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[flagged] ‘Everyone is dying’: Myanmar on the brink of decimation (asiatimes.com)
46 points by terminalcommand on July 17, 2021 | hide | past | favorite | 34 comments


The situation there sounds dire, but this story is literally a set of WhatsApp messages turned into “news”.

> One very reputable public health specialist expects that the population will be decimated by at least 10-15 million by the time Covid is done with Myanmar

I really don’t think you can come up with a headline figure like that and then hand-wave away the actual source.

My Bangkok dentist with an MPH from a good American university has been forwarding me Covid horror stories that are trivially debunked as fake news for the last 18 months — without names and verifiable quotes, the whole thing is worthless.


Given the recent military coup and the history there, naming sources could literally get them killed. The medical assessment may be off, but I'm inclined to trus tthe judgement of an IR expert with years experience of the country they study on the security situation.


Sure, but the medical claim is clearly insane and also the headline


I'm not so clear about that. It definitely seems panicky, but Burma/Myanmar has uniquely bad risk factors.


> I'm not so clear about that

Try your best to get a projected CFR of 25% using any metrics you can with a population that’s 70% under 40, even one with TB rates like Myanmar. Can’t be done.


> One very reputable public health specialist expects that the population will be decimated by at least 10-15 million by the time Covid is done with Myanmar.

The population is only 54 million. How could Covid possibly kill 15 million there!?


I won't comment on how they came up with that number or how accurate it is, but Covid won't be the only killer. As one example, people who have heart attacks aren't going to get prompt care either with the medical system overworked and over capacity.

That was one of the goals of the lockdowns in the US. Keep the healthcare system operational for all the other responsibilities it needs to fulfill on top of pandemic response.


Even if we shut down all medical facilities, 20% of the population dying is outlandish.

Myanmar's circumstances excluded.


20% might be high but in the absence of oxygen support most people over 65..70 will expire if they stay sick longer than a week with this damned virus.

I don't know the how big the senior population of Myanmar is but 10% is not unreasonable.


According to a 2020 report, [0] the hospitalisation rate for over-80s is around 20%. The hospitalisation rate for over-65s will be far lower.

[0] https://www.imperial.ac.uk/news/196573/covid-19-one-five-ove...


In any given year very few people have heart attacks, or otherwise require advanced medical care to survive. So that would have only a miniscule impact on the overall death toll. Especially in a nation like Myanmar with a median age of only 29 years.


Highly recommend this Asian Boss interview[0] for anyone who doesn't know what is going on in Myanmar. She talks about the military coup, how militants regularly shoot at civilians in their homes if they have their lights on at night, how people are starving and live grenades are randomly thrown into neighborhoods.

It's a war zone.

[0] https://www.youtube.com/watch?v=YVbfY0Qcpos


Entirely speculation, but one reason I can imagine is that if everyone is sick at the same time then even basic nursing is not possible, and often just getting fluids into someone makes a giant difference. Has there been a place/time during the pandemic where millions got infected at once in a high density, poorer country?


I assume most of those are from non-Covid medical emergencies that go untreated due to the entire medical infrastructure having collapsed.


That would not be a valid assumption. Few people have medical emergencies each year.


> > One very reputable public health specialist expects that the population will be decimated by at least 10-15 million by the time Covid is done with Myanmar.

> The population is only 54 million. How could Covid possibly kill 15 million there!?

I think this number could end up being 'accurate' for many reasons:

* Their medical system is entirely overloaded. Dead people are simply being left in homes in Myanmar and people are being told to wrap them in cling film and try to keep them cold. The result of dead people in homes and streets will be more deaths from contamination.

* There isn't any oxygen for most people, and the methods they are telling each other to try are just insane. They are sharing information on Facebook about using tea and rice to prevent COVID, as well as using steam to 'burn it out' of the lungs. In desperation, people are more likely to try something crazy than to not try anything at all, as the act of 'trying' makes them believe they are helping.

* The military have vaccinated all of their soldiers, and only the close family of the soldiers (who would take it). Despite this, tonnes of their soldiers are now coming down with COVID within the ranks. I suspect this is because the military have been getting their vaccine supply from China, which has shown low-efficacy. (The 'samples' show high efficacy, but tested vaccines from batches have been incredibly low. Apparently China have been mixing their vaccine with foreign vaccines to bring up efficacy.)

* The military are literally just walking into houses and shooting everybody in there if they suspect they have any involvement in a series of bombings and road blocks. They are likely marking these as 'COVID deaths' so that they do not need to report they are killing people on the world stage, and to avoid local push-back. There is also the added bonus that they can receive global funding pretty much unchallenged for 'COVID relief'.


Easy, once the hospitals get overwhelmed nobody will be able to get hospital treatment. Everyone who needs to be hospitalized who isn't hospitalized WILL DIE. The hospitalization rate is about 20%. So right off the top we'll see about 6 million deaths.

Everyone who is sick will be stuck at home with family members, entire households will get sick, and they will keep re-infecting each other because, doubly difficult is the fact that there are multiple variants being spread, so it's possible to get re-infected with a different variant, the immune systems of the sick are overwhelmed and compromised. We'll see entire households dying. This is where the death rates really start to climb, it wouldn't surprise me if we see 8-9 Million deaths from this group.

Combine COVID with other illnesses and you get very high death rates.

Because Myanmar will be acting like a petri dish we'll start to see all kinds of variants get spawned, we could end up with a version the burns itself out. We could get a version that has 10-12 day incubation period where people are asymptomatic but that has a 50-80% death rate, a version like this could sweep back through the world with devastating effects.

Because some people are vaccinated and the vaccine is only 90% effective, we'll see people who are vaccinated who get sick. One of the variants could end up not be prevented by the vaccine, and that version could boomerang back through the world.

A lot of really bad things are possible.


The hispitalization rate is not 20% aside from the extremely elderly. It is <1% for those under 30.

https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/burd...

https://www.statista.com/statistics/1122354/covid-19-us-hosp...

Mutation is always a risk, but another 25 million isn't a substantial increase in infected. There have already been 1-2+ billion infections globally, and 100+ million in the USA.

https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/burd...

Edited to update hospitzation rate.


One estimate provided by public health experts in Myanmar predicts that 50% of Myanmar’s 55 million people will be infected within three weeks by either the Alpha or Delta variant of Covid-19.

One very reputable public health specialist expects that the population will be decimated by at least 10-15 million by the time Covid is done with Myanmar.


I'm comparing countries in death/million inhabitants, and now the record is in Peru ~6,000 and a few countries have ~3,000 and then the count goes down fast. Go to https://ourworldindata.org/explorers/coronavirus-data-explor... and sort by total death.

10 millions death in a country with a population of 55 millions is 180,000 death/million inhabitants. Perhaps I'm too optimistic, but 30x times the current country record is too much. I doubt that prediction is accurate.


That and current fatality rate is pretty low. Even without medical treatment I can't see it topping 5% across the population.


This quote doesn't explicitly state that the 10-15 million will die from COVID but its certainly implied. That doesn't sound like it makes any sense at all though. 20% of the population? Why would Myanmar see 2-3x the global death toll on its own? I don't think there's any data to suggest a 20% death rate even with 0 medical treatment at all (and assuming 100% infection).

Is this just someone getting trigger happy with an exponential model?


Untreated other medical issues due to health system overload? Maybe combined with civil unrest and partial societal collapse?

That's about the only way the #s make sense and even than it's about an order of magnitude larger than seems plausible. It's really a number that needs explaining.


Seems unlikely still. E.g. the american civil war cost 2% of the population. What prop dies if all medical facilities shut down entirely? Probably no more than 5%?

20% is just utterly enormous.


20% is definitely a lot. But if you look at the estimates of the death rate in Cambodia after the Khmer Rouge, they range from a bit over one million to almost three and a half in a population of roughly eight. So it does seem doable.


According to Wikipedia they killed only(!!!!!!!) like 1.5 to 2 million people (around 25%). https://en.wikipedia.org/wiki/Khmer_Rouge#Number_of_deaths

Also, Khmer Rouge had like 4 years to kill the people, and big waves of covid-19 last approximately one or two months. For example famine and unrelated illness that can't be treated because the hospitals are not working usually take more time to kill people.


Tragic fact:

Although in modern usage decimated means "eliminate a large number", historically it meant "eliminate 10%". So if the predicted loss of 20% to 30% of the populations is correct, Myanmar will be much worse than decimated.

I can't wrap my head around the idea. I hope it's not true.


Historically, decimation was a punishment for Roman legions where every 10th solider was killed by his comrades in arms.


Sounds like real humanitarian disaster, but how do they get a 50% case fatality rate in a country with an average age of 28. Doesn't sound very reputable to me..


> Sounds like real humanitarian disaster, but how do they get a 50% case fatality rate in a country with an average age of 28.

That's probably not the assumption, they are probably counting indirect effects, such as those from:

(1) Medical resource exhaustion impacting death rate from non-COVID direct causes,

(2) Impact on necessary life-sustaining non-medical services from people being sick or dead

(3) Increase in poverty-related mortality from lost work (due to laborer sickness, and due to service disruptions from other people being sick or dead).

#2 and #3 are potentially particularly significant given that Myanmar has a large portion of the population that is already good insecure or otherwise marginal.


I guess decimation doesn't mean what it used to.


I was thinking that too, but apparently in modern English it can mean "to reduce by a large amount". The 1/10th thing is a historical usage.


What do you have to be smoking to claim a 25% population-wide fatality rate from covid?





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