
Don’t Be Fooled by America’s Flattening Curve - hef19898
https://www.nytimes.com/interactive/2020/05/06/opinion/coronavirus-deaths-statistics.html
======
mkl
Um, what flattening curve? Flattening growth rates just mean linear growth
instead of exponential. Flattening total or active case numbers is what
flattening the curve usually means.

Here are some clearer graphs:

[https://boogheta.github.io/coronavirus-
countries/#currently_...](https://boogheta.github.io/coronavirus-
countries/#currently_sick&ratio&places=Australia,Belgium,Brazil,Denmark,France,Germany,Italy,Japan,New%20Zealand,Norway,Russia,Singapore,Spain,Sweden,USA,United%20Kingdom&alignTo=confirmed)
(active cases normalised by population)

[https://boogheta.github.io/coronavirus-
countries/#deceased&p...](https://boogheta.github.io/coronavirus-
countries/#deceased&places=Australia,Belgium,Brazil,Denmark,France,Germany,Italy,Japan,New%20Zealand,Norway,Russia,Singapore,Spain,Sweden,USA,United%20Kingdom&alignTo=confirmed)
(deaths, absolute numbers)

~~~
tomohawk
I wouldn't get too spun up by an opinion piece designed to spin you up. But,
since you asked:

[https://ourworldindata.org/grapher/daily-covid-deaths-per-
mi...](https://ourworldindata.org/grapher/daily-covid-deaths-per-
million-7-day-average?country=USA)

~~~
mkl
That's a graph of growth rate again, showing similar data to the article. That
roughly flat growth rate means linear increase in total deaths, day by day. To
be flattening that total curve, the growth rate needs to keep decreasing.

~~~
tomohawk
It is not a graph of growth rate. It is a graph of death rate, and it shows
the death rate on a day-to-day basis is pretty much constant for a while. If
we have pretty much the same deaths per 100000 from one day to the next, where
is the growth?

~~~
mkl
It is a graph of the rate of change of the total number of deaths, in units
deaths/day. I.e., the growth rate of the death count. The total number of
deaths is approximately the area under the curve, so if the curve stays
constant as time goes on, the total area (number of deaths) increases
linearly.

------
austincheney
I like how they made an example of Texas where I live. My observation is that
people in urban areas aren’t take this seriously from their frequent visits to
stores for shopping, lack of face masks, eagerness for normalcy and so forth.
The risk of exposure is multiplicative of population density. Counter-
intuitively the lower risk rural areas appear to be taking this far more
seriously.

It seems impatience will get the best of us. The only way to beat this is with
very strict exercising of social distancing for not less than three months,
healthy habits, and extreme sanitation. It seems urban areas are not willing
to wait 3 months until there is an uncontrolled outbreak.

~~~
graeme
Flu hits rural areas hardest, but hits them later than it hits cities. I
wouldn’t make quick assumptions this early on.

This may be different, as people don’t take flu as seriously. But America is
already loosening up. You also can’t see stuff as clearly in rural areas. The
big risks are indoor gatherings at private homes, church, work, and school.

If you aren’t doing those things, you won’t see them happening. Whereas it’s
easy to see people walking on an urban street as you drive by, or to watch the
news going to a central urban location.

You see this with crime rates. People assume it’s a big city issue due to
visibility, but crime _rates_ tend to be higher in rural areas.

Coronavirus may well require urban density, but don’t be too quick to assume
it as an axiom.

[https://www.ajc.com/news/state--regional/flu-hits-rural-
geor...](https://www.ajc.com/news/state--regional/flu-hits-rural-georgia-hard-
data-shows-will-covid-the-same/dzStNJhbzIVTQJ7MG0PfJP/)

~~~
Retric
Vaccination rates vary by location.
[https://www.cdc.gov/ruralhealth/vaccines/index.html](https://www.cdc.gov/ruralhealth/vaccines/index.html)

COVID-19 lacks a vaccine, making the flu comparison problematic.

~~~
graeme
That data isn’t about flu. Got anything specific about flu vaccination rates
in urban vs. rural areas? The HPV vaccine in particularly is an issue in the
culture wars.

That said you’re likely correct. I found this from cdc, with rates by state.
At a glance, rural states have lower rates:
[https://www.cdc.gov/flu/fluvaxview/coverage-1819estimates.ht...](https://www.cdc.gov/flu/fluvaxview/coverage-1819estimates.htm)

However, this gap could also be due to health system efficacy in general. So
unclear if we might expect worse covid results in places with fewer/worse
hospitals.

~~~
Retric
This says rural areas have lower influenza vaccination rates:
[https://www.sciencedirect.com/science/article/pii/S0264410X1...](https://www.sciencedirect.com/science/article/pii/S0264410X11009029)

For underlying data you may need to look at BRFSS.

------
coldcode
Living in Florida I wouldn't trust any official numbers of cases or deaths.
Also case numbers in general are dependent on the quantity of testing
available which is highly variable across states and across the country. Even
deaths can easily be uncounted due to people dying without a Covid-19
diagnoses before (or after) death.

~~~
tehlike
You can normalize by checking yoy overall death change, and attribute a good
chunk to covid19.

~~~
votepaunchy
Except it will be impossible to sort out deaths from COVID and deaths due to
lockdown measures.

~~~
bluntfang
Why do you think deaths directly from the virus is more important than virus
deaths + collateral damage? Are you trying to make the claim that lockdown
measures are more destructive than the extremely infectious disease?

~~~
DuskStar
It is quite possible for lockdown measures to be more destructive than the
disease they seek to prevent. Taken to an extreme, forbidding all human
contact to protect against the common cold would be an example of such.

And it's definitely worth considering when trying to determine if a lockdown
was "worth" it. If you locked down and 10k people died, the lockdown looks a
lot worse when 9k of those deaths were due to suicides/"elective"
procedures/missed cancer/etc. Especially if only 20k deaths were expected from
the disease if there was no lockdown at all...

------
SllX
You know what's not being reported on? I'm going through the charts on
[https://www.worldometers.info](https://www.worldometers.info) and I notice
something. There's different tabs for "cases" and "active cases", and you can
drill down into some individual countries (like the USA), and you can drill
down into some individual States (like California).

So I'm going through it today, and one of the columns is total deaths. So for
the purposes of this thread, Closed Cases = Deaths + Recoveries, and while
there isn't a column for recoveries specifically, you can infer a couple of
things from the data that is there.

First, the data sucks. Each State and in some cases, each county health
department is responsible for reporting their own cases and deaths, but it
seems not every place is making good efforts to track recoveries. If you drill
into California and check San Francisco, and it's not limited to just San
Francisco, you can see the "Active Cases" over in about the sixth column is
only Cases - Deaths instead of Cases - (Deaths + Recoveries). Not all 58
Counties are like this, but you also have outliers like Humboldt where
apparently 52 of 54 total cases are recoveries because there aren't any
reported deaths and there's only 2 reported active cases.

It isn't limited to just individual counties in California. If you go back up
a level to the USA and look at various States, you can see that New York is
making some effort to track recoveries because at a glance, Active Cases does
not equal Cases - Deaths, it's actually quite a bit lower than Cases - Deaths,
which is good. But if you look below New York at New Jersey which has had the
second highest number of cases, it would _seem_ like every closed case has
been a death, because Active Cases = Cases - Deaths, same probably with San
Francisco County in California.

So when I last looked a few hours ago, the United States had about 964K Active
Cases. This is probably both an overcount and an undercount. It's certainly an
undercount because we obviously have no idea how many people are actively
carrying it right now. But it's also an overcount because of the verified
cases, recoveries are being underreported.

This bloody chart in the NYTimes is annoying. It is seemingly trying to apply
some corrective measures to people's expectations about how much the curve is
actually flattening in the country, that it is not equally flattened, and that
reporting is fine. It's leaving out half the bloody story which is:
recoveries. If the goal is to lead and not mislead with this piece, then by
not attempting to address the discrepancy in reported cases and active cases,
and how many closed cases are closed because of recoveries and not because of
deaths, it will leave people with a sense that maybe the country is in worse
straits than we think, or at least different pockets.

To be blunt, nobody knows. They don't know, the Administration doesn't know,
apparently half the bloody Governors don't have a clue about a big part of the
situation in their own States in addition to almost every other part of the
situation, and if you assume that in terms of closed verified cases,
recoveries outnumber deaths 4:1, then New Jersey should probably be
subtracting somewhere around 30K Active Cases (assuming there have been 4x as
many recoveries as their reported 8K deaths).

A lot of people are dying or dead, but what about the other side of this coin?
How many are recovering, and why don't we know? Is it really the case that in
New Jersey, not a single person has reportedly recovered and all the closed
cases are actually deaths? The number that's getting trotted out by the media
in terms of cases is 1.2M (implicitly, verified cases rather than actual
cases). But we don't currently have 1M verified active cases, we may not even
have 900K (yet) but the best available data I can find doesn't even reflect
that.

------
amelius
What's that strangle blip in the last days of Sweden's data?

~~~
SuoDuanDao
I'm not sure, but typically when that happens there's a change either in how
deaths are counted or how tests are administered.

~~~
amelius
Could the historical data be adjusted for this blip? Because now it looks like
Sweden's curve is flattening.

~~~
SuoDuanDao
Retconning the data? That's highly unpopular among a vocal minority. Typically
these sorts of things show the raw data and allow people to extrapolate 'real'
infection rates etc for themselves. Changing all data from before there was a
change in the measurement standard would be putting extrapolation right into
the data feed. I think the responsible thing to do might be to show error
bars, then it would be more intuitive what happened.

------
chasd00
there's enough metrics and ways to manipulate them to support any agenda.
we'll probably never get any real insight until after the US election.

------
spodek
My science background leads me to look at the situation as the NY Times does.
I find this article compelling in motivating me to support sticking with
protocols from science experts on social distancing, etc.

Last week I appeared on a very pro-Trump podcast. The starting point for the
very pro-Trump person was freedom and the economy. Numbers like in this
article seemed irrelevant to him, or even signs of people trying to seize more
power.

If we want to lower the spread of this pandemic, our biggest challenge is
influencing people's behavior. If telling people more numbers doesn't
influence people how we intend, they may be verifiable and right, but if we
want to save lives, including our own, we have to figure out what works.

Elsewhere in this thread somebody wrote

> _Another story with tunnel vision._

> _I don 't pay attention to the NY Times, but have they had any opinion
> pieces suggesting that maybe the destruction of the economy is also a bad
> thing? And, maybe, someone besides a reporter or "health expert" should make
> some kind of attempt to determine if it is even possible to sustain these
> policies?_

> _I really feel like I 'm in a Tales from Dark Side episode._

Currently the comment is downvoted to near invisibility.

But that perspective is motivating tens of millions of people. If we want to
motivate them, we have to figure out how to respond. Spewing facts, however
right, if it motivates people to stop listening, or downvoting instead of
addressing is a matter of life and death.

How do we respond effectively to people with such views?

~~~
dhimes
Changing people's minds to something they don't want to hear is really
difficult. I have a personal hypothesis that some people are just _really bad_
at abstract reasoning- they don't really get patterns, and they can't see the
same pattern in a different context. Even something like, "If we're wrong and
come out of this too early we may have to do this all over again next fall."

~~~
DuskStar
Well, here's something you're going to love to hear, then:

"If we do this _right_ and come out of it this summer, we're _still_ going to
have to do it again this fall"

~~~
dhimes
ugh.

------
generalpass
Another story with tunnel vision.

I don't pay attention to the NY Times, but have they had any opinion pieces
suggesting that maybe the destruction of the economy is also a bad thing? And,
maybe, someone besides a reporter or "health expert" should make some kind of
attempt to determine if it is even possible to sustain these policies?

I really feel like I'm in a Tales from Dark Side episode.

~~~
infecto
This is just my own experience but I think its just the usual political
extreme sides arguing with each other.

On the tea party side we have these crazy gun toting nuts (I own guns myself)
that are yelling freedom and other crazy things regarding the lockdown.
Storming government buildings with open carry and at least to me look like
fools

Then on the flip side in the Bay Area we have a bunch of tech workers, working
from home and being comfy yelling that we cannot open up businesses and
everyone is going to die that goes out. I look at my own company internal chat
and its basically this.

Unfortunately both sides and a lack of overall national leadership has
detracted from the real discussion. Our news agencies on both sides are
playing the extremes and nobody is talking about the real issue.

Shelter-in-place does work but its only there to reduce the impact on
hospitals. Its not there to prevent people from getting sick necessarily. We
don't know how long this virus is going to be around. Maybe it disappears,
maybe its here for a year. The whole point of sheltering is so hospitals can
continue to work without being overburdened. I think in the Bay Area the
hospitals have been extremely under-utilized.

What we need are discussions on how to reopen safely. What type of rules do
people need to follow when we do reopen. I don't want to argue what is legally
allowed but I think things like wearing masks in public, public temperature
checks, more testing and forcing quarantine of those and those that have been
around them are all sensible if we want to get the economy going again.

~~~
watwut
> Then on the flip side in the Bay Area we have a bunch of tech workers,
> working from home and being comfy yelling that we cannot open up businesses
> and everyone is going to die that goes out.

Based on polls, most Americans are for shelter in place and are afraid of
economy opening up too soon. The people who are for opening are not
concentrated within groups who lost jobs, but are rather spread out over the
society.

The thing about lower paid workers is that they are also the most affected by
Covid, most likely to get it, more likely to die from it and more likely to
know someone who dies. More affected by healthcare price too if they dont die
but merely need hospital. You can see that in stats from New Yourk too -
middle class people able to work from home and just not as much affected as
those who work in low paid jobs.

The place where I see most pressure for opening economy is HN - Bay Area tech
workers. People here dont work in meat plants nor in essential services nor in
Amazon. Their employers wont have them working in close proximity with other
people even when those are having symptoms. They wont get Covid and wont
spread it to elderly relatives regardless of whether economy is open or not.

~~~
infecto
I think this is again part of the problem with all the misinformation going
around. At some point its too much, we have massive levels of unemployment and
for many parts of the country, underutilized hospitals. We need a leader that
helps focus the message on what criteria is necessary to open and how to do it
safely. There are many countries that have sane rules and the exposure rate is
pretty damn low. Instead of distracting the conversation about low-paid
workers and who is most at risk. We should be looking at the data both the
financial and health side and figure out how to manage both.

~~~
watwut
Answering one of your points is not "distracting the conversation".

Your claim was that one side is "Bay Area workers telling everyone to stay
home". Answering it with "no actually this is not some kind of Bay Area tech
only" phenomenon is completely legitimate. There is no rule that we should
accept made up divisions between groups of people just because it suits you.

> There are many countries that have sane rules and the exposure rate is
> pretty damn low.

Sure, lets say German or Czech republic. The sane rules still involved closing
stores, limiting amount of people in stores, closed schools, mandated hands
sanitation upon entering stores. Mandated masks in public places or plexiglass
between shoppers and sellers. Their hospitals also instantly limited non-covid
related procedures and were underutilized and still are despite countries
slowly opening. Both countries also had citizens who were fairly disciplined.
Their top politicians did not claimed it is all hoax by opposing party to
destroy the country.

Czech Republic reacted quite fast to first few sick people and mandated masks
right away. Germany ramped up testing quickly and super high. They did contact
tracing before virus spread.

> We need a leader that helps focus the message on what criteria is necessary
> to open and how to do it safely.

Maybe start by not forcing both-sides framework on everything. Or making
strawman groups of Bay Area tech workers who are definitely only ones making
America close.

Had there be elevated testing regime now, opening would be closer. Had there
been faster reaction by the start of it all, the New York did not had to
happen and America could be where Germany or Czech Republic is. And it does
not seem to me that this state of things is both sides issue nor Bay Area
techies issue.

~~~
infecto
Oh boy we went down the "strawman" route. Enjoy!

