/article207311157/Co
             | r...
             | 
             | also check interviews of Prof. Klaus Stohr - he mentions
             | that regularly.
             | 
             | > A lot of doctors now offer visits via video chat, if you
             | need a sick leave for work it's often enough just to call
             | the doctor and they send you the papers.
             | 
             | they need my physical HI card every quarter ...
             | 
             | > Overall, Germany still has a pretty good record on
             | keeping people alive while never using really hard
             | measures. What we really could use though is a more civil
             | communication.
             | 
             | Deaths per infections is relatively high compared to other
             | EU countries. Again, check Prof. Stohr interviews.
        
               | tonyjstark wrote:
               | The WDR link discusses different opinions on intubation
               | as well as the fincial incentives. It even mentions that
               | guidelines got adjusted which led to less invasive care.
               | The second link is very 'Welt'-typical, at first using
               | almost tabloid language only to then not delivering on
               | the promise. The interviewee goes into the topic of
               | hospitals having the wrong financial incentives for
               | optimizing the duration of intubation but doesn't accuse
               | a systemic wrong-doing or patient harming. Fair enough,
               | the system is not perfect but it's far from "systematic
               | hospitalization where ambulant treatment would be
               | possible and recommended". Not sure about Prof. Stohr, I
               | read some of his criticism on how the pandemic is handled
               | regarding schools, the idea of a mandatory vaccine and
               | things like country wide measures vs. more local adjusted
               | measures. I didn't hear him saying there is a _systemic_
               | problem of wrongly administered intensive care just to
               | make money.
        
           | reacharavindh wrote:
           | Unsafe Doctor waiting rooms and dubious testing kits in
           | Germany are some big claims that need some serious sources to
           | be taken as truth.
           | 
           | Particularly if said by a person that says "Arab
           | Familienclans".
        
             | 2-718-281-828 wrote:
             | oh really?
             | 
             | https://www.youtube.com/watch?v=s157CbfS5xg&list=PLuiYhcgFT
             | m...
             | 
             | > Unsafe Doctor waiting rooms
             | 
             | what source? it's trivial to verify. visit a couple of
             | doctors in the city of a large German town and count number
             | of people sitting in a room with special notice to those
             | who are coughing and sneezing ...
             | 
             | > dubious testing kits
             | 
             | I'm not aware of systematic audits of test kits. In Germany
             | a device is considered alright if it has a CE printed on it
             | and maybe some other numbers. That's a usual source of many
             | problems with food, toys etc. nothing new here. Also it's
             | currently in the media that not all test kits respond
             | equally to Omicron - so, it's not like they are
             | standardized. They are now starting device specific audit
             | to check for sensitivity.
        
               | tloup wrote:
               | >In Germany a device is considered alright if it has a CE
               | printed on it and maybe some other numbers.
               | 
               | No. I'm a software engineer for clinical studies and
               | medical devices and this is not true for any medical
               | device, which includes antigen tests, at all. Also these
               | tests had a time limited special permit which ran out a
               | few months ago, which is why they were able to be sold.
               | here is a FAQ about antigen tests:
               | https://www.bfarm.de/DE/Medizinprodukte/_FAQ/Antigen-
               | Tests/f...
               | 
               | >Die Neubewertung hat ergeben, dass ein gravierender
               | Versorgungsengpass und damit das Interesse des
               | Gesundheitsschutzes an einer Sonderzulassung
               | entsprechender Tests nach SS 11 Abs. 1 MPG durch das
               | BfArM nicht mehr besteht. Diese Bewertung wird ab dem 15.
               | Juli 2021 fur die Antragsbewertung aller laufenden und
               | neu eingehenden Antrage nach SS 11 Abs. 1 MPG zugrunde
               | gelegt.
        
               | 2-718-281-828 wrote:
               | https://www.fr.de/panorama/horror-
               | mandarinennetz-12204896.ht...
               | 
               | seems like you're up for a surprise.
        
           | Sander_Marechal wrote:
           | Source? Because that sounds like a whole bunch of conspiracy
           | theories packed together.
        
             | tloup wrote:
             | It's because it is. The money they get from intubating and
             | all care required covers the cost and makes a little
             | profit, but there is no reason at all why they would do
             | that to a person that doesn't need it. It takes a heavy
             | toll on the doctors and nurses too. If a hospital director
             | would run rampant and tell docs to willy nilly intubate
             | someone it would be all over the news and doctors wouldn't
             | agree to it either (they are in very short supply in
             | Germany and wouldn't bother putting their reputation on the
             | line).
             | 
             | You also have to be aware that around 25% of all Germans
             | are in one way or another prone to believe in conspiracy
             | theories, e.g. great reset and so on. Sadly I only have a
             | German source on this, but this was a major point of
             | discussion in the long running "Mitte Studie" which is one
             | of the best and most rigorous studies about Germans and
             | their political beliefs.
        
             | 2-718-281-828 wrote:
             | source for what? you're welcome to use google btw. might
             | save us some time.
        
               | maaanu wrote:
               | One can make any statement and if the "opposition" wants
               | to see some proof you just deflect it and require them to
               | bring proof that your statement is incorrect? That sounds
               | incredible one-sided.
        
               | 2-718-281-828 wrote:
               | i'm asking for what do you want a proof ...
        
         | OJFord wrote:
         | > As stupid as it sounds, I could not force my parents to go
         | and wait in the line to get COVID test, after he says "I
         | believe I don't have COVID now. But if I go to the testing
         | center that is so badly managed and understaffed where only
         | people with obvious high level of COVID are brought to get
         | official result, I will get COVID there!".
         | 
         | May I ask why you wanted them to? Honestly his response sounds
         | rational to me.
        
           | javajosh wrote:
           | It does sound rational, but incomplete. The missing piece is
           | the one where he searches for (and hopefully finds) an
           | alternative where he can get tested without increasing risk
           | of infection. For example, tracking down an at-home test (he
           | could have used one of the 1M+ tests that Florida recently
           | allowed to expire).
        
           | reacharavindh wrote:
           | My parents visited my sister for 2 days. They traveled by a
           | private car, but must have stopped for food along the way.
           | After they have been back, both of them experienced fatigue
           | and cold symptoms. As much as it is normal for them to
           | experience after a trip, I wanted them to rule out COVID
           | early. I have heard that early diagnosis and treatment for
           | COVID at their age can be a life saving difference.
           | 
           | If I experienced the same symptoms here in NL, I'd have also
           | taken a test myself just to be sure that I am not spreading
           | it around.
           | 
           | His decision is rational after he explained the reason to me.
           | However, I wish that reason doesn't exist and that people can
           | get tested without such concerns.
        
         | ftzay wrote:
         | Your parents are smart. Hospitals are a prime spreading
         | location and testing centers are often crowded. Also, an
         | overworked nurse may make mistakes in testing centers and slip
         | up on hygiene rules.
         | 
         | The situation is similar in Europe, actually. Including loss of
         | trust.
        
           | 0x0nyandesu wrote:
           | Everyone talks so much shit on USA car culture but our
           | testing centers are typically a drive thru where patients are
           | isolated in their cars thereby protecting everyone. Patients
           | swab themselves and then hand the sample over through a few
           | inch opening in the window.
        
             | jhatax wrote:
             | This isn't the typical scenario in the Bay Area where
             | testing centers are walk-in vs. drive through. To ensure
             | testing consistency, swabbing is done by a healthcare
             | worker (e.g., nurse) not by the person being tested. This
             | is my experience across 4-counties here, San Francisco city
             | included.
             | 
             | Net-net, COVID-testing privacy isn't a laudable consequence
             | of the US's car culture, at least not everywhere in the US.
        
               | yumraj wrote:
               | I know of at least 1 drive-through testing center, at the
               | San Jose Fairgrounds. There may be more, but not sure.
               | 
               | Though there the testers/nurse puts the swab in the nose.
        
             | Avalaxy wrote:
             | So many downsides to that.. how do you get tested if you
             | dont have a car? How do you drive a car when you are very
             | sick? How do you make sure properly do the test on
             | themselves?
             | 
             | Sorry, but I dont find this a good argument in favor of a
             | car-culture at all.
        
               | ceejayoz wrote:
               | It's not a theoretical harm, either.
               | 
               | https://www.latimes.com/opinion/story/2020-07-07/op-ed-
               | drive...
               | 
               | > For each walk-up site, we looked at how many people
               | live within a mile radius and could conceivably walk to
               | the site. You don't need to look at a map to know that
               | too many people and places are left behind. If you don't
               | have a car but live in South Los Angeles, chances are you
               | can find a nearby walk-up test site. But if you're
               | carless in East L.A., there is not a single walk-up
               | option in your community. The entire San Fernando Valley
               | -- with a population of almost 2 million -- received its
               | first and only walk-up site, in Arleta, in late June.
               | 
               | https://www.businessinsider.com/new-yorkers-without-a-
               | car-ar...
               | 
               | > After trekking nearly two hours on public transit to
               | get to the testing site in Flatbush, a neighborhood in
               | New York's Brooklyn borough, the 30-year-old taproom
               | manager was surprised to discover a line of cars snaking
               | around the address instead of a line of people. McGrath,
               | who does not own a car, approached a state trooper at the
               | testing site to confirm his suspicions that a vehicle was
               | required to be tested.
               | 
               | > "I walk up to one of the state troopers and he says,
               | 'You can't walk in, you have to have a car,'" McGrath
               | told Business Insider, adding that it appeared as though
               | he was not the first New Yorker to arrive at the testing
               | site on foot.
        
               | rob74 wrote:
               | And here I was thinking that Germany was car-centric...
               | anecdotal evidence, but in my small town there is a
               | testing site in a pharmacy a few hundred meters from my
               | home, and I couldn't imagine that you would have trouble
               | finding a testing site accessible by foot or public
               | transport in larger cities.
        
               | 0x0nyandesu wrote:
               | I have gotten so many covid tests in the past two years.
               | Some of them are drive thru only but most don't care
               | either way. In DTLA proper the testing centers are mostly
               | for pedestrians.
        
               | ceejayoz wrote:
               | Consider the possibility that your experiences aren't
               | universal.
               | 
               | I cited specific examples of people having trouble
               | getting tested without a car.
        
               | 0x0nyandesu wrote:
        
               | jeromegv wrote:
               | Services only being available for the middle class car
               | owners is hardly something that has been dealt with in
               | the US. But you would never recognize it if you drive
               | your own car and never had to deal with taking public
               | transit to live your daily life.
        
               | 0x0nyandesu wrote:
               | I literally walked by a testing center in LA two days ago
               | that was for pedestrians but please continue making
               | assumptions about what I know.
               | 
               | I spent YEARS taking public transportation in
               | Philadelphia and you know what? It sucked massive donkey
               | balls.
               | 
               | This is why I bought a house in the suburbs. Public
               | transportation is for the poors (and New Yorkers I
               | guess). Sorry not sorry.
        
               | dang wrote:
               | You've posted an egregious number of comments breaking
               | the site guidelines recently, so we've banned this
               | account.
               | 
               | If you don't want to be banned, you're welcome to email
               | hn@ycombinator.com and give us reason to believe that
               | you'll follow the rules in the future. They're here:
               | https://news.ycombinator.com/newsguidelines.html.
        
               | 0x0nyandesu wrote:
        
               | ceejayoz wrote:
               | Still happening to people in September 2021:
               | https://blockclubchicago.org/2021/09/21/after-cvs-denies-
               | bic...
        
               | 0x0nyandesu wrote:
        
               | 0x0nyandesu wrote:
        
               | chasd00 wrote:
               | has the type of "swabs" changed? i don't see myself doing
               | the tickle-your-brain type nasal swab i've had done when
               | getting tested (only once when my wife ( a teacher ) was
               | exposed ). My hand would just respectively refuse the
               | order from my brain.
        
               | gentryb wrote:
               | There are various types of PCR tests - I suspect you are
               | referring to a Nasopharyngeal swab - which goes from tip
               | of the nose to base of the ear (and it much smaller than
               | a long Q-Tip) vs a nasal swab that usually gets both
               | nostrils and doesn't go in nearly so far.
               | 
               | I've personally done Nasopharyngeal swabbing in a drive-
               | thru. I will be supervising self-swabbing at a University
               | starting tomorrow. They are very different things. One is
               | a Q-Tip that only gets inserted into the nasal cavity.
               | The tickle-your-brain swab is a different thing entirely.
               | It requires training to do properly (enters approximately
               | 90 degrees to your face) and while I learned how it feels
               | from both sides, I can't imagine someone being asked to
               | self-administer a Nasopharyngeal swab.
        
               | Moto7451 wrote:
               | Having a car is not a requirement to get tested. It has
               | made it really easy to get tested though. For what it's
               | worth, this isn't our idea as a nation. Korea was doing
               | it before us.
               | 
               | The drive through testing really does offload a lot of
               | stress that would otherwise be placed on physicians and
               | pharmacies. The logistics are a huge win. Locally we've
               | had unoccupied parking structures used to house the
               | tests. Even without that you basically just need a
               | parking lot, a couple tents, and a restroom.
               | 
               | If you're so sick you can't drive you can have DoorDash
               | or any other delivery service send you an at home test.
               | If you're too sick for that, you probably should call for
               | medical services and not an antigen test.
               | 
               | I'm in Georgia, which has not offered any support for
               | people during the pandemic beyond what the Federal
               | government provided, and it's pretty easy to get a test
               | due to the efforts of private companies. If you don't
               | have a car you can often walk up provided there is a
               | sidewalk. We also have testing available in every chain
               | pharmacy and in dedicated facilities that have sprung up
               | in unoccupied mall space or buildings used by bank
               | branches and fast food establishments that are vacant.
        
               | 0x0nyandesu wrote:
        
               | Tostino wrote:
               | I rode my scooter through the CVS drive through for a
               | test this weekend to get tested. It's really not an
               | issue.
        
               | refurb wrote:
               | You walk. That's what they did in SF. One lane for cars,
               | one for pedestrians.
        
               | [deleted]
        
             | giraffe_lady wrote:
             | "drunk driving may kill a lot of people, but it also helps
             | a lot of people get to work on time, so, it;s impossible to
             | say if its bad or not,"
        
               | refurb wrote:
               | You're equating cars with drunk driving?
        
               | [deleted]
        
             | hiyer wrote:
             | In India - at least in the cities - you don't even need to
             | step out for a Covid test. You can request a technician to
             | come and collect your sample from the comfort of your home,
             | and you'll get the result in a few hours or the next day at
             | most. I'm not sure where the commenter's parents live, but
             | if they live even in a moderate-sized city, they're being
             | unnecessarily paranoid.
        
               | reacharavindh wrote:
               | Thanks for bringing this up. I will check whether such a
               | facility exists in the village where my parents live. If
               | you're curious, they live in Srirangam, Trichy,
               | TamilNadu.
        
               | hiyer wrote:
               | > If you're curious, they live in Srirangam, Trichy,
               | TamilNadu
               | 
               | Wonderful place, except for the heat :-). I've visited
               | there (for the temples) on a few occasions.
        
               | cocoland2 wrote:
               | A lot of testing centers / labs such as Lister or
               | Thyrocare can do in person sample collections, such as
               | this one below are available.
               | 
               | Its quite easy to get a test done at home. (Mentioned of
               | lister metropolis because they had come home for some
               | other sample collection and mentioned of this) . You can
               | check aggregator apps as well that provide this list.
               | 
               | https://www.metropolisindia.com/parameter/trichy/covid-19
               | -rt...
        
             | weird-eye-issue wrote:
             | Here in Thailand I can walk into 7-11 and buy a rapid
             | antigen test for $3 and go take it at home
        
               | FabHK wrote:
               | Same in Germany.
        
               | 0x0nyandesu wrote:
               | The testing centers are free for the most part.
        
               | weird-eye-issue wrote:
               | Driving to a testing center and sitting in your car could
               | easily use $3 in gas and more of your time. 7-11 is
               | absolutely everywhere here, you don't understand the
               | level of convenience.
               | 
               | I'm in my condo right now, I could go to a 7-11, come
               | back and have my result all within 10 minutes for $3. But
               | yeah car culture in America is great
        
               | 0x0nyandesu wrote:
        
               | cinntaile wrote:
               | 4 min drive? That sounds like perfect walking distance.
               | It's better too, when you suspect you might have covid.
        
               | 0x0nyandesu wrote:
        
               | cinntaile wrote:
               | That's not bad, only 22 min difference between walking
               | and driving.
        
               | weird-eye-issue wrote:
               | There is a 7-11 within short walking distance of
               | virtually everybody here in Bangkok. And free delivery
               | too from 7-11 if you order more than 100 baht (around $3)
               | 
               | > If there even is public transportation to speak of
               | 
               | The public transportation here in Bangkok is amazing.
               | It's clean, on time, and affordable
        
         | dathinab wrote:
         | Are home/self tests an option?
         | 
         | I mean if it's just about knowing it yourself so that you can
         | get yourself PCR tested when you known you likely have it (and
         | as such might soon need medical support).
         | 
         | That seems like a valid option for me, though only if available
         | and hospitalized reasonable priced.
         | 
         | For be the difference between self-tests rapid tests and test
         | station rapid tests seem to mainly be:
         | 
         | - if you have self-test
         | 
         | - if you can afford it (test station rapid tests are up to some
         | limit payed by health care, in my case)
         | 
         | - if you need the digital certificate that you did a tests
         | (some places require vaccination + test)
         | 
         | - self-test produce more wast through additional packaging,
         | non-reusable plastic tubes etc.
        
         | alkonaut wrote:
         | > hospitals faking COVID test results just so that they can
         | admit them for 4 days, administer expensive drugs, charge them
         | some hefty bill, and send home
         | 
         | Why would hospitals admit someone who isn't actually in need of
         | care? If you need hospital care for Covid, it's (almost
         | exclusively) because you need supplemental oxygen, and that's
         | something that's pretty hard to fake.
         | 
         | Edit: the question is: how are these hospitalizations actually
         | done practically. Are doctors faking diagnoses (e.g. hypoxia),
         | convincing patients they need care, which they are persuaded to
         | accept? Or are patients forcibly admitted without being asked?
        
           | reacharavindh wrote:
           | Blunt answer : Money, greed, short term thinking and lack of
           | ethics.
           | 
           | How? Doctors turn into actors and cheat the public.
           | Anecdotally, my relatives say they were never treated for
           | COVID, but told that they needed admission because they have
           | high risks(diabetes, respiratory troubles, high blood
           | pressure) and need to be monitored in order to make sure
           | COVID is treated early. After 4 days of a battery of
           | tests(non COVID related), they are sent home saying they
           | escaped the wrath of COVID because they were lucky. I don't
           | know what to say.
        
             | alkonaut wrote:
             | This is why I'd never want to visit any doctor whose
             | paycheck is affected by the treatment he gives (or
             | doesn't).
             | 
             | A doctor who has even a small kickback on prescriptions
             | from a pharmaceutical company is completely out of the
             | question in my book at least.
        
           | junon wrote:
           | > Why would hospitals admit someone who isn't actually in
           | need of care?
           | 
           | In places without socialized medical coverage and low levels
           | of ethical integrity (unfortunately, too many places in the
           | world - especially impoverished states), the answer is
           | "money".
        
             | refurb wrote:
             | Why would socialized medicine exclude this behavior?
             | Medicare fraud in the US is in the billions.
        
               | krageon wrote:
               | The US does not have socialised medicine.
        
               | merpnderp wrote:
               | A large subset of the US does have socialized medicine.
               | Medicare (65 million people), Medicaid (75 million
               | people), and the military health system (10 million
               | people).
               | 
               | That's nearly half the US population.
        
               | burmanm wrote:
               | That insurance isn't socialized medicine. In Europe for
               | example, the hospital is owned by the
               | government/state/etc, the doctors are hired directly by
               | the hospital, the medicine costs are directly set by the
               | state and so on.
               | 
               | No private parties at all.
        
               | triceratops wrote:
               | > In Europe for example, the hospital is owned by the
               | government/state/etc,
               | 
               | Europe is a big place with many different types of
               | systems. What you're describing sounds like the UK. But
               | places like NL[1] or DE[2] are more like Medicare/aid for
               | all (basic coverage) + Obamacare (mandatory private
               | insurance, sometimes supplementary). The providers may be
               | private practitioners.
               | 
               | NB: I'm not an expert in these systems so I may have
               | gotten some details wrong. My main point is that
               | "European healthcare" isn't a monolith and it's not all
               | state-owned.
               | 
               | https://en.wikipedia.org/wiki/Healthcare_in_the_Netherlan
               | ds
               | 
               | https://en.wikipedia.org/wiki/Healthcare_in_Germany
        
               | rm_-rf_slash wrote:
               | I believe parent referred to Medicare as a subset in
               | American health care that is socialized, to some degree.
        
               | krageon wrote:
               | I guess I am mostly alone in thinking that for a system
               | to be socialised, it has to apply to everyone or almost
               | everyone in a country equally. From the comments and the
               | voting, I understand that having it apply to "almost"
               | half the population is already socialised to this time
               | slot :)
        
               | refurb wrote:
               | So by your definition much of Europe (which has a robust
               | private healthcare system) isn't socialized?
        
               | krageon wrote:
               | Europe isn't a country and doesn't have uniform policies
               | in this way. It also doesn't have things as an entity
               | (except for a selection of laws that it's members
               | implement differently in most cases).
               | 
               | Because of those facts, I have trouble even formulating a
               | response to your question - it doesn't make sense to me.
        
               | notch656a wrote:
               | We do, just for certain groups, such as elderly and the
               | poor. Hell like 40% of births here are paid for by
               | medicaid. But we have system here where only up to upper
               | middle class (~$142k) of income is paid to social
               | security tax, so middle class pays for both poor and
               | themselves, while poor pays for no one and rich
               | disproportionately only pay for themselves.
        
               | seanmcdirmid wrote:
               | There is no income limit on Medicare payroll taxes, just
               | social security.
        
               | notch656a wrote:
               | Agreed, although that doesn't negate the presence of
               | socialized health care.
        
               | seanmcdirmid wrote:
               | Yes, but at least there is more equity between poor and
               | rich in this regard.
        
               | notch656a wrote:
               | More like equity between middle class and rich. The poor
               | are getting free stuff at expense of both.
        
               | seanmcdirmid wrote:
               | The rich have more because they have more money, giving
               | poor people free stuff actually increases equity, it
               | doesn't decrease it. SS isn't very equitable because of
               | the income limits, payroll taxes in general are less
               | equitable because they aren't (very) progressive.
        
               | notch656a wrote:
               | One person being handed health care on a silver platter
               | while I work the better part of a week to pay for it for
               | my family doesn't sound equitable to me.
        
               | seanmcdirmid wrote:
               | You are assuming the poor in America aren't working hard
               | and are having health care handed to them on a silver
               | platter, neither of which is true in general. But sure,
               | many poor people (who don't qualify for Medicaid) are
               | looking forward to the day they turn 65 and can get
               | healthcare benefits...hoping that they live that long
               | enough to see any of that.
               | 
               | Of all the developed countries, only America treats its
               | non-rich citizens so harshly. Your implied advice that
               | poor people should "just work harder and make more
               | money!" isn't very useful.
        
               | notch656a wrote:
               | Resorting to a bunch of straw-man attacks making lying
               | and vicious, calculated claims to make me look like I've
               | attacked the poor as "not working hard" is a really bad
               | look for you. It's the look of someone who failed at
               | making a cogent argument so they resort to a sob story
               | about me attacking the poor.
               | 
               | All I'm saying is it isn't equitable for one person (who
               | could have not worked a day in their life) to be handed
               | health care on a silver platter while I work the better
               | part of a week to pay for it for my family. Do you not
               | understand many on public health care don't have to work
               | for the better part of a week to receive benefits, and
               | never have? I'm not talking about old people who spent 40
               | years paying into the system.
        
               | seanmcdirmid wrote:
               | You said:
               | 
               | > One person being handed health care on a silver platter
               | while I work the better part of a week to pay for it for
               | my family doesn't sound equitable to me. reply
               | 
               | This exactly implies that if only those poor people
               | worked a "better part of a week to pay for it" like you
               | did, they wouldn't be getting their health care served on
               | a silver platter. Not a straw man.
        
               | notch656a wrote:
               | The straw man is that I've assumed ' the poor in America
               | aren't working hard' and that I implied 'that poor people
               | should just work harder and make more money!'
               | 
               | Of course if you compensate providers for health care
               | through the fruit of your labor and investments, you've
               | earned it and it hasn't been provided to you on a silver
               | platter; I don't think anyone is disputing that.
               | 
               | >This exactly implies that if only those poor people
               | worked a "better part of a week to pay for it" like you
               | did, they wouldn't be getting their health care served on
               | a silver platter.
               | 
               | See my response below:
               | 
               | By handed on a silver platter I was referring to someone
               | capable of working, but who requests (and is handed)
               | health care for free without performing any labor at all
               | at the expense of someone working and paying an
               | involuntary tax. I never said that was all or even most
               | poor. I'm not referring to the poor person making 7.50
               | buying their own private health insurance. There's
               | probably an argument from some perspective that
               | 'equitable' could mean everyone works the same amount of
               | labor (20 hours or whatever) per month to pay for
               | healthcare, although I'm not sure even that would
               | precisely be equitable. One able bodied person of equal
               | insurance risk pool to another working BOTH more hours
               | AND paying more for same insurance would certainly sound
               | inequitable.
        
               | pessimizer wrote:
               | The person you replied to was being generous to your
               | argument, and nothing but polite. The fact is that plenty
               | of the "poor" work as much as you do, but you think
               | they're somehow enslaving you because you get paid more.
               | 
               | If you continued working the same job you have now, but
               | at $7.50/hr, would it be fair to characterize your
               | receiving the same health care you receive now as being
               | handed to you on a silver platter?
        
               | notch656a wrote:
               | >The person you replied to was being generous to your
               | argument, and nothing but polite.
               | 
               | And nothing says generous and polite by making the lying,
               | vicious claim that I've assumed ' the poor in America
               | aren't working hard' and that I implied 'that poor people
               | should just work harder and make more money!' It's purely
               | fiction designed to paint me as the evil denigrator of
               | the poor.
               | 
               | >The fact is that plenty of the "poor" work as much as
               | you do, but you think they're somehow enslaving you
               | because you get paid more.
               | 
               | 'The fact' that both of you have to put words in my mouth
               | (or alleged thoughts) to make your argument speaks
               | volumes here.
               | 
               | >If you continued working the same job you have now, but
               | at $7.50/hr, would it be fair to characterize your
               | receiving the same health care you receive now as being
               | handed to you on a silver platter?
               | 
               | By handed on a silver platter I was referring to someone
               | capable of working, but who requests (and is handed)
               | health care for free without performing any labor at all
               | at the expense of someone working and paying an
               | involuntary tax. I never said that was all or even most
               | poor. I'm not referring to the poor person making 7.50
               | buying their own private health insurance. There's
               | probably an argument from some perspective that
               | 'equitable' could mean everyone works the same amount of
               | labor (20 hours or whatever) per month to pay for
               | healthcare, although I'm not sure even that would
               | precisely be equitable. One able bodied person of equal
               | insurance risk pool to another working BOTH more hours
               | AND paying more for same insurance would certainly sound
               | inequitable.
        
               | rm_-rf_slash wrote:
               | The key word is fraud: getting something for nothing.
               | Medicare itself bills at a lower rate than private
               | insurance. For many doctors and hospitals, Medicare can
               | be a margin-reducing annoyance. The private insurance
               | patients are where the moneys at.
        
               | refurb wrote:
               | Fraud being changed for unneeded services?
               | 
               | Not sure what your point is.
        
               | seanmcdirmid wrote:
               | That kind of fraud can occur because you have a
               | socialized system interfacing with a non-socialized one.
               | The government is paying the costs, but they don't
               | actually have much control over or oversight of the care.
               | It is not like Australia where the government is all in
               | by funding the hospitals and doctors directly.
        
               | refurb wrote:
               | https://www.counterfraud.gov.au/case-studies/clinic-
               | owner-co...
               | 
               |  _"A medical clinic owner defrauded the Commonwealth of
               | more than $3.3 million by claiming rebates for services
               | not given to over 5,870 different patients."_
        
               | seanmcdirmid wrote:
               | He got caught very quickly, I'm not sure what this proves
               | (that idiots exist in every country?).
        
               | refurb wrote:
               | You claimed it doesn't happen in Australia and I proved
               | it does.
               | 
               | Why are you moving goal posts?
        
               | seanmcdirmid wrote:
               | This is like a Trump supporter claiming that the
               | Democrats stole the election because a bunch of Trump
               | voters got caught voting illegally, very easily
               | because...the system actually works. Here, yes, you can
               | still commit fraud in Australia, but your chances of
               | getting caught quickly are almost 100%.
        
             | alkonaut wrote:
             | Yes perhaps the question was unclearly posed, I mean - how
             | do people allow themselves to be admitted to expensive care
             | without being in need of it?
             | 
             | Are doctors "persuading" patients that they need care, and
             | the problem is lack of information about what rights you
             | have to actually refuse, or information about what the
             | symptoms would be etc?
        
               | junon wrote:
               | Yep that's usually what happens. Not everyone has the
               | same access to basic medical information and rely solely
               | on the doctor's word. That is how many people fall into
               | cult-like or religious "medicine" or end up spending way
               | too much on otherwise farsical treatment.
        
           | Alterlife wrote:
           | As an Indian living in India, I've heard some of these
           | stories:
           | 
           | a. They are asked to get admitted "for observation because
           | they are at high risk". If they ask to leave, the doctors ask
           | them to sign a very scary sounding wavier disclaiming the
           | hospital of responsibility for their death.
           | 
           | b. There apparently this one lab that will return a positive
           | covid test if the docs ask them to and they get a cut of what
           | the patient pays.
           | 
           | It needs to be said that I don't know if any of these are
           | true.
        
         | slowhand09 wrote:
         | The [US]CDC director just said over 75% of "covid deaths"
         | occurred in people with at least four comorbidities. Since the
         | US administration can't shut down covid, suddenly all this data
         | is getting shared publicly.
        
           | wumpus wrote:
           | The whole point of studying excess deaths is to figure out
           | covid's contribution over and above the usual number of
           | deaths due to these pretty common conditions (like high blood
           | pressure.)
        
         | instagraham wrote:
         | As an Indian, I can tell you that every single family I know
         | has lost someone to COVID. But this part of India wasn't as
         | torn apart as the cities like Delhi or Bangalore. Or like rural
         | India, whose death toll we never counted.
         | 
         | Both sides of the ideological split here were arguing over the
         | stats until the Ganges swelled up with bodies. But even then,
         | the right continues to deny the extent of death.
        
         | johnchristopher wrote:
         | > Say what you will, but if the basic trust in doctors and
         | healthcare is lost, how would people get tested, and how can
         | you trust any statistics from there?!
         | 
         | To me this is a huge problem: some doctors are gaming the
         | system and providing fake covid certificates or vaccination
         | stamps. What else could doctors be hiding from me in other
         | situations ? My mom said it was a war crime to deliver fake
         | covid vaccination stamps (I can see how a doctor doing that
         | would see himself as a resistant so good luck having a healthy
         | debate about that). It breaks something fundamental. In a way I
         | hope most of them did it for the money rather than out of anti-
         | vax/anti-system.
         | 
         | On a related note I was stuck for three days in a house during
         | this summer's flood (floor level flooded, second okay, I stayed
         | at the third) . I had food, water and was okay. At some point I
         | could have left the house to be relocated in a roofed sport
         | centre or a school with other people but I decided against it
         | in fear of getting covid in a crowded space. It was before
         | omicron. Maybe I overreacted but I didn't want to take any
         | risks.
        
           | MomoXenosaga wrote:
           | All this hate for the medical profession. You have people who
           | work long hours, bear huge responsibility and are treated
           | like shit for a pathetic salary.
           | 
           | I honestly don't even know why they keep doing it. You get
           | less crazies as a prison guard and they have better security.
        
             | reacharavindh wrote:
             | Lack of trust because of misdeeds does not mean one hates
             | all Doctor and nurses who work their ass off to literally
             | save people's lives. It is not binary.
             | 
             | There is a difference between - will I go to the hospital
             | if I get hurt or have a medical need versus do I trust the
             | hospital to not fleece for some care I may not need. The
             | fact that this question needs to be asked is a result of
             | the lack of trust. If there is any profession where there
             | should have been zero tolerance for malpractice, it is this
             | noble medical profession.
        
             | johnchristopher wrote:
             | What hate ? Most people who hate on the medical profession
             | are antivax. There has been violent actions taken against
             | the medical workers in vaccination and testing centers in
             | Belgium and France.
        
             | AtlasBarfed wrote:
             | In the US it is the accumulation of years of frustration
             | with our for-profit system. Insurance at a minimum feels
             | like a parasite, and then on top of that it is the
             | personification of byzantine bureaucratic mazes and
             | arbitrary rulings.
             | 
             | Insurance is also fragile, where an employee that needs
             | their healthcare for something like cancer is then exposed
             | to be laid off and lose coverage.
             | 
             | When you need it most, you are subjected to exploitation
             | and fraud: surprise billing, lack of coverage, and doctors
             | that feign ignorance about costs and complexities.
             | 
             | Meanwhile anyone that knows how billing professionals
             | knows: #1 rule is bill when you can, the #2 rule is to bill
             | as much as possible.
             | 
             | The end result is a lack of faith in our system, where it
             | is just a system of profiteering and exploitation.
             | 
             | They work long hours because they will eventually make a
             | lot of money (my friend is a cardiologist, not even a
             | surgeon, and makes 800k per year in the US) and get huge
             | amounts of prestige. Doctors are the only nerd profession
             | that is cool and sexy. And the number of hours is actually
             | less than it used to be back in the day.
             | 
             | Of course, you don't get as many perks from the drug/device
             | company reps anymore, or have they figured out how to give
             | doctors steak dinners and golf junkets again?
        
           | dudul wrote:
           | A war crime? For which ongoing war?
        
             | johnchristopher wrote:
             | The one on Covid. See Macron last year's speech
             | https://www.bbc.com/news/av/51917380
             | 
             | Of course my mom is not asking for a war tribunal to
             | prosecute people. She's talking about the gravity of the
             | facts.
        
             | Tsiklon wrote:
             | I believe they meant to express the idea that such a
             | scenario is beyond morally reprehensible, so as to liken it
             | morally to a war crime.
        
               | johnchristopher wrote:
               | In her head it's more like "these people are fighting the
               | state and are enemy of the state and its citizens".
        
           | thematrixturtle wrote:
        
             | [deleted]
        
             | johnchristopher wrote:
             | > If vaccination does not meaningfully prevent
             | transmission, as increasingly seems to be case with
             | Omicron, faking vaccination harms only the fake recipient.
             | 
             | keyword being _if_ and _meaningfully_.
             | 
             | Anyway that fake recipient may still need top notch
             | expensive care to stay alive if he doesn't get mild covid.
             | Are you suggesting that he should pay in full for those
             | care since you state it only harms the fake recipient ?
             | 
             | Also, it increasingly seems that a third dose significantly
             | increases protection against omicron.
        
               | toolz wrote:
               | The unvaccinated haven't done nearly the damage policy
               | has to hospitals. The US has like 6-7% fewer staffed beds
               | than before the pandemic and has stupidly decided to fire
               | unvaccinated healthcare workers that have almost
               | assuredly developed their immunity naturally.
               | 
               | People seem to forget much of the world still has no
               | access to vaccines. Every person being vaccinated with
               | natural immunity is someone without immunity missing that
               | vaccine.
        
               | refurb wrote:
               | Yup. California is now changing the rules to allow Covid
               | positive healthcare works to come back without any
               | quarantine.
               | 
               | https://www.kcra.com/article/nurses-react-
               | covid-19-protocols...
               | 
               | So is France and Canada.
        
               | selimthegrim wrote:
               | What does natural immunity mean with new variants and
               | when it lasts from 90 days to six months? Are these
               | people going to pay to get their antibody titers checked
               | every week? If they incubate a new variant themselves are
               | they willing to be held personally liable?
        
               | toolz wrote:
               | >What does natural immunity mean with new variants and
               | when it lasts from 90 days to six months?
               | 
               | I'm not sure what you're asking. Are you saying that
               | antibodies last 90 days to 6 months? Firstly that's
               | incorrect as antibodies seem to be detectable even after
               | 8 months in the study I'm remembering, but more
               | importantly your immune system is made up of many parts
               | and antibodies are not the primary response to
               | coronaviruses since the antibodies do fade rather
               | quickly.
               | 
               | Instead the many other parts of our immune system are
               | extremely long lived with other coronaviruses and there's
               | no reason to expect they won't be extremely long lived
               | with covid.
               | 
               | In fact the reason you see so many asymptomatic cases
               | with covid is because of preexisting natural immunity to
               | similar coronaviruses.
               | 
               | > If they incubate a new variant themselves are they
               | willing to be held personally liable?
               | 
               | Are you suggesting if we had the tech (we don't) to trace
               | down the exact host where a virus mutates into a
               | recognizably different strain that host should be liable?
               | I think you should really reflect on exactly that would
               | mean and exactly how harmful that would be for society.
               | You do realize every single person in the entire world
               | will either die in the next couple of years or without a
               | doubt be attacked by covid, right? That means you'd
               | basically be putting up a lottery system to see who gets
               | to lose for being "ground zero" for a new variant
               | mutation. This would be completely pointless and would
               | serve only to hurt people with zero chance of helping
               | anyone.
        
               | thematrixturtle wrote:
               | Yes, I think that would be an excellent idea, and quite a
               | few countries are in fact moving in that direction.
               | 
               | Early evidence is that the protection against
               | transmission from the booster appears to be quite
               | fleeting (weeks, not months), so the main reason to
               | vaccinate is really to protect yourself.
        
             | acdha wrote:
             | Vaccination continues to reduce transmission (less for
             | Omicron than before, but it was known never to be be 100%)
             | but it also significantly reduces the number of people with
             | serious cases (still quite successful even with Omicron).
             | 
             | That means there's a big side effect from people not
             | getting vaccinated: the healthcare system has finite
             | capacity and when it's full of people who wouldn't be there
             | if they'd been vaccinated, that means space isn't available
             | for anyone who has some other problem and the healthcare
             | system is losing a lot of expensively trained people due to
             | stress. It is extra hard on them to watch people die for
             | avoidable reasons and many nurses, doctors, etc. have left
             | at least temporarily due to burnout.
        
               | robbiep wrote:
               | Not sure where the early downvotes are coming from but
               | this is correct: my state has 95% 2 dose vaccination of
               | adults and currently 150 ventilated patients- half of
               | those are unvaccinated.
               | 
               | So 5% of the population represents 50% of ICU ventilator
               | capacity.
        
               | stefantalpalaru wrote:
        
               | toolz wrote:
               | While I'm sure the unvaccinated represent more, it's also
               | true that many reporting stats considered double
               | vaccinated to be in the unvaccinated category if they are
               | eligible for a booster and haven't had them.
        
               | refurb wrote:
               | Yup. I've seen similar gaming. Of the people who died in
               | Singapore, 5/8th weren't "fully vaccinated", so they lump
               | in the ones with one dose and those who haven't met some
               | predefined period of time post-2nd dose.
        
               | acdha wrote:
               | I don't know which sites you're seeing but the ones I use
               | tend to break that out as "partially vaccinated" or
               | "fully vaccinated" vs "fully vaccinated with booster" --
               | which is good since the evidence has shown that there's a
               | big difference between the waning protection against
               | infection (i.e. neutralizing antibodies) versus
               | protection against severe cases (i.e. T cells) even for
               | partial vaccination.
               | 
               | https://ourworldindata.org/covid-vaccinations https://www
               | .washingtonpost.com/graphics/2020/health/covid-va...
               | https://www.nytimes.com/interactive/2021/world/covid-
               | vaccina...
               | 
               | https://covidactnow.org/ uses "at least one dose" for the
               | national map but breaks out their state-level displays as
               | "1+" and "fully vaccinated".
        
               | robbiep wrote:
               | This is not the case where I live, work and practice
               | medicine
        
               | throwawaylinux wrote:
               | How much does it reduce transmission? Do you have links
               | or know the studies to look for? (It's difficult for me
               | to wade through everything out there and know what the
               | "good" studies and data are)
        
               | acdha wrote:
               | It's still early but here's an example of what it's
               | looking like:
               | 
               | https://www.medrxiv.org/content/10.1101/2021.12.27.212682
               | 78v...
               | 
               | > Our results show that the Omicron VOC is generally
               | 2.7-3.7 times more infectious than the Delta VOC among
               | vaccinated individuals (Table 3). This observation is in
               | line with data from (18), which estimated that 19% of
               | Omicron VOC primary cases in households in the UK
               | resulted in at least one other infection within the
               | household, compared to only 8.3% of those associated with
               | the Delta VOC. Furthermore, we show that fully vaccinated
               | and booster-vaccinated individuals are generally less
               | susceptible to infection compared to unvaccinated
               | individuals (Table 2). We also show that booster-
               | vaccinated individuals generally had a reduced
               | transmissibility (OR: 0.72, CI: 0.56-0.92), and that
               | unvaccinated individuals had a higher transmissibility
               | (OR: 1.41, CI: 1.27-1.57), compared to fully vaccinated
               | individuals.
               | 
               | > Surprisingly, we observed no significant difference
               | between the SAR of Omicron versus Delta among
               | unvaccinated individuals (Table 3). This indicates that
               | the increased trans-missibility of the Omicron VOC
               | primarily can be ascribed to immune evasion rather than
               | an inherent increase in the basic transmissibility.
               | 
               | That last part is why the boosters matter: neutralizing
               | antibodies (which your body stops producing over time
               | after the infection) can prevent someone from getting
               | sick at all, whereas the longer-lasting T cell response
               | helps your immune system fight it off more effectively.
               | If the entire population is boosted, that would have been
               | plenty to fight off Delta but with Omicron we still need
               | a combination of other measures (masks, air
               | filtering/exchange, etc.) and eventually updated boosters
               | to put an end ot it. That doesn't mean that being
               | vaccinated isn't worthwhile, of course: you're still far
               | more likely to have a better outcome if you get it and
               | the window where you're contagious is smaller.
        
               | nradov wrote:
               | I encourage everyone eligible to protect themselves by
               | getting vaccinated but we're really chasing our tails by
               | focusing on antibody levels. In the long run cellular
               | immunity is more important. We can't give everyone
               | boosters every few months just to keep antibody levels
               | up.
               | 
               | https://youtu.be/GklHGYY8vN8
               | 
               | We can't put an end to this virus. It will be around at
               | some level forever.
        
               | acdha wrote:
               | That's why the different between the neutralizing
               | antibodies and T cells is so important: when the pandemic
               | is raging, your odds of exposure are high and so public
               | health people are concerned about the ability of
               | vaccinated individuals to slow the spread impacting the
               | entire healthcare system. The medical system is under
               | levels of stress which haven't been seen in a century so
               | they're understandably focused on trying all of the tools
               | available to calm things down.
               | 
               | Once it's spreading at a lower level, your risk of
               | personal exposure is much lower and the long-lasting T
               | cell response becomes more of a focus because that
               | reduces risk to the person and you're less worried about
               | the crunch of many thousands of people showing up at the
               | hospital at the same time because for someone vaccinated
               | it's more like something like influenza where most people
               | have a bad week or two but don't urgently need medical
               | treatment.
        
             | 542458 wrote:
             | 1) I'm not aware of any research that shows near-zero
             | reduction in transmission rate. As far as I'm aware,
             | research shows that vaccination rate reductions in
             | transmissiveness that are less than previous strains, but
             | dramatically better than nothing.
             | 
             | https://www.medrxiv.org/content/10.1101/2021.12.27.21268278
             | v...
             | 
             | > For households with the Omicron VOC, the corresponding OR
             | for infection for unvaccinated individuals was 1.04 (CI:
             | 0.87-1.24) and 0.54 (CI: 0.40-0.71) for booster-vaccinated
             | individuals.
             | 
             | 2) Keeping hospitals from being overwhelmed and keeping
             | people from dying is a legitimate goal of vaccination, even
             | in the absence of any reduction in transmission. The
             | vaccine remains effective at this. Hospitalization rates
             | for the unvaccinated are leagues higher than the
             | vaccinated.
        
               | yorwba wrote:
               | > As far as I'm aware, research shows that a two-dose
               | vaccination rate provides disappointing reductions in
               | transmissiveness - but far, far better than nothing.
               | 
               | The paper you quote shows two-dose vaccination (or
               | previous infection) _increasing_ the secondary attack
               | rate from 29% (unvaccinated) to 32%, i.e. worse than
               | nothing. Only a booster reduces it back to 25%.
               | 
               | My guess is that the increase is not due to direct
               | biochemical effects of vaccination/prior infection, but
               | due to people assuming that they're protected and taking
               | fewer precautions. Demographic differences might also
               | play a role.
        
               | sudosysgen wrote:
               | Nope, nope nope, not at all.
               | 
               | > _After adjustment for confounders, we found that in
               | households with the Delta VOC, the OR of infection was
               | 2.31 (95% confidence interval (CI) 2.09-2.55) for
               | unvaccinated individuals and 0.38 (CI: 0.32-0.46) for
               | booster-vaccinated individuals when compared to fully
               | vaccinated potential secondary cases. For households with
               | the Omicron VOC, the corresponding OR for infection for
               | unvaccinated individuals was 1.04 (CI: 0.87-1.24) and
               | 0.54 (CI: 0.40-0.71) for booster-vaccinated individuals._
               | 
               | For delta, two dose vaccination helps. For Omicron, there
               | is no statistically significant effect of two dose
               | vaccination.
               | 
               | In no case is there an increase from two dose vaccination
               | of attack rates.
        
         | nsonha wrote:
         | this question will appear insulting but do you think there is a
         | cultural reason why there is so much scamming in India or by
         | Indians? I've read many hackernews posts on Indian swe
         | candidate lying on the take home test or CV. 100% of the phone
         | scammers I encountered here in Australia have a South Asian
         | accent.
         | 
         | I am from a developing country myself and do understand that
         | this kind of thing happens when a big part of a country is low
         | on the Maslow's hierarchy, but India seems to get it worse
         | somehow?
        
           | thematrixturtle wrote:
           | India is by far the largest poor country by population, it's
           | reasonably advanced technically, and English is widely
           | spoken.
           | 
           | It's no coincidence that the other country we often associate
           | with scams, Nigeria, is also large and has many English
           | speakers.
           | 
           | There are plenty of scams in (say) China as well, they just
           | target Chinese speakers.
        
             | pessimizer wrote:
             | I get a ton of Chinese language scam robocalls in the US,
             | they're just not specifically memorable because I don't
             | speak Chinese.
        
           | mschuster91 wrote:
           | > this question will appear insulting but do you think there
           | is a cultural reason why there is so much scamming in India
           | or by Indians? I've read many hackernews posts on Indian swe
           | candidate lying on the take home test or CV. 100% of the
           | phone scammers I encountered here in Australia have a South
           | Asian accent.
           | 
           | It's not "cultural", e.g. here in Germany we have a _huge_
           | problem with phone fraud originating in Turkey [1]. The
           | reason why scams are so common for  "foreign" countries is
           | relatively simple: fraudsters need people speaking the
           | language pretty well, but do not want attention from domestic
           | law enforcement... meaning you need a remote country with a
           | shoddy/easily bribable law enforcement, speaking the same
           | language as the "target" country, a _huge_ supply of
           | desperate, poor people willing to turn to crime for money and
           | easy ways to transfer money from the target country to the
           | source country and back to wherever the ringleaders are. For
           | English-speaking countries, the biggest country where these
           | conditions meet is India and the Philippines (and
           | historically, Nigeria), for German-speaking countries it 's
           | Turkey (with historically close migration links from the
           | post-WW2 "Gastarbeiter" era).
           | 
           | [1]: https://www.bka.de/DE/UnsereAufgaben/Deliktsbereiche/Bet
           | rueg...
        
           | tempuser12121 wrote:
           | I know few companies in India who for some amount would write
           | essay, thesis for students. A large number of them are from
           | US. These companies make very good money from them. Yeah
           | everybody cheats, maybe westerns are very good at hiding it.
        
         | andreygrehov wrote:
         | Another anecdote from the US (New York).
         | 
         | A friend of mine works as a cop. One day someone got shot and
         | he had to help get the victim to a hospital. The victim was
         | bleeding blood and eventually died in that hospital. A few
         | hours later, the hospital provided the cause of death as COVID,
         | because they found out that the victim had the virus
         | -\\_(tsu)_/-
        
           | [deleted]
        
         | nelblu wrote:
         | Another anecdote: In my home town, a doctor took the government
         | funding to open a covid centre. She then only admitted patients
         | that were mild cases and had chances of survival, for those who
         | had little chance of surviving she would not admit them and
         | send them home. One might think that maybe she was being smart
         | in triaging the patients, but I know her personally and her
         | only motive was money.... Because relatives are less likely to
         | pay for a dead patient than they are for someone who came home
         | alive.
         | 
         | Extremely shameful but not surprising.
        
           | laxmin wrote:
           | Can you please share the name of that Centre? I would love to
           | investigate.
           | 
           | Thanks.
        
         | complexmango wrote:
         | I'm from India, and have plenty of family and friends there in
         | close contact, and I have literally never heard of anything as
         | ridiculous as this yet. No idea why this is a top voted
         | comment.
        
         | aluksi wrote:
         | So much for the self-righteous angst. As an Indian 'expat',
         | what did you do to help? What is it about it that is so
         | surprising. It's obvious that being a low income country, the
         | health care is not the best, but compared to the rest of the
         | world they are doing alright.
        
           | reacharavindh wrote:
           | I hope you feel better that you called out on the
           | righteousness of someone who highlights a problem. How dare
           | someone speak of a problem when you can happily live in an
           | ignorant world where everybody always speaks of how good
           | things are.
           | 
           | In the interest of a civil discourse. I will say that I did
           | mean that I am not surprised by the fact that the stats are
           | not correct because I am aware of the ground reality from my
           | anecdotal sources that point in the same direction. Not that
           | my country does or doesn't do anything.
           | 
           | The first step to solving a problem is recognising that it
           | exists, and not wish washing it away.
           | 
           | As an Indian, I'm sad that you're not angry.
        
           | srean wrote:
           | > being a low income country, the health care is not the best
           | 
           | The Indian state of Kerala would like to differ.
           | 
           | States and leadership that are more keen on disrupting the
           | social fabric, polarize it to gain votes, sure that would
           | divert resources into such harmful instruments. The
           | consequences were well observed as dead bodies by the
           | thousands buried on river sand bars or floating down the
           | water, with government officials working to conceal the
           | evidence by removing religious commemorative markings left on
           | the sand graves.
        
             | nonamechicken wrote:
             | > The Indian state of Kerala would like to differ.
             | 
             | Kerala chief minister who is a communist is coming to US
             | for health care next week.
             | 
             | https://www.indiatoday.in/india/story/kerala-chief-
             | minister-...
        
       | formula_ninguna wrote:
       | And? What should an average person do with this knowledge -- "may
       | have killed"? Get petrified once again and, of course, rush to
       | get jabbed, or get a new booster?
       | 
       | And then, of course, keep waiting for other scary news, and yet
       | new solutions dictated by the governments and corrupted doctors,
       | which will always involve jabs and boosters, and QR codes.
       | 
       | What's the point in this kind of knowledge? Does it impove or
       | harm your life?
       | 
       | Compare the mortality rates of bubonic plague and covid, and see
       | whether the latter is really dangerous for an average person.
        
         | rhines wrote:
         | Same thing you do with knowledge of more people having died in
         | anything, say "damn, that sucks" and continue living your life,
         | unless you're in a position to do more than that.
         | 
         | As for the mortality rates of bubonic plague and covid, it is
         | quite a bit more sensible to be concerned about covid right now
         | and want to avoid catching it.
        
       | AtlasBarfed wrote:
       | We (US) are at 850k. No way India is doing better than us per
       | capita.
       | 
       | The Omicron new cases reported surge on worldometers is up to
       | 800,000 new cases PER DAY, this is more than 300% higher than at
       | any point in COVID ever.
       | 
       | The death curves trail the new cases by a bit, so we'll see. But
       | holy cow is something up. I really really hope Omicron has
       | substantially less mortality.
        
       | jimbob45 wrote:
       | After the Spanish Flu and now COVID-19, I think it's time we
       | admit that deaths in a pandemic are fully susceptible to
       | Goodhart's Law. It may be best if each country's number of deaths
       | is kept under wraps until everything is over.
        
       | rajeshp1986 wrote:
       | In rural places in India most deaths are not registered at all.
       | There are no funeral and memorial services. Family members and
       | neighbors get together and perform the last rituals without
       | notifying the authorities in any way. The death is counted only
       | when family approaches govt for death certificate which is needed
       | for bank accounts, transferring real-estate or any other govt
       | formalities that needs to be closed. It is hard to get the exact
       | count of deaths with such an unorganized system. I don't deny
       | govt conspiracy to lower the numbers but I think majority of
       | deaths didn't even reach govt books.
        
       | christmm wrote:
        
       | 99_00 wrote:
       | High-risk Covid gene more common in South Asians
       | 
       | They say around 60% of people from South Asian backgrounds and
       | 15% of people of European ancestry carry the high-risk version of
       | the gene.
       | 
       | They estimate the risky version of the gene is present in about
       | 2% of people from African-Caribbean backgrounds and 1.8% of
       | people of East Asian descent.
       | 
       | https://www.bbc.com/news/health-59165157
       | 
       | I'm surprised how little press this study got. What is the
       | explanation for the lack of coverage I'm missing?
        
       | rei_ayanami wrote:
       | Or... its being over reported in the west. US counts people who
       | died with covid in the total number, maybe India is a bit more
       | sensible in that regard.
        
         | ycIsGarbage wrote:
        
         | hogrider wrote:
         | It is well documented they straight up covered up covid deaths
         | in republican states.
        
           | vixen99 wrote:
           | If you make comments like this, why not provide some link as
           | a 'reason to believe'. For all I know you're absolutely spot
           | on but I won't get far quoting "hogrider on HN" as a source,
           | will I? And if your observation thus goes no further, what's
           | the point of it?
        
         | kmos17 wrote:
         | This is so easily disproved, just look at total deaths for the
         | period. Where do you think they are coming from?
        
           | everforward wrote:
           | DUIs are up, suicides are up, overdoses are up, and we keep
           | putting off both routine and urgent medical procedures. There
           | are people with cancer whose procedures are getting bumped
           | because hospitals are full.
           | 
           | There's a meaningful difference between "died from COVID",
           | "died with COVID", and "died due to circumstances surrounding
           | COVID". Our excess deaths are the sum of those 3 categories.
           | 
           | I can tell you for a fact that "died from COVID" is not 100%
           | of those excess deaths, because suicides and overdoses are
           | up. I can't tell you what percentage are in each category,
           | but this "all excess deaths are from COVID" idea is obviously
           | untrue.
           | 
           | The CDC data doesn't even agree with equating excess deaths
           | to COVID deaths. [1] Note that they call out accidents and
           | diabetes deaths increasing 15%.
           | 
           | 1. https://www.cdc.gov/nchs/pressroom/podcasts/2022/20220107/
           | 20...
        
             | gilbetron wrote:
             | Nearly everything you said is incorrect:
             | 
             | https://jamanetwork.com/journals/jama/fullarticle/2778234
             | 
             | In 2020, suicides down, cancer deaths down (because covid
             | tends to kill cancer pages much earlier than they would've
             | died, if at all). Some deaths are up, but no where near the
             | numbers to outweigh covid deaths.
        
               | everforward wrote:
               | You're right on the suicides, I misremembered, my
               | apologies.
               | 
               | I don't know why you're going after a straw-man here.
               | Your own link even shows that COVID isn't anywhere near
               | 100% of the excess deaths, it's ~70% of them. That's my
               | only point. Excess death is not a suitable proxy for
               | COVID deaths, because COVID deaths are only a portion of
               | the excess deaths, sizeable though it may be.
               | 
               | We have excess death, a big portion of those is from
               | COVID, but there are numerous elevated causes of death
               | that also form a substantial portion of those excess
               | deaths. You can't just declare that we have 500k excess
               | deaths, and COVID is around, so COVID killed 500k people.
        
               | [deleted]
        
               | Ensorceled wrote:
               | Interestingly, the sudden, unexplained spike in a bunch
               | of categories for 2020 is very suspect.
        
               | gilbetron wrote:
               | Many of them are probably due to the fact that people
               | were less likely to go to the hospital due to fear or
               | hospitals being clogged. Patient care took a big hit,
               | basically.
        
             | FabHK wrote:
             | > suicides and overdoses are up
             | 
             | Do you have reliable statistics on that? Quick ducking
             | showed that suicide rates in the US rose during the 2010's,
             | but it's hard to find more recent numbers. This article
             | claims that suicide rates fell in 2020.
             | 
             | https://edition.cnn.com/2021/11/03/health/suicide-
             | rate-2020-...
        
               | everforward wrote:
               | Somebody else posted the overdoses, I think I stand
               | corrected on the suicides. They're down overall, but up
               | among adolescents and I think my brain extrapolated that
               | out to a general increase. My apologies on the bad data!
               | 
               | I'm slightly suspicious of the claim that they fell,
               | because it flies in the face of common sense and
               | historical trends, but weirder things have happened. It
               | just seems strange that amidst a period where people are
               | self-reporting increases in mental health issues that the
               | suicide rate would drop.
               | 
               | Suicide hotline calls were way up in 2020 [1] (Crisis
               | Text Line was up 40%, SAMHSA hotline was up circa 500%).
               | Major depressive disorder was up 28% in 2020, and anxiety
               | disorders were up 26%. [2]
               | 
               | Perhaps there's a confounding factor here like telehealth
               | increasing the availability of and participation in
               | mental health treatment. Or maybe the abundance of death
               | made people cherish life more.
               | 
               | The cynic in me wonders if the data was massaged to
               | maintain support for lockdowns, but I don't have anything
               | to substantiate that, so it's not a declaration of fact.
               | 
               | 1. https://www.npr.org/sections/health-
               | shots/2020/05/04/8478417...
               | 
               | 2. https://www.statnews.com/2021/10/08/mental-health-
               | covid19-pa...
        
               | triceratops wrote:
               | > It just seems strange that amidst a period where people
               | are self-reporting increases in mental health issues that
               | the suicide rate would drop.
               | 
               | Maybe the lockdowns brought people closer together with
               | roommates and family. Long commutes are awful for mental
               | and physical health - widespread WFH cut down on that
               | significantly. Home cooking went slightly up[1] which
               | improves physical and mental health because of healthier
               | eating. People had to do more outdoor recreational
               | activities instead of going to malls and bars, and maybe
               | that made them healthier and less likely to commit
               | suicide.
               | 
               | There are so many confounding factors that it's
               | impossible to tease them apart.
               | 
               | 1.
               | https://www.fooddive.com/news/survey-7-in-10-consumers-
               | say-t...
        
               | everforward wrote:
               | We're way into conjecture territory at this point, so I
               | don't mean any of this as fact.
               | 
               | What confuses me about theories like that is that self-
               | reported mental health issues were up in 2020 [1]. I
               | would have thought if it was increased closeness to
               | roommates/family or home cooking or recreational
               | activities then people would report higher life
               | satisfaction and lower rates of mental health issues.
               | 
               | That CDC report even indicates a 4.4% rate of suicidal
               | ideation, which is higher than normal.
               | 
               | It might be something we never know, but it does make me
               | curious and skeptical. If the data really is correct,
               | there might be advances in mental health treatment hidden
               | here somewhere, which would be great.
               | 
               | 1. https://www.cdc.gov/mmwr/volumes/69/wr/mm6932a1.htm
        
               | aortega wrote:
               | See this article. Theres an updated one with even more
               | striking statistics.
               | 
               | https://www.nytimes.com/2021/11/17/health/drug-overdoses-
               | fen...
        
               | hwillis wrote:
               | You're responding to a question about suicide with a
               | completely different article about opioid deaths, and the
               | article itself attributes those deaths to the still-
               | increasing substitution of fentanyl, which has nothing to
               | do with lockdowns. Yet you're talking about "striking
               | statistics" when suicides _did_ decline.
               | 
               | So... a new 22k deaths by overdose, plus 2.5k new
               | vehicular deaths, minus 1.7k suicides, vs _522k excess
               | deaths_. There were a _total_ of 45,855 recorded deaths
               | by suicide. ALL suicides, ALL drug overdoses, and ALL
               | traffic fatalities TOGETHER do not add up to half of the
               | excess deaths. You 're spewing complete bullshit.
               | 
               | https://jamanetwork.com/journals/jama/fullarticle/2778361
        
             | depaya wrote:
             | If someone dies because they cannot get treatment in a
             | hospital (because it is full of covid patients) do you not
             | consider that death a byproduct of the covid epidemic?
        
             | thrwn_frthr_awy wrote:
             | Fwiw a friend mine had a stage 4 breast cancer diagnosis
             | that went undetected for months because of COVID. They have
             | a 92% chance of dying in the next five years.
             | 
             | My uncle is got final approval for a heart transplant in
             | December. We are currently unsure if there will hospital
             | room if he gets called this week.
             | 
             | COVID is killing people just fine with or without the
             | disease and the unvaccinated by choice need to stop taking
             | up hospitals beds.
        
           | refurb wrote:
           | Looks at the CDC numbers. Accidental deaths are up several
           | fold.
        
             | hwillis wrote:
             | You are blatantly lying:
             | 
             | https://www.cdc.gov/mmwr/volumes/70/wr/mm7014e1.htm
             | 
             | https://jamanetwork.com/journals/jama/fullarticle/2778234
             | 
             | Accidental deaths:
             | 
             | 2018: 167,127
             | 
             | 2019: 173,040
             | 
             | 2020: 192,176
        
           | [deleted]
        
           | an9n wrote:
           | Can't be flu can it, because that's miraculously disappeared!
        
             | triceratops wrote:
             | What's miraculous about flu disappearing? Most Covid
             | countermeasures (masking, distancing) work on flu, we
             | already had a flu vaccine, and flu is far less contagious.
        
             | CorrectHorseBat wrote:
             | If you call all the measures against covid miraculously,
             | sure.
             | 
             | And why would the flu deaths suddenly be up so much
             | compared to earlier years? And how would it do that while
             | we're looking for it and don't find it?
        
           | ekianjo wrote:
           | > This is so easily disproved
           | 
           | Oh, you were checking every dying patient?
        
           | aortega wrote:
           | > just look at total deaths for the period. Where do you
           | think they are coming from?
           | 
           | People clearly died. Now, the question is, they died directly
           | from covid, or died from effects of the lockdown?
        
           | mk81 wrote:
        
       | nsxwolf wrote:
       | We seem not surprised that India could undercount millions of
       | deaths, but my impression is that China's near-perfect
       | suppression of all variants of the virus in their population of
       | 1.4 billion is taken at face value. Is it not possible that China
       | is also covering up their real death toll?
        
         | rootsudo wrote:
         | Of course not, there's no incentive for China to lie. None at
         | all, they first established the virus existence, where it came
         | from and took appropriate action.
         | 
         | What else do you expect? /s
        
         | eldaisfish wrote:
         | The Chinese state has the ability and means to do what few
         | other countries can - lock down millions of people and mean a
         | lockdown where people are confined to their homes.
         | 
         | There are also millions of Chinese citizens outside china. If
         | China were hiding millions of deaths, we would have heard about
         | it.
        
           | swagasaurus-rex wrote:
           | I've heard anecdotally by a Chinese immigrant that many
           | people back home had family members that mysteriously didn't
           | make it.
           | 
           | Just the usual "Nothing to see here, move along" that's
           | common to authoritarian regimes who would rather sweep things
           | under the rug than admit failure.
        
           | nsxwolf wrote:
           | I can accept their extreme methods could potentially suppress
           | outbreaks. But could anything really work this well? And
           | shouldn't it have a breaking point - at some point you run
           | into something like omicron that spreads so quickly it has to
           | overwhelm your ability to track and trace and you can't make
           | testing supplies fast enough or hire people to police it fast
           | enough.
           | 
           | And if you're not being given good information, how does an
           | overseas Chinese individual spot anything amiss? Their parent
           | or grandparent dies in China. Well, that's not unusual in
           | itself. It's only unusual if it is happening more frequently
           | than it should, and if that information isn't being made
           | available, how could they know?
           | 
           | COVID is rampant in the United States, yet it doesn't seem
           | like my friends parents and grandparents are dying at any
           | particularly worrying rate - and yet overall, they absolutely
           | are. If the data weren't there, it would be hard to notice
           | anything were happening at all. You could lie to me and make
           | me think supply chain issues were caused by something else,
           | that my occasionally crowded local hospital was seeing a bad
           | flu season, etc.
        
             | dirtyid wrote:
             | People have extended social circles in PRC that span
             | hundreds to thousands depending on connections. Family &
             | friends, their acquaintances, coworkers etc. No one I know
             | in PRC has or knows of anyone that's tested positive.
             | Reports are similar from other PRC diaspora as well.
             | Including business owners with thousands of employees.
             | 
             | Whereas every Chinese diaspora knows of someone getting
             | covid abroad. Every Indian / Pakistani I know have lost
             | people during delta wave back home. Everyone I know in west
             | knows someone whose tested positive during omicron. And
             | this is with noticeable lockdowns, congested hospitals,
             | burning dead bodies on the streets. Versus PRC that has
             | been open since mid 2020 except for targeted lockdowns.
             | 
             | There's also other indicators like import case statistics
             | that many countries maintained into 2020. The TLDR is while
             | flights from North America / EU and other regions were
             | transporting massive amounts covid positives in
             | repatriation flights early in the pandemic, PRC exported
             | very little in the months after Hubei lockdown and then as
             | far as I know, none.
        
         | Symmetry wrote:
         | Probably not, people would "notice the bodies piling up in the
         | corner" and change their behavior if friends and relatives
         | start dying and you'd see that in terms of how full restaurants
         | are, etc. It's not like the Hunanese government was all that
         | good at keeping the scale of the original outbreak secret.
        
       | obelix74 wrote:
       | I live in the Bay Area. I just visited my parents who caught
       | Covid in November. Nobody wants to get tested in India. If you
       | test positive, the local Government gets notified of it and they
       | harass you. My father had GI issues so he was in the hospital for
       | a week (and hated it), my Mom had mild symptoms. She had to get a
       | doctor's note to stay home. Even then, multiple people harassed
       | her at home ("we have to sanitize the home" - take money and
       | throw random chemicals).
       | 
       | I spent Christmas to Jan 7th in India. I carried a bunch of
       | antigen tests and delayed my RT PCR tests till the last day. Did
       | not leave home, just spent time with parents.
       | 
       | In general, nobody cares about Covid in India anymore. Every
       | family has lost one or more family members (my family lost 7)
       | during Delta in April - July 2021, so there is a general
       | resignation. The general Hindu / Indian resignation to karma
       | kicks in and they have largely moved on.
       | 
       | My parents felt comfortable doing antigen tests with me and not a
       | RT PCR - and I don't blame them.
       | 
       | I struggled quite a bit. Relied heavily on Gerson Duckbill N95
       | masks. Not surprised by these numbers at all.
        
       | [deleted]
        
       | keskadale wrote:
       | > The analyses find that India's cumulative COVID deaths by
       | September 2021 were 6-7 times higher than reported officially.
       | 
       | The officially reported number of Covid deaths are ~483k. So
       | according to this analysis, the real number of deaths should be
       | closer to 3.3 million.
        
       | rg111 wrote:
       | I was seeing the image of the funeral pyres, and was thinking
       | that this is the easiest way to make a body disappear.
       | 
       | As 70-85% of Indians are Hindus and they burn their deceased, if
       | someone wanted to count total number of deaths by dead bodies,
       | they would not be able to.
       | 
       | All bodies are gone.
        
         | mohanmcgeek wrote:
         | Births and deaths are registered with the government.
         | 
         | can't burn in the burning grounds unless a death certificate is
         | produced
        
           | bellyfullofbac wrote:
           | Well, there were stories of unburned bodies found floating in
           | the rivers, there are many who couldn't afford the cremation.
           | There's the official rule (registration needed) and the
           | reality on the ground: insufficient government service
           | coverage leading to undocumented births and deaths.
           | 
           | Even China has a lot of undocumented births, because of the
           | 1-child-policy: https://thediplomat.com/2015/03/chinas-
           | hidden-children/ (IMO the accepted "legend" that there were a
           | lot of abortions just demonized the Chinese, whether
           | nefariously or on purpose)
        
         | hnbad wrote:
         | You can't just cremate a corpse by throwing it on some wood and
         | pouring gasoline on it. Even proper cremation still leaves
         | behind some "scrap" (of course medical devices and prosthetics,
         | but also some bones can be very difficult to fully turn to
         | ashes).
        
       | panini_tech wrote:
        
       | AlbertCory wrote:
       | "I think all governments want to downplay the degree of deaths"
       | 
       | That is really unsupported. There is also the opposite desire,
       | e.g. to justify unpopular covid control measures.
       | 
       | Hospitals definitely have a financial incentive to classify any
       | death "with covid" as a death "from covid."
        
       | t_minus_4 wrote:
       | Clickbaity and really questionable science. The author did 0.1%
       | sample survey of adults and asked about covid deaths in the
       | family. I am sure a common man is no expert to tell if someone
       | died of covid, or with covid or during covid - unless there is a
       | medical report. I would not trust any conclusions of phone survey
       | of such small size of general population. The paper would have
       | more credibility if the looked at health records. I am just
       | saying, this is hard problem and the authors of the paper did a
       | very lousy job and with questionable standards.
        
         | 101011 wrote:
         | Any surveys of India are going to amount to a small sample size
         | across the entire population - India is massive.
         | 
         | Also, they're almost certainly undercounting the extremely
         | poor, a very sizable group that is going to fall through the
         | cracks no matter what standards you're trying to abide by.
         | 
         | There's a reason the title says "may" - there's an
         | acknowledgement of room for error here.
         | 
         | The point is, India, in spite of their lack of adequate
         | healthcare, are showing mortality rates well below other
         | countries. I applaud the attempt to discern what the toll may
         | truly be, flawed as it may be.
         | 
         | I'm sure if it was as simple as looking at public health data
         | then they wouldn't have spent the money calling people in a
         | survey.
         | 
         | I'm fine with people calling out error margins for research,
         | but do you really have to say this is lousy clickbaity work?
        
       | nkoren wrote:
       | Unfortunately it's too easy to believe this. During the height of
       | the delta wave, my old classmates from India were frantically
       | sharing tips on our alumnae Whatsapp group on how to source
       | ventilators for family members. Everybody had a parent, aunt, or
       | uncle in the ICU. Many didn't make it. One classmate reported
       | that in the space of a 2-week period, 10 members of his extended
       | family had died. This is all anecdotal, but seems indicative of a
       | situation that goes far far FAR beyond the official statistics.
        
       | jacquesm wrote:
       | This really should not be a surprise. There are many countries
       | that have extremely low covid case counts and deaths compared to
       | their population and development status. And even some of the
       | developed countries get it terribly wrong, for instance, NL,
       | where I live has a 50% gap between the official COVID deaths and
       | the excess deaths taken over the same period (about 21000
       | officially, and about 40000 when looking at excess deaths). The
       | government publications, debates and various websites all use the
       | first number, only the CBS, the bureau for statistics uses the
       | second.
        
         | johnchristopher wrote:
         | Let's hope somehow all kind of numbers were recorded anyway
         | (instead of only one kind reported in mass media) and we can
         | get a better picture of what happened in coming years and start
         | comparing impacts, costs, benefits, disadvantages of different
         | covid policies.
        
           | oblio wrote:
           | They are recorded, as part of regular, normal statistics
           | (cause of death, etc).
        
         | Zigurd wrote:
         | Now that there are good updated numbers on excess deaths, that
         | should be observed before saying, for example, that South
         | Africa is not suffering much from omicron.
         | 
         | There are some plausible reasons to think omicron is not as
         | dangerous as Delta, but it remains very dangerous. The gap
         | between official numbers and excess deaths means that,
         | unfortunately, South Africa's numbers are not a reliable
         | indicator.
         | 
         | The Economist has a web page that tracks excess deaths. I'm
         | sure there are others.
        
           | FabHK wrote:
           | Yes, https://www.economist.com/graphic-detail/coronavirus-
           | excess-...
           | 
           | And for India, The Economist estimates 1.1 to 7.6 m excess
           | deaths, implying 27 to 184 (!) infections per 100 people so
           | far.
        
           | logifail wrote:
           | > The Economist has a web page that tracks excess deaths. I'm
           | sure there are others.
           | 
           | EuroMOMO[0] is one everyone should take a look at.
           | 
           | The "pooled number of deaths by age group" graphs I found
           | thought-provoking, particularly the 0-14 years and 15-44
           | years graphs.
           | 
           | [0] https://www.euromomo.eu/graphs-and-maps
        
         | jnsbck wrote:
         | There is a great paper on excess mortality during the COVID-19
         | pandemic that also corroborates this for almost every country
         | that tracks death count.
         | 
         | https://elifesciences.org/articles/69336
        
           | jacquesm wrote:
           | Interesting. Those figures actually do not agree with the
           | amount that the Dutch CBS reports, the CBS figures are _much_
           | worse than the 12% undercount reported in this paper. But the
           | paper is from a while ago already so maybe that explains the
           | discrepancy.
        
       | srean wrote:
       | I see many comments dissing corrupt doctors and hospitals.
       | 
       | I think this is really unfair and demoralizing to the many in the
       | medical profession who have been working in the middle of this
       | crisis often at the cost of great personal sacrifices, showing up
       | for yet another grueling long day of work, day after day, braving
       | lynching and the attitude of the government that does little
       | apart from token gestures of flower showers and setting the
       | brutality of the police force on medical students should they
       | complain about their lot.
       | https://www.youtube.com/watch?v=yIrOLwQtwYo
       | 
       | Disclaimer: I am not in the medical profession
        
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