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Covid-19: India excess deaths cross four million, says study (bbc.co.uk)
80 points by monkey_monkey 8 days ago | hide | past | favorite | 157 comments

Excess deaths may come from the restrictions that were placed upon businesses, not from COVID itself. Especially in a place with many food-insecure people like India.

Edit: since people downvote anything that goes against their narrative, here’s a link.

> “For eight days, there was not a single grain in our house to eat and my sister became very weak during this time,” reflects Pooja Kumari, 15.

> “We were all worried about her deteriorating condition but due to our lack of money, we could neither feed her or get her treated at any nearby hospital.”


Covid would still be implicated in that case, because its the Covid lockdowns that would have disrupted that. This is a counterfactual analysis with and without Covid, that certainly does not rule out indirect ways that Covid could have increased mortality. If anyone reads this without taking that into consideration, that's either dumb or agenda motivated, very likely both.

Its fairly straightforward. The number of deaths under a given circumstance have its natural uncertainty and fluctuation that's captured by its statistical variance. One compares the recorded deaths during Covid period against the typical number of deaths during a comparable situation, account for the natural fluctuation, what remains is the excess death that cannot be explained by natural fluctuation of these numbers.

With presence of Covid being the significant way in which the scenarios are different, it can be claimed with statistical accuracy which are the excess deaths that happened as a result of Covid, either directly or because of other factors influenced by Covid (Oxygen shortage being one such example).

That said, those close to the government and its agenda will leave no stone unturned to dispute and discredit this study. As long that's an informed, good faith and rational argument I dont mind at all. I do have serious doubts on whether majority of the disputing and discrediting will be based on good faith.

Ah! downvotes. Why am I not surprised.

"may not be from COVID itself" is already clearly stated in the article.

Right, and the headline surely isn’t designed to make you think it’s from COVID...

It's from the pandemic, excess death and "people are dying because they didn't get medical care for other things" has been a regular talking point, ... At least on HN, commenting on just some snap impression from the headline shouldn't quite cut it, commenting things the article already covers, and a large previous subthread already covers, doesn't really tell us anything new.

No, they may not be “from the pandemic”, they may be from the actions taken in response to the pandemic. These aren’t the same things.

I was literally flagged on HN last year from pointing out potential side effects of lockdowns.

It was weird being pro science and seeing this turn political. It really showed which of my friends could think scientifically for themselves, and which repeated what authority said.

I think the difference is between people who see science as a process and people who see science as a priesthood.

A true pro-science position is to follow the conclusions from scientific observations wherever they may lead however uncomfortable that may be. Someone who is not pro-science but merely adopting the aesthetic of science will claim "obey the science" as though it's a doctrine rather than simply a tool.

I find that these people don't read studies but rather treat scientists as Science.

Scientists are Authority, not science.

It was mind boggling how many scientists made this mistake.


The discussion on this topic here is just opinion and speculation, as are the votes. I think of the upvotes and downvotes in a discussion like this as nothing more than a poll of HN readers' opinions.

   Please don't post comments saying that HN is turning into Reddit. It's a semi-noob illusion, as old as the hills.
From the guidelines https://news.ycombinator.com/newsguidelines.html

Matter of perspective I guess. Deaths directly from COVID also depend on the actions taken in response to the pandemic, so in both cases they are (potentially avoidable) consequences of the pandemic and societies reaction to it.

This is irresponsible. Especially as policy decisions are made from it.

What's irresponsible is making policy decisions based on numbers that are clearly not useful for that purpose.

No other cause of death is reported this way.

> consequences of the pandemic and societies reaction to it

But which? That's an extremely important distinction because the correct response might be further lockdowns or the exact opposite. Merely knowing there were four million excess deaths, while tragic and important information, is not a useful guide for the response.

Of course it's an extremely important question, if you can get data for it, awesome. Doesn't mean we shouldn't publish other numbers just because they are not useful to answer all questions - this is clearly labelled all-cause mortality estimated on extremely thin data. If you just take any random number you see and base your policy on that without context you'll always have problems.

Who said we shouldn't publish that data? I agree with you that it should be published, and considered in context.

And discussion about the effects of lockdowns on the supply chain is part of that context.

The obvious inference many people will jump to is that the deaths are directly due to covid. It's important to remember there are other possible explanations.

And all I objected to was the (perceived) claim that the article and existing discussion didn't acknowledge that, or that readers wouldn't be familiar with the idea.

> Right, and the headline surely isn’t designed to make you think it’s from COVID...

Is that an attempt at sarcasm, or are you pointing out that the headline doesn't make you think it's 'from COVID'?

Because to my eyes, the headline very much describes a situation of excess deaths, including those indirectly attributable to COVID19.

The average person looking at this headline will assume it means COVID caused 4 million deaths. There’s even a colon used, implying that the thing before the colon implies the thing after it.

A less misleading headline would be something like:

> 4 million excess deaths in India: caused by COVID or the response to COVID?

The phrase 'response to COVID' is pretty much a dog whistle for conspiracy theorists.

'4 million excess deaths in India: directly caused by COVID?'

Would leave it less politicised. TBH I'm fine with the headline anyway.

If you're the only person that always hear dogwhistles... Maybe you are the dog?

The only ones who can detect dog whistles are dogs.

Posing a question the data explicitly doesn't even attempt to answer is not a useful title either.

Why stop there, why not add the full paraphernalia and their parents. The fine print towards the end of medicine advertisements make such great titles, dont you agree ?

I have a strong suspicion that its only people reading the title in bad faith who will assume that the word 'caused' does not include all sorts of causations triggered by Covid, be it direct or indirect.

Starvation and supply chain issues are caused by the lockdowns. I'd say that the lockdowns are caused by politicians. It is a bit like, "why did you make me beat you?"

It's the BBC. They love their clicks more than the truth.

The behaviour of the press really has concerned me during the pandemic, I know yellow/tabloid journalism is nothing new but that kind of sensationalism on top of highly targeted social media is. I have no doubt the press as an industry is at least in part morally responsible for causing cases of intractable anxiety and depression in their customers. Media outlets have a Darwinian struggle for your attention and the emotions of fear, rage, and rushed judgement against your neighbours all produce incredible engagement metrics. Think of how many people came to watch public executions in the 19th century for example, we as humans eat that kind of thing up like a half-starved labrador.

Since social media became widespread our society has possessed a well-oiled machine powered by human sentiment and the pandemic has filled that machine's fuel tank with liquid fear and suspicion. News sites don't exist to report the news, they exist to get your eyeballs on them whatever the cost and drive up their site traffic (in the case of most media outlets to serve more ads, in the case of the BBC it's an enormous part of the UK's soft power domestically and overseas).

Think of how many inaccuracies, oversimplifications, and claiming that edge-cases are the norm goes on in the press when it comes to our industry, the tech industry. How many times do we read unsubstantiated bollocks even from supposedly reputable publications about AI or cybersecurity, roll our eyes at the obvious inaccuracies, and move on to the next article about COVID which we suddenly take at face value as though our last reaction never happened at all? The truth is usually messy, complicated, and with hundreds of asterisks; it often cannot be made concise or useful to get eyeballs on ads. It certainly can't be concisely summed up in a five-minute article or judged as a binary true or false by the likes of Mark Zuckerberg.

That's not even mentioning the likes of the UK's SPI-B (a subcommittee of SAGE) which I think has acted very unethically in its approach of employing what in my opinion are abusive behavioural psychology tactics against the British population. The reliance on inducing fear among the general public to improve compliance statistics I think will be judged very harshly by future historians, and this deliberate emotional colouring of current affairs by public sector authorities won't just go away with the pandemic; a power once used is rarely given up voluntarily. The nice thing about conspiracy theories is that they give a feeling that at least somebody is in control however malevolent and that's actually a comforting thought to many, but I think the reality is that we've built an enormous machine that in an Asimov-esque way has run out of control doing exactly what we told it to do: optimise eyeballs on ads with engaging content. Nobody's really in control, and I think that's terrifying to a lot of people.

I don't doubt death from starvation is a possibility, but probably not the majority cause.

I don’t have reason to be confident about any particular percentage. In 2019, 7.7% of the Indian population had incomes lower than $1.9 PPP. A literally undocumented homeless person in Berlin could make more by collecting forgotten drinks bottles and claiming the deposit for recycling them (this is an actual thing that happens: I’ve had beggars asking for my empty bottles since I came here).

7.7% of India in 2019 is ~105 million, so if 4% of the poorest people in India starved as a side-effect of the pandemic, that’s still 4 million excess deaths.

I would be willing to believe 4 million deaths caused by any of bad harvests, loss of labour opportunities due to economic slow-downs in other countries, COVID directly, the response to COVID, or by diseases that developed economies would consider minor and easily remedied.

> I don't doubt death from starvation is a possibility, but probably not the majority cause.

"Probably"? Is that pure speculation or are you basing it on something?

A year ago Oxfam predicted "By the end of the year 12,000 people per day [worldwide] could die from hunger linked to COVID-19."


Starvation, depression, lack of medical care, lack of future economic prospects, etc. are only a few possible causes.

Not to mention just general comfort, if it's 38c and you have a high fever, it's pretty hard to deal with as apposed to sitting in and air conditioned building in a nice bed.

I imagine high air temperature would be beneficial for these with fever. You get hot for a reason. Artificially cooling yourself will not help.

You are not a freezer. Your basal metabolism doesn't switch off as if it had a thermostat. So no, it's not a beneficial, it compounds, and you die faster.

In the past, when I had certain fevers I would go into a dry sauna or steam and it helped but I think it depends on the type of fever though.

Very true, me too, to "burn" a flu out. However, you can get out of the sauna whenever you want ;-)

I guess it depends how hot. But you're probably right that India goes above the point that it helpful.

I nearly died when thalis were beaten so there is that too. I wonder why they did not put that in the title as a potential cause.

> I don't doubt death from starvation is a possibility, but probably not the majority cause.

There is quite a possibility it is.

A lot of the remoter and poor regions grow their own crops. What they lack is

- education (understanding how to slow the spread the virus with many not even wearing a mask when looking after family members who are ill)

- money (to pay for any medical care needed to treat COVID victims)

And in the poorer but non-remote areas you have population density and hygiene issues.

I’m not saying there aren’t going to be cases where famine is an issue. But it’s certainly not the majority killer — COVID is an effective enough killer on its own if it’s not handled carefully.

India is much less of an agricultural economy than how it appears to people in the West.

People may be living in villages, but fully reliant on city jobs for income to feed themselves.

I doubt even a distant relative will lend a hand to a starving person in India.

The society is extremely stratified. People just a step away on the income ladder live completely separate lives.

I’m not talking about farmland. I’m talking about the basics like having a few trees that grow fruit.

Yes it’s not much, but it can be the difference between life and death when you’re talking about starvation.

Most people in villages do not own any land, not even an inch of it to plant a single tree.

I didn’t say “people”, I said “regions”. Indians generally have a large and collaborative communities, which is a concept totally alien to many westerners who don’t even talk to their neighbours.

This is also part of the reason COVID is so rampant there.

And yes, I’m aware I’ve now reduced the discussion down to massive generalisations about a massive country with a diverse populous and I’m sorry. Obviously there will be a great many counter examples that disproves my point. But from the perspective of my friends and family who have other friends and family in poorer regions of India (and I do mean poorer by Indian standards not poorer but ours but relatively rich by Indians) what I’ve said is fair and accurate. Im sure what you’ve said is also true by virtue of the size of the country.

Also remittances from abroad.

Do you realise that "poor Indian people going to work abroad" are in their prime majority not that poor by India's own standards?

It takes a fortune for a village to send a man for work in the gulf.

I'm sure it does. I would still like a link to the study. I always wondered why is it so hard to actually link to the study in question.

Because the author hasn't seen the actual study, they've just rehashed something from Reuters/AP/similar and fleshed it out a bit with some more 'India facts'.

Also because, although I agree with you, 99.9+% of BBC visitors don't care and won't click it, and some high proportion of the remainder won't have access to more than the abstract, another will immediately bounce because they clicked accidentally or didn't realise studies had lots of boring words and weren't YouTube videos of exciting lab experiments with white coats, etc.

Attribute all excess deaths as Covid deaths? And there's a supreme court order to give money to these families. Tough times for the govt

> Attribute all excess deaths as Covid deaths?

"Excess deaths are a measure of how many more people are dying than would be expected compared to the previous few years.

Although it is difficult to say how many of these deaths have been caused by Covid-19, they are a measure of the overall impact of the pandemic."

Especially in India, it's likely that a good chunk of those deaths are the result of attempts to aggressively stop the virus without thinking about the costs of doing so. They're really not in a good place to attempt any kind of lockdown given how their economy and food supply chains are, and yet they ended up attempting it anyway with ugly results.

Can you estimate a percentage? Even if say 50% of deaths were due to lockdowns, do you really think that free movement would have not contributed to an equal or greater increase?

As a further counterpoint, I'll use Norway and Sweden as examples. Sweden did not implement a lockdown, yet had a 10x worse per capita death count than Norway. If anything, this suggests that you'd need around 70-90% of the excess deaths to be attributed to something other than COVID, which feels like a heavy bar to clear.

Honestly, I'm not sure how you'd even be able to measure that. India doesn't seem to be doing so great at recording the cause of death, given that only a tenth of these were counted as Covid deaths and it's unlikely to be that low, plus you'd expect a lot of starvation-related deaths to show up as people dying from diseases that shouldn't otherwise be fatal...

Other things besides lockdown is obviously at play considering Sweden being smack in the middle of the statistics. Ahead and behind countries with law mandated lockdowns.

Many pieces to this puzzle - generational living, skin tone and diet for example.

>Sweden did not implement a lockdown, yet had a 10x worse per capita death count than Norway.

the situation is much more complicated. Looking at excess deaths


one can see that in Sweden despite high rate of death, the excess rate is very low compare to countries with comparable Covid death rates. The Norway and Finland are among the few exceptional countries who had negative excess rates.

This is my perception aswell. India doesn't have the infrastructure and social well-fare systems needed to support a population in lockdown. Because of quarantine restrictions many householders were not able to provide food for their families.

How many died from starvation? Or is it something you feel happened.

I've based my comment on observations from relatives living in Maharashtra. Getting estimates seems impossible to me, because India doesn't record cause of death very well (if deceased person itself is even recorded)

I think it was more of a half baked lock down that caused the economy to get worse, and yet hardly see any improvement at curbing the pandemic.

Countries like Vietnam were very protective, and took very immediate actions. They faced both the first two waves quickly, and recovered fairly well for the region.

What lock down related mechanisms do you propose could be responsible for 4 million deaths? Working with more concrete examples might help determine how likely this scenario is.

Do you have evidence for your claim?

yeah, here comes the anti-BJP brigade

> Attribute all excess deaths as Covid deaths?

Unless you have an alternative explanation, it's a fairly reasonable assumption. In fact it's arguably more reliable in aggregate than trying to positively identify the cause of death for each victim, given the magnitude of the number. That wouldn't work for smaller effects though.

Each dead persons family will get 4 lakh rupees, thats around $5000. Unbelievable. Why should the govt pay everyone who died? In a country that’s already poor and starved of cash.

India economy has already been eroded with lockdowns and huge expenses on vaccines being given out for free, and now you have to pay those who died too.

I think you and the parent commenter don't understand the ground realities in such countries. A lot of stuff will remain "on paper" or in "official" communications. There is no way any government here is going to pay $5000 to so many people. Either they will claim fewer numbers or will make an argument in court that they can't pay. Also, the availability of free vaccines is much lower than paid ones, so your claim is inaccurate.

> In a country that’s already poor and starved of cash.


India has announced plans for a third lunar mission, months after its last one crash landed on the Moon's surface.

The cost of space missions done by ISRO is extremely low. Even if you cancel all the space missions, the money saved will be in pennies and the loss of tech know how will be enormous.

The wastage of finances is in other areas. Full page advertisements by govt departments on nonsensical things. Useless litigations. Implementing big changes to laws and systems without proper discussions and studies. Awarding contracts to entities whose track record is a bad one. And so on.

India has become a morally poor nation and 90% of the citizens do not try to see and understand the big picture. They have on interest in spending time to learn what is happening in their nation and see what is happening in other nations and then question why we are doing things in proven wrong ways.

Indians believe more in what is circulated on whatsapp and facebook than if you get a bunch of Nobel winners to explain the truth.

There is an ROI to India's space mission.

The US has homeless problems too, but doesn't stop it from spending on the space program.

Resources need to be spent on all things no ..... not just on the poor, but even on things which may payoff in the future. Another point is, you can never alleviate poverty by just giving the poor money

While I don’t doubt that the actual deaths from covid is far higher than what’s officially reported, I find the attempts to come up with a multiplier amusing. India has never had high quality data to use as a baseline, even those reported from cities. Besides as others have pointed out, the actual cause of death reported isn’t necessarily accurate either. Which is why we see “studies” predicting the actual number to be anywhere from 3x to 10x.

Not having causes of death reported, or rather purposely obfuscated, is precisely the value of these excess-over-baseline mortality studies.

The science and maths of these things are quite well understood and one can give Bayesian credible bounds, or frequentist prediction interval bounds for these quantities.

I also have no doubt that those close to the government will no doubt try everything possible to deny, dispute and discredit these numbers because it does not show a pretty picture.

What you're saying doesn't make any logical sense.

We have data of how many people died (from all causes) for every year from around 1960 to now, getting more accurate as time went on. Certainly for 2000 until now the numbers are very dependable.

We can graph it, see abnormalities, and have very accurate estimates of how many people are expected to die next year in any given country.

Suddenly, for the first time in many, many decades, the estimates from 2019 about 2020 were wildly low. In virtually every country in the world more people died than would have ever been predicted, and suddenly decades and decades of accurate estimations are out the window. Again in 2021 the deaths are way up.

How can you possibly explain so many "extra" or "unpredictable" deaths after decades of numbers that perfectly matched estimates based on previous years?

I don't think you understand how unreliable or easily fudged indian data is. Just during the pandemic, there are good reports of individual indian cities reporting more COVID infections than entire states with the population of a Germany or Brazil.


Indian data on deaths is so bad that deaths not being registered is par for the course. Your entire comment is built on the flawed assumption that data from dysfunctional countries like India is directly comparable to data from the west. It is not. A single death going unrecorded is highly unusual in the west. In India, not only do most indians die outside the hospital system but between 2 - 7 % of deaths are simply not recorded.

Not fudged, deliberately and actively obfuscated, if we are talking Covid numbers. This is so that the enormity of the government does not come in the public domain. Their measures include instructing cremation places to record cause of death just as 'bimari' (Hindi for disease) and refrain from mentioning Covid, removing of shrouds over graves so that the otherwise unmarked thousands of shallow graves on riverine sandbars do not get counted by drone photography.

There is good faith incompetence and then there is deliberate cover up.

The government and their fanboys when describing government's purported achievements -- you are antinational, unpatriotic, treasonous to doubt our reliable data collected by our upstanding officials and members, you should go to Pakistan. Same government when questioned on Covid -- quality of data is very poor I reject all conclusions that do not show us in good light.

@eldaisfish I hope you are aware that the story that you have linked to points towards the rampant undercounting bias. The bias will only lead to gross undercounting of the deaths.

Can you give me proof of the two government measures that you quoted? I'm honestly shocked although at this point I know it's on par for this (or any) Indian govt.

I can certainly show you enough video evidence, whether these are admissible in a court I am not sure. Most of the reporting is in local language, Hindi. Here is one such video


For those who cannot follow Hindi, what you see here is that the government is removing the burial shrouds over these shallow graves (thousands upon thousands) so that they cannot be counted from areal photography.

For some context

https://www.youtube.com/watch?v=ALO0VjfxXDA (pardon the annoying and dramatic music)



Let me find something in English to give context on these shallow graves



For the 'bimari' thing, Shekhar Gupta a reputed Indian journalist covered that on his YouTube channel. Since I dont bookmark any of these, the links are little hard to find again. You can give it a shot by searching youtube and ThePrint. If I find time I can add a few other links that show the same.

UP government (a state that's run by the ruling party) was arresting and slapping terror charges (that allow holding the accused in jail indefinitely without trial) on those who were turning to social media to arrange oxygen cylinders for themselves or for their near relatives. The state government wanted to suppress the scale of their failure. In this particular case, the Supreme Court thankfully intervened and threatened the state contempt of court proceedings if anyone is charged according to these terror laws for asking for help on social media. You should have no trouble finding sources for this.

The tobacco industry tried everything possible to discredit the studies showing how harmful smoking cigarette is. We will be seeing the exact same response from the government, the ruling party and those that are close to its agenda.

Galileo barely escaped alive from the Church.

Dont be surprised by what you see here.

Sad to see how many comments are trying to downplay the number of deaths. Did we forget that these were real people not a number? Or how many families lost their loved ones? Is it time to compare the "fatality rate" with other countries?

I think many people are trying to determine policy decisions.

Do you shut down a country, causing starvation and lack of medical care OR do you attempt business as usual with masks?

People are going to die, the question is how to limit it, and who gets priority.

It shouldnt surprise you, the governments next election is at stake, should their astronomic screw up become more widely known and appreciated. That's as high stake as it gets for the ruling party.

So no wonder that the ruling party and those that are close to their agenda will take every steps possible to discredit the numbers.

The tobacco industry did and does the same to studies that demonstrated the harmful effects of cigarette via statistical studies. Galileo was discredited by the church ...

This is how the game is played

This article was specifically a claim about the number of deaths.

Also, "68% of Indians have Covid-19 antibodies" [1]

Really unscientific calculation: The death rate is estimatedly (4 million) / (0.67 * indian population) * 100 which makes the death rate 0.4%.

[1]: https://timesofindia.indiatimes.com/india/68-of-indians-have...

Seropositivity surveys have a tendency to fall apart.


> In mid-April [of 2020], an eye-catching statistic appeared in the news: the number of people who’d been infected with SARS-CoV-2 in the California county of Santa Clara was 50 to 85 times higher than thought. While just 956 cases of COVID-19 had been officially recorded by April 1, the true number of infections was between 48,000 and 81,000, outlets reported.

> These elevated numbers were reassuring, some outlets noted, because they suggest that most SARS-CoV-2 infections are milder than feared—a point seized on by conservative political commentators and some of the study’s own coauthors as support for the view that restrictive lockdown measures are an overreaction.

Didn't pan out.

It's true, however that same article has previous tests too:

May-June 2020: 0.7%

Aug-Sep 2020: 7.1%

Jan 2021: 24.1%

July 2021: 67.6%

Which makes me think it's better, as it clearly ticks going upwards over time.

Just to bring this in a relative context. This is a fatality rate of 0.28 %. Seems to be higher than in other countries. Germany for example has a rate of 0.11%. I have no clue which the factors between India and Germany are or what these numbers are saying. But just spitting a number of 4 million (little less the population of Denmark) into the room, says even less to me.

Fatality numbers in India during the first wave was lower, the government was prepared and had taken preventive measures. For the second wave India's infrastructure was overwhelmed, because the ruling party was busy throwing 'mission accomplished' media parties, election campaigns and allowing religious congregation attended by millions without any efficacious protection against the virus, rather the dumb belief that the holy water will flush it all away and cure.

Add to it the spread of the narrative that cow urine and cow dung, whether you wallow in it or drink or eat it, its going to protect you from Covid, a narrative that's very dear to the ruling party, and pushed by their members in parliament and members in legislative assemblies.

The consequences were hardly surprising.

> Taken together, the researchers found that excess deaths were estimated to be in the range of 3.4 million to 4.7 million

Gotta give points to BBC for being just as good as any tabloid out there: the headline says "crossed 4 millions" as if it were a fact, while it's obviously a range and the lowest estimation is BELOW 4 millions.

Regular mortality in India is about 7.5 per 1000 inhabitants. That's about 9.8 million deaths per year in India.

Population of India is about 1.3 billion.

Just to bring numbers into perspective.

It actually just shows that Covid is far from as dangerous as it is made out to be.

Many people in India live under 3rd world conditions in extremely crowded slums and towns. They have barely any medical infrastructure. The air quality in the bigger towns is abysmal.

If the exponential growths panic would be justified we'd have to see a way higher excess morbidity!

The truth is there is no exponential growth in reality because any growth hits an upper limit at some point. The western media wants to make us believe that no such upper limit exists or is so high that we can just assume exp growth. In fact all countries show dynamics indicating a rather low upper limit at which point growth ceases to be exponential and instead starts to either stagnate or decrease.

> It actually just shows that Covid is far from as dangerous as it is made out to be.

This doesn't really follow from your numbers.

If it did indeed kill 4M people, that's a nearly 50% annual increase in mortality for India, largely within a few months, despite restrictions and mitigations.

I think the method used in the study is completely flawed. It used case fatality rates from other countries (probably including the ridiculously high first wave numbers) to derive the deaths in India from the number oif infections.

Did they even care to check for a small region if their results are plausible at all?

That's extremely flawed considering India's average age.

it's using age-group specific data.

The study they're using as reference for IFR (Levin) estimates 0.6% for the US. The IFR for the US as of end of Mar 2021 is ~0.5%.

More importantly, their rate estimate does not taken into account obesity. US is at ~36%; India is at ~4%. As per Global Diabetes Atlas, estimated (not just diagnosed) prevalence of DM for US is ~9.3% and for India, ~5.5%. The translation of IFR needs to take into account of these factors, but they don't.

India has a gigant diabetes epidemic.

Per capita, India has more diabetes than much more wealthy countries.

This is the kind if a country it is. People may be dying from obeseti in the city, and starvation in the village just 100km apart.

Simple way to get better estimates is to see YoY gross deaths across states & then subtract it for the 2020/2021 numbers. That way even if they are not tagged correctly you can still arrive at a better estimate.

That's the general idea but some care is needed to account for any trends and to account for the natural variance in the numbers.

For example the 2019 numbers subtracted from 2018 numbers wouldnt be zero. There will be some systematic trends, seasonal variations and some unexplained fluctuations. This requires some model fitting that uses not only past mortality data but also the usual macroeconomic data. Once you are at a point where you see that there are no systematic pattern in the error between the predicted number and the actual numbers, that this error is equally likely to be an over-estimate as an under estimate, then you would be in a position to use the model.

Is ivermectin still evil and misinformation too? Is upcoming september discrimination as proposed by Boris on "freedom Day" good?

It's getting really tiresome to see propaganda day in and day out. Most people aren't afraid. Politicians, by their actions, aren't afraid.

This is all about keeping the fear cycle going and blaming people again for the failings of corrupt governments.

Ivermectin remains unproven; it's not an antiviral, it's a nerve poison for invertebrates.

Are there opportunistic invertebrates that might move into an infected person's lungs or sinuses that could explain reports of it working, if there are such reports?

I hear too much talk from politicians on a daily basis, if it works, I'm in ;)


> The efficacy of a drug being promoted by rightwing figures worldwide for treating Covid-19 is in serious doubt after a major study suggesting the treatment is effective against the virus was withdrawn due to “ethical concerns”.

I have yet to see one large trial confirming or refuting the efficacy of Ivermectin. As long as that doesn't exist, the efficacy of Ivermectin is undecided. I'm highly skeptical myself, but the existince of one poorly executed study is completely irrelevant, as is the assocation with "right wingers".

The onus, right now, is on ivermectin proponents to demonstrate significant efficacy. The evidence introduced thus far has not been compelling, and until that changes, the onus remains on them.

That its advocacy seems to be driven ideologically rather than scientifically is relevant, IMO.

There are dozens of studies demonstrating the effectiveness of ivermectin.


Previously discussed at https://news.ycombinator.com/item?id=26434247, and they're still slogging the HCQ thing in the header.


War is peace.

Freedom is slavery.

Flagged is discussed.

Actually, the advocacy comes from many sides of the political aisle but a very specific "anti right wing" sentiment seems to be hell bent on shutting it down as fast as possible and ignoring real world use.


That podcast addresses the claims against ivermectin and the double standards regarding the high bar for such a cheap and available treatment and the censorship surrounding it.

You apparently do not understand how the evaluation of medicine works. You have to prove efficacy vs a placebo in a test with a control that only receives the placebo (double blind test).

Trials do not refute anything, they can only prove that something works, never that it does not work.

What sort of semantic game are you playing? If you have a large RCT that shows no effect of Ivermectin, its efficacy is refuted, for all intents and purposes. I don't know how else you would phrase it.

No, there is no semantic game here.

You can prove something works but you can not prove something does not work. You might get a different result at different dosage, timing, some other random factor. You can only prove that it works in a certain setting and with a certain dosage.

It's like proving a negative.

For a nice example: water is normally not toxic. But in large enough quantities it is toxic. That doesn't mean that water isn't normally safe to consume, it normally is. But in certain circumstances it can be lethal.

Similar for other molecules.

> It's like proving a negative.

"You can't prove a negative" is one of dopey philosophical slogans[1] that are meaningless in practice. It gives undue weight to absolutes that do not exist in reality. The statement "money doesn't grow on trees" is obviously true, yet you can't logically rule out the existence of such a tree. What are the practical implications of this? None.

If we tested a hypothesis thoroughly, we can say that it is true or not true, not with absolute platonic certainty, but for all intents and purposes.

[1] https://www.youtube.com/watch?v=X8aWBcPVPMo

Again, you don't understand how testing for medicine efficacy works. Your comment history shows long exchanges where you end up in the same spot as where you started without gaining any insight so I am not going to continue this conversation, life is way too short as it is. An attempt was made to explain something to you, it is then up to you to extract value.

Have a good day, nevertheless.

> Again, you don't understand how testing for medicine efficacy works.

I understand perfectly well how the process works. I understand your objection. It is not wrong, it is merely of no consequence.

Outside the realm of logical posturing, "evidence of absence" is valid. In the real world, you need to distinguish between there being "no evidence (but we haven't looked)" and "no evidence (but we have looked everywhere)" and everything in between. Any treatment starts out unproven, but as the evidence of absence mounts, the impetus to look even further dwindles, to the point where a treatment can be considered proven ineffective, again, for all intents and purposes.

The fact that it says "promoted by right-wing figures" shows how politicizes this whole thing is.


That podcast addresses the claims against ivermectin and the double standards regarding the high bar for such a cheap and available treatment and the censorship surrounding it.

It's perhaps worth taking the opportunity here just to note how remarkably stable western society has been in these times.

This sort of mindset could be running and destabilising society. But, really, it isn't.

It feels to me obvious why millions of people, looking at their TVs, far away from the-reality-on-the-ground would be afraid and paranoid. It's less obvious why everyone isnt.

I think this says something hopeful about how governable and mature civilisation at-this-unprecendented-scale happens to be.

> It's getting really tiresome to see propaganda day in and day out.


A suspiciously timed article, just after we ease restrictions. The same scare stories about India happened in March, when we heard the plan to begin easing lockdown restrictions.

It's almost like we're in a pandemic that we are continuously investigating

Are you saying that four million people have not in fact died?

Nobody is actually saying that four million people died. These are estimates based on surveys and other derived data.

You know that I neither wrote that nor implied it.

When has government willingly returned freedoms taken under the guise of "emergency measures" ?

Well in fairness the UK gov did roll back some laws, but they’re certainly keeping some and riding this pandemic to write some even worse ones. Terrorism has been put to bed, and now it’s viruses’ turn I guess.

I propose next a lockdown / travel ban to save the climate?

aww_dang, I happened to look through your past comments. You may want to look at my profile and see if my version of non-conformism interests you.

Last I checked, the US still have income tax https://mises.org/library/origin-income-tax

Careful, that domain is shadowbanned from submissions at HN...

jokethrowaway, I happened to look through your past comments. You may want to look at my profile and see if my version of non-conformism interests you.

My friend jokethrowaway, mises.org will trigger a lot of people. You have been warned, lol.

What are the motives you are implying?

BS headlines everywhere.

Straight from the study: https://cgdev.org/publication/three-new-estimates-indias-all...

"Estimating COVID-deaths with statistical confidence may prove elusive. But all estimates suggest that the death toll from the pandemic is likely to be an order of magnitude greater than the official count of 400,000;"

But no one is adding this disclaimer, everyone is just parroting the 4 million number.

Another thing to ponder, if this amount of people had died, do foreigners really think Indian people would have sat silently? There may be underreporting or missing stats, but I doubt if it is a 10x difference.

> an order of magnitude greater than the official count of 400,000


> An order of magnitude is an approximation of the logarithm of a value relative to some contextually understood reference value, usually ten...

An order of magnitude seems to usually mean something at least multiplied by 10. 400,000 times 10 is 4 million.

An order-of-magnitude means "about 10."

In contexts, it's a way of expressing uncertainty. If I say "About a hundred, but I might be off by an order-of-magnitude," that means "probably between ten and a thousand, perhaps even as low as 5 or as high as 2000"

In the same context, if I say "I'm might be low by an order-of-magnitude," that means "between 100 and 2000"

Bringing that back to a number is nonsense.

Conversations aren't the same as written articles. In a study or article you expect a proper and more precise use of language, hence the 4 million.

The entire point of language like "order-of-magnitude" in an article is to convey uncertainty, and that you're sure at the level of the log of the number.

Error bars are important.

A different poster pointed out other language in the article which DID estimate 4 million deaths more precisely, but that level of imprecision is exactly what scientists and engineers mean by "order-of-magnitude."

It's common for press to take a result with huge error bars, and to condense it to a number.

> if this amount of people had died, do foreigners really think Indian people would have sat silently

Yes? I mean, the UK has had 129k deaths and the government's approval rating remains leading the opinion polls of voting attention.

The statistical deaths of strangers just don't move the needle in politics.

In India, you have the opposition party and then lots of regional parties which are in power in state governments. These parties would never sit silent if the numbers were like this, since they could have used it politically, or people from all parties should be in on the game, which I can't believe.

They don't sit silently at all, but Modi's phenomenal approval ratings barelly took a hit for things which would've been a political suicide to any politician in the West.

Modi's approval rating has taken quite a hit recently though. Your point still stands. Even after the hit in ratings those would be the envy of many.

> do foreigners really think Indian people would have sat silently?

Most of my Indian relatives and family (who all live in India) find this 10x under-reporting very plausible.

An order of magnitude above 400000 is 4 million.

3 million and 5 million are also an order-of-magnitude above 400,000, as are quite a few other numbers.

OP has conveniently left out a few lines just before their quoted bit:

> We report excess mortality estimates from three different data sources from the pandemic’s start through June 2021. First, extrapolation of state-level civil registration from seven states suggests 3.4 million excess deaths. Second, applying international estimates of age-specific infection fatality rates (IFR) to Indian seroprevalence data implies a higher toll of around 4 million. Third, our analysis of the Consumer Pyramid Household Survey, a longitudinal panel of over 800,000 individuals across all states, yields an estimate of 4.9 million excess deaths.

If their (or your) complaint is with these actual methods of estimation, then pick on those, but the assumption that the study authors just want to Jedi mind-trick you into 10x'ing the official Covid deaths number is flawed.



The two of you have gotten into flamewars with each other in the past. This is destructive of what HN is for and is not acceptable. Would you please stop it? We've had to ask you this before. Not cool.


Its very rare that I disagree with you, but I think this would be one such. PP made a claim that data from Indian government is not trusted, and implied bad faith as if the rest of the world has a chip on their shoulder about India.

I think it is legitimate to show why numbers quoted by this government (in particular, but its largely true in general) is distrusted. The examples that I quoted are publicly available and very overwhelmingly typical.

I think a corollary of free speech is that the community should contest and call out misinformation.

You seem to be misunderstanding the guidelines against flamewar and political battle on HN. Your comment clearly broke them and you've done this many times before. This sort of thing is obviously flamewar:

The same government and the ruling party on their claimed achievements -- how dare you question our rock solid reliable numbers. You must be a traitor, unpatriotic, anti-national, tukde-tukde-gang-urban-naxal-protest-jeevi, why dont you go to Pakistan.

We need you not to do that here regardless of how wrong someone else is or you feel they are. Actually your entire comment was flamewar - using sarcasm to sharpen political points, ridiculing opponents, and so on. None of that is ok, and being right (or feeling that you are right) does not entitle you to do it.


Dan I respectfully disagree. It may appear to be sarcasm, I wish it was, it is however entirely and quite dryly literal, multiple statements by cabinet ministers, members of the parliament, official party spokesmen would adequately demonstrate that.

The purpose of adding a link to a Google query was to address this specific misapprehension and criticism. Those are literally the official responses by the representatives of the government.

It only goes on to show how bad the situation is that lifting statements from the official party line gets interpreted as bad faith sarcasm.

To give an example, if I write

   Early Indian scientist unsullied by western corruption could transplant face of an elephant on a human being. -- Indian Prime Minister.
That may appear to be sarcasm, but that's the PMs publicly aired belief. Similarly, wallowing in cow dung and drinking cow urine can prevent/cure Covid is a publicly aired belief of many members of the Indian parliament coming from the ruling party. Problems are exacerbated by the fact that they now have megaphone and people close to their agenda defend them on forums using the idea than any disagreement is sourced from antinationalism, Hindu phobia, proximity to Islam or communism or Pakistan as an argument.

I don't think 'both sides were at fault' does justice.

Hinduphobic guy does not like current Govt. What are the odds!!

We've asked you before not to post like this: https://news.ycombinator.com/item?id=25985903. If you do it again we will have to ban you. Religious and nationalistic flamewar is not welcome on HN, and doubly so in the form of cheap drive-by comments. No more of this, please.

Edit: it was even the same user you were flaming. This is seriously not cool.

That what happens if you let tolerate those kind of comments. Stupid false blatant false info are upvoted. If you try to answer civilly then you are donwvoted. I could have left it, but choose to indulge. You can ban me, anyway that would stop me getting involved in these petty situations. I don't anyway contribute much, just here for some tech news.

btw you implied i would be banned, but not the other user. What makes me special?

Your comment was noticeably worse.

ok. I can understand that.

btw there is no way to delete the account is it? I just need to loose the password?

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