Guest Essay by Kip Hansen – 27 November 2020
There has been massive media attention on Covid-19 deaths – and there have been a lot of them. The CDC as of noon on 26 November 2020 was reporting that there have been 259,005 total Covid-19 deaths in the United States.
Yet anyone who reads widely is aware that there have been reports of a motorcycle accident victim being reported as a Covid death. There are many who correctly report that all people dying from or with Covid and even suspected of dying from-or-with Covid-19 are all being counted as certified reportable must-make-the-headlines Covid-19 Deaths.
[Note: This is a long and rather detailed explanation of what leads to the situation in which we find ourselves regarding Covid-19 Deaths reporting. Those who want a better understanding of the issue should continue reading. Readers with no or little interest can just accept this brief synopsis: “It’s Complicated” and move on to other posts. ]
Various experts, journalists, bloggers, and pundits tells us that “Covid Deaths” are being over-counted, mis-counted and even under-counted. Other pundits and media-reported experts desperately try to reassure us that Covid Death counts are correct and real – and that we should all stay concerned and follow all government mandates – which vary from “reasonable” to “obviously based on magical thinking” (closing bars and restaurants at 10 PM because that’s when the Corona Virus Zombies attack) — all this despite various governments having different and contradictory mandates (or even an absence of mandates) and the various States in the United States following differing rules and policies on Covid Deaths reporting. Those reporting “facts” like “US Covid-19 Deaths overestimated by 17 times” (based on this CDC comorbitity data) are sadly mistaken and misinform the general public, just adding to the general confusion on the subject.
Doctors, Coroners and Medical Examiners will calmly explain that “Cause of Death” is complicated and not simple. And they are right. Most of us think that when a person dies, it is obvious what killed him/her. But that is just not the case. In fact, everyone dies of a combination of ”heart stoppage” [cardiac arrest] and “cessation of breathing” which eventually leads to “brain death”. But these are not usually listed as the Cause of Death on a death certificate.
Covid Deaths are being counted and reported based on advice from the CDC, who has based its advice on advice from the Council of State and Territorial Epidemiologists (.pdf). More on what that means later.
The Primer: What is meant by Cause of Death?
When a person dies in a hospital or other setting, there is some doctor, coroner or medical examiner that fills out a death certificate – officially certifying that John/Jane Doe has died and reports the date, time, place, Social Security number and other personal details along with the circumstances and sequence of events that led to that death.
Here’s a CDC-annotated image of the Cause of Death portion of a typical death certificate:
We are interested here only in Parts I and II.
“Part I
This section on the death certificate is for reporting the sequence of conditions that led directly to death. The immediate cause of death, which is the disease or condition that directly preceded death and is not necessarily the underlying cause of death (UCOD), should be reported on line a. The conditions that led to the immediate cause of death should be reported in a logical sequence in terms of time and etiology below it.
The UCOD, which is “(a) the disease or injury which initiated the train of morbid events leading directly to death or (b) the circumstances of the accident or violence which produced the fatal injury” (7), should be reported on the lowest line used in Part I.”
[ source: CDC here – .pdf ]
Let’s look at a CDC example:
This patient had Coronary Artery Disease for seven years — which led to Coronary artery thrombosis from which the patient suffered for 5 years — which led to Acute myocardial infarction (heart attack) after which he survived for 6 days until — his heart ruptured resulting in death within minutes. Conditions contributing to his/her death were diabetes, COPD, and smoking. Each of these “significant conditions contributing to death, but not resulting in the underlying cause” are themselves known to cause a wide range of other serious conditions. For instance, smoking is believed to cause COPD and heart disease. Diabetes can cause cardiovascular diseases “including coronary artery disease with chest pain (angina), heart attack, stroke and narrowing of arteries (atherosclerosis).” Notice that there is a dedicated section “35” asking “Did tobacco use contribute to death?” For this patient, the doctor chose “Yes” – thus the CDC will count this death as one of the 480,000 annual tobacco deaths.
Let’s look at another example (from the same document):
This person suffered from noninsulin dependent Diabetes mellitus, often called Type 2 Diabetes, for 15 years. As sometimes happens, this diabetes sufferer eventually went into a Hyperosmolar nonketotic coma in which she/he remained for 8 weeks before finally succumbing to Acute renal failure (kidney failure). The family of the patient would have told friends and neighbors that their loved one died of kidney failure. They may have mentioned this was probably the end-of-line result of his/her long-term diabetes. Type 2 Diabetes is known to cause the following conditions: Heart and blood vessel diseases, Nerve damage (neuropathy), Kidney damage (as in this patient), Eye damage, Slow healing, Hearing impairment, and even Alzheimer’s disease.
It is clear that this second patient died of acute kidney failure – “Acute kidney failure is most common in people who are already hospitalized, particularly in critically ill people who need intensive care” — and is not necessarily a direct result of diabetes – but assumed in this case as kidney damage can be caused by diabetes. The death certificate Part I sequence is reasonable and represents the doctor’s professional opinion.
“In certifying the cause of death, any disease, abnormality, injury, or poisoning, if believed to have adversely affected the decedent, should be reported. If the use of alcohol and/or other substance, a smoking history, or a recent pregnancy, injury, or surgery was believed to have contributed to death, then this condition should be reported. The conditions present at the time of death may be completely unrelated, arising independently of each other; or they may be causally related to each other, that is, one condition may lead to another which in turn leads to a third condition, and so forth. Death may also result from the combined effect of two or more conditions.”
Source CDC Medical Examiners’ and Coroners’ Handbook on Death Registration (.pdf)
So, you call the Cause of Death of these two patients. What was the Cause of Death of each? Did diabetes kill them both? The first patient via atherosclerosis which kicked off the sequence in Part I? The second from the diabetes induced coma or was the coma from simply caused by being in intensive care? Or was it the first patient’s life-long cigarette smoking causing the coronary artery disease? Or would you, as this doctor did, start the death sequence with his/her seven years of Atherosclerotic coronary artery disease? In each case, there are several sequences that would be reasonable and could have been correctly entered by the attending physician, a coroner, or later by a medical examiner.
The above are pretty common examples – long-term conditions which lead to the next condition that finally leads to death. We don’t see the personal information part of the Death Certificate so we don’t know the age of these patients. The age of the patient is often key to Cause of Death – but is not to be used as a cause itself.
“Common problems in death certification
The elderly decedent should have a clear and distinct etiological sequence for cause of death, if possible. Terms such as senescence, infirmity, old age, and advanced age have little value for public health or medical research. Age is recorded elsewhere on the certificate. When a number of conditions resulted in death, the physician should choose the single sequence that, in his or her opinion, best describes the process leading to death, and place any other pertinent conditions in Part II.” [ source: CDC my bolds – kh ]
And then this:
“For statistical and research purposes, it is important that the causes of death and, in particular, the underlying cause of death, be reported as specifically and as precisely as possible. Careful reporting results in statistics for both underlying and multiple causes of death (i.e., all conditions mentioned on a death certificate) reflecting the best medical opinion.
Every cause-of-death statement is coded and tabulated in the statistical offices according to the latest revision of the International Classification of Diseases. “
Source CDC Medical Examiners’ and Coroners’ Handbook on Death Registration (.pdf) – my bold — kh
There are over 69,000 ICD-10 diagnostic codes. Someone goes through every death certificate filed and translates the diseases and conditions the doctors, coroners and medical examiners enter in Parts I and II into ICD-10 codes (soon to be ICD-11 codes). There are so many codes that there are many online look-up tools and apps to help medical staff code up office visits and others to code up Cause of Death certificates. The first Death Certificate above might be coded: “ E08.01 Diabetes mellitus due to underlying condition with hyperosmolarity with coma” – which would cover Part I lines “c” and “b”. This diagnosis is billable. This app helpfully informs the staff if the ICD-10 code they select is “billable” – if not billable, we can safely suspect that office assistants coding office visits can search for a true but alternate diagnostic code that is billable. “All conditions mentioned on a death certificate” are translated to ICD-10 codes and eventually tabulated “for statistical and research purposes”. In our two sample Death Certificates, there are ten different diseases and conditions mentioned. Thus each of the ten condition codes eventually, at the CDC and WHO level, gets a little “tick-mark” – a plus one – added to the number of deaths involving that ICD-10 code.
Thus the huge number of deaths reported for which smoking is claimed to be the cause, as we see in this next quote from the CDC:
“Smoking is the leading cause of preventable death.Worldwide, tobacco use causes more than 7 million deaths per year. If the pattern of smoking all over the globe doesn’t change, more than 8 million people a year will die from diseases related to tobacco use by 2030.
Cigarette smoking is responsible for more than 480,000 deaths per year in the United States, including more than 41,000 deaths resulting from secondhand smoke exposure. This is about one in five deaths annually, or 1,300 deaths every day.”
[ source: CDC here ]
Most people simply accept those statements as fact, though they know of no one who put a cigarette in their mouth, lit up, and died as a direct result. Through many years of public health anti-smoking/anti-tobacco education we have been taught that smoking or otherwise using tobacco can lead to a long list of health problems, many of which cause or contribute to the eventual death of the smoker. In this case, a life-time of tobacco use is referred to, by public health officials, as a “cause” of death – though it probably would not be listed as a cause on a death certificate. Despite not being listed as a cause on the Death Certificate, the CDC and WHO unequivocally tells us that smoking is “the leading cause of preventable death”.
As in many complicated subjects, there are varying definitions in use for the same terms – in this case “cause of death”. There is the general everyday use – like “something that directly causes the death of a person, if it hadn’t happened, they wouldn’t have died”. So, a person gets lung cancer, probably or presumably because they had been a life-long smoker, and dies from the lung cancer. We know they died of lung cancer but accept that smoking led to that death. It is this definition that the WHO uses above. But it is not the official definition that is to be used on a Death Certificate as Cause of Death, which is in the quote far above, labelled Part I.
Those readers who watch any of the popular crime and police television series know that Cause of Death in trauma deaths is even more complicated — “homicide, accident or suicide?” — though those TV Medical Examiners are always portrayed as having almost paranormal insight – “blunt trauma to the head…but that’s not what killed him.”
One last quote from the handbook for medical examiners:
“Precision of knowledge required to complete death certificate items
The cause-of-death section in the medical examiner’s or coroner’s certification is always a medical opinion. This opinion is, of course, a synthesis of all information derived from both the investigation into the circumstances surrounding the death …. It represents the best effort of the medical examiner or coroner to reduce to a few words his or her entire synthesis of the cause of death.”
[ emphasis in the original – kh ]
Bottom Line: Cause of Death determination and reporting is complicated and highly dependent on the training and opinion of the person making the report.
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Reporting of Covid-19 Deaths
Here’s the pivot point on Covid-19 Deaths:
This is from the CDC’s weekly Covid report. See the Column 2 heading? It says “All Deaths Involving Covid-19 (U07.1)1”. The keyword is INVOLVING. To be perfectly clear, what is being reported by the CDC, as collected by the National Center for Health Statistics, are All (every one) Deaths (people dying) that Involved Covid-19. See the little footnote indicator “1”?
Footnote 1 says: “COVID-19 deaths are identified using a new ICD–10 code. When COVID-19 is reported as a cause of death – or when it is listed as a “probable” or “presumed” cause — the death is coded as U07.1. This can include cases with or without laboratory confirmation.”
Not just verified cases in which Covid-19 was the immediate cause of death. At least, to be even clearer, not necessarily what you, the average reader, would consider THE cause of death.
So, what exactly are they counting when the CDC and WHO report Covid-10 Covid-19 Deaths? The World Health Organization’s official guidelines are:
2. DEFINITION FOR DEATHS DUE TO COVID-19
A death due to COVID-19 is defined for surveillance purposes as a death resulting from a clinically compatible illness, in a probable or confirmed COVID-19 case, unless there is a clear alternative cause of death that cannot be related to COVID disease (e.g. trauma). ….
A- RECORDING COVID-19 ON THE MEDICAL CERTIFICATE OF CAUSE OF DEATH
COVID-19 should be recorded on the medical certificate of cause of death for ALL decedents where the disease caused, or is assumed to have caused, or contributed to death.
[ my emphasis – kh source: WHO here .pdf ]
Note that the Death Certificate — Cause of Death Part II is “Other significant conditions contributing to…”. So, there is where Covid-19 (ICD code U07.1) would be written for any death in which Covid wasn’t “caused, or is assumed to have caused” but only contributed to the death. If the decedent was a “Covid case” then he/she becomes a “Covid Death” if they die. Read on . . .
For the general public, who want to know “How many people are being killed by the SARS-CoV-2 Pandemic?”, this definition does not supply the answer to their question. The vagueness and breadth of these definitions is exacerbated, in this “possibly-too-broad” sense, by the definitions being used to define “What is a Covid-19 case?”. We see that the WHO definition of a Covid death includes “a probable or confirmedCOVID-19 case”.
So, how do WHO and the CDC define or advise doctors how to define/determine a Covid-19 case?
Clinical Criteria
At least two of the following symptoms: fever (measured or subjective), chills, rigors, myalgia, headache, sore throat, new olfactory and taste disorder(s)
OR
At least one of the following symptoms: cough, shortness of breath, or difficulty breathing
OR
Severe respiratory illness with at least one of the following:
Clinical or radiographic evidence of pneumonia, OR
Acute respiratory distress syndrome (ARDS).
AND
No alternative more likely diagnosis
[ source: CDC here ]
So, by this definition, I could at this very moment be declared to be a Covid-19 case. I have muscle pain (myalgia) and a headache — two symptoms – — and yesterday, I had a cough — and, if I have reported to the ER and doctors are both rushed and spooked by the pandemic, there might be “no alternative more likely diagnosis”, in their minds at least. (Of course, I have these symptoms for reasons well known to me and my personal physician but this might not save me in the ER.) Especially if they also ask me a bunch of epidemiological questions:
“Epidemiologic Linkage
One or more of the following exposures in the 14 days before onset of symptoms:
Close contact** with a confirmed or probable case of COVID-19 disease;
OR
Close contact** with a person with:
clinically compatible illness
AND
linkage to a confirmed case of COVID-19 disease.
Travel to or residence in an area with sustained, ongoing community transmission of SARS-CoV-2.
Member of a risk cohort as defined by public health authorities during an outbreak.
**Close contact is defined as being within 6 feet for at least a period of 10 minutes to 30 minutes or more depending upon the exposure. In healthcare settings, this may be defined as exposures of greater than a few minutes or more. Data are insufficient to precisely define the duration of exposure that constitutes prolonged exposure and thus a close contact.”
[ source: see previous quote ]
So, if I were in the Emergency Room, the ER doctor might ask me these questions: Do you know anyone who isn’t feeling well? Have you been in close contact with them for more than 10 minutes? Have you attended any meeting with more than 10 people in the last 14 days? Have you been to church or a party? Have you visited a restaurant or a bar? Any YES epidemiologically qualifies me as a Covid case. More questions: Do you wear a face mask whenever you are out of your own home? in your car? in WalMart? at the park? while mountain biking? Any NO qualifies me as a Covid case epidemiologically.
You can see how easy it is to be classified as a Covid-19 case. And they haven’t even tested me yet. (Read the link to see why even testing wouldn’t save me.) They would report me as a Covid case even if I tested negative – I might not be positive “yet”.
And while I describe my pending Covid-19 Case classification jokingly, it is a very real scenario. And, heaven forbid, were I to die of almost anything (except obvious trauma) in the next 14 days, I would become another Covid-19 Death statistic.
As most of us know by now, advanced age is a key factor in the vast majority of Covid-19 deaths:
Eighty percent (80%) of Covid-19 deaths are of those 65 years of age of or older – and a full one-third of the deaths occur in those over 85 years. If you are an adult today, then you were born between 1925 and 2000. At your birth, you could expect to live (life expectancy at birth) between 58 to 72 years, depending on your birth year. Those who are dying at 85 or older had a life expectancy at birth of less than 61 years. [My life expectancy at birth was about 66 years – so I have beaten the odds and hope to continue to do so for many years more.]
If this does not seem significant to you, I’ll repeat the CDC quote on reporting cause of death for the elderly – those 65 year of age or older.
“Common problems in death certification: The elderly decedent should have a clear and distinct etiological sequence for cause of death, if possible. Terms such as senescence, infirmity, old age, and advanced age have little value for public health or medical research. Age is recorded elsewhere on the certificate. When a number of conditions resulted in death, the physician should choose the single sequence that, in his or her opinion, best describes the process leading to death, and place any other pertinent conditions in Part II.” [ source: CDC my bolds – kh ]
For the elderly, the aged, the older citizen, which comprise the majority (80%) of Covid-19 deaths, any illness or condition that leads to breathing problems is prone to being classified as a Covid case, and thus a Covid-19 death in “a clinically compatible illness, in a probable or confirmed COVID-19 case”.
Bottom Lines:
- It is complicated.
- Make no mistake, there are lots of people dying deaths that involve confirmed, assumed, or suspected Covid-19.
- Somewhere between “Most” and “Almost All” of those deaths involved other conditions that were already killing the patients – sometimes slowly, sometimes rapidly.
- The official health organizations have their own reasons for what they are counting and they are counting exactly what they say they are counting – but it is not what you or I would expect them to count. They are counting, as the CDC does, “All Deaths Involving Covid-19”.
- The Covid-19 Death statistics represent the counts of the WHO, the CDC and other National and State public health agencies. The general public often mistakenly thinks those counts mean deaths in which Covid-19 was the immediate cause of death – deaths in which the person was killed by Covid-19. That is not the case – it is far more complicated than that.
- The common citizen would have grave doubts about including each and every one of those dead people in the count of “Deaths Caused by Covid-19” if they were tasked with the job of reviewing all of the details of each death. Our citizen might make up our own sensible classifications: such as: ”Old Age complicated by Pneumonia initiated by a viral respiratory infection: maybe Covid-19 or influenza or the common cold”.
- Doctors (and here), Coroners and Medical Examiners are not immune to taking easy shortcuts. The official definitions for Covid-19 cases (in the essay) make it an easy choice for hurried doctors, and official guidance requires at least Covid-19’s mention on Death Certificates, under a vast array of normal circumstances during this pandemic. This is exacerbated by RT-PCR tests returning “positive” test results for very small amounts of viral RNA fragments in asymptomatic people.
# # # # #
Addendum:
There has erupted a flap concerning Genevieve Briand’s research at John Hopkins on U.S. Covid-19 Deaths: I supply these links on the controversy:
Covid-19 Deaths: A Look at U.S. Data
pdf file: https://drive.google.com/file/d/1iO0K75EZAF8dkNDkDmM3L4zNNY0X-Xw5/view
William Briggs: https://wmbriggs.com/post/33680/
Twitter Thread on the Paper: https://mobile.twitter.com/jhunewsletter/status/1332100136152035330
YouTube: https://www.youtube.com/watch?v=3TKJN61aflI
John Hopkins News-Letter retraction notice: https://www.jhunewsletter.com/article/2020/11/a-closer-look-at-u-s-deaths-due-to-covid-19
Author’s Comment:
I have mentioned previously that I come from a medical family and studied the prerequisites for medical school in university, before changing majors for personal reasons. Our home was filled with the joys of new life and the sorrow of babies’ and children’s deaths. My generation fought and died by the thousands in the misguided military intervention in Viet Nam – some of these were my cousins and high school and college friends.
We are all sad when lives are cut short.
Covid-19, the illness caused by the SARS-CoV-2 virus, is shortening the lives of thousands in the United States and around the world. One blessing is that it is mostly shortening the lives of those who have already had a life – as opposed to stealing the entire lives of our children and young people.
Public health organizations have valid reasons for counting “All Deaths Involving Covid-19” using their own internal definitions, which are suitable for epidemiological studies and research when combined with all the other information being collected to produce that statistic. That statistic, created with their surveillance and epidemiological definitions, is not suitable for release to the general public without a long and complicated explanation – releasing just the number, and labeling it as Covid-19 Deaths is a form of misinformation.
The media, politicians, health agencies and governments have utterly failed to effectively communicate the reality of Covid deaths, failed to illuminate the caveats and complexities of Cause of Death reporting and instead of have repeatedly just reported this “Big Number” in a usage that is seems to be intentionally misleading.
Opinions vary on this subject.
Address your comments to “Kip…” if speaking to me.
Thanks for reading.
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Kip, a very nice summary of the fog surrounding COVID-19 death data. Our first cases locally began in mid-March and I have reported to various groups on the biological growth curve of SARS-CoV-2 in various counties in Florida, Alabama, Mississippi and Louisiana since that time. If I could figure out how to do it, I could regale you with various charts on total cases, new cases, accumulated new cases and the like; however, the one area I have avoided reporting, or reporting very little, is death from COVID-19 because that number is so fraught with uncertainty for the reason you so thoroughly delineated. The report that has my attention is the upcoming annual report for 2020 by the State of Florida which lists the top 30 cause of death, which I anticipate will have a new category related to SARS-CoV-2. I want to compare deaths from respiratory illnesses in 2020 to previous years and see if that adds any clarity. This virus is following the expected growth curve (using humans as proxy, of course) of an organism (virion in this case) invading new territory with no limiting factor, initially and many questions remain regarding its origin, biology/ecology and medical effects as well as its socio-economic and political impact. Time will sort all of that out.
JRF in Pensacola ==> Appreciate your input and look forward to your analysis. Would you email it to me at my first name at i4.net?
Done.
Kip, I was a Coroner for 9 years here in British Columbia, I left the Coroners Service because I was tired of being dragged out of bed at 03 double buffalo (I’m 72) Your exposition on cause of death was right on the money I had many arguments with my superiors over what was put in part 1, most of which I lost. It would be interesting to see the actual number of deaths where Covid was number 1 in Part 1
Kevin McNeill ==> Thanks for the input of someone with actual Coroner experience and for backing my view. Appreciate your sharing your experience with us.
I forgot the most important comment earlier assuming it ewver shows up here.
This is a good article on a complicated subject.
69,000 causes of death codes?
Only government bureaucrats could come up with such a ridiculous total.
Richard ==> ICD-11 will have even more codes ….
Kip, you wrote:
Readers with no or little interest can just accept this brief synopsis: “It’s Complicated” and move on to other posts. ]
And then at the end you wrote:
Author’s Comment:[268 words]
You night have said, “Readers with no or little interest can just accept this brief synopsis: “It’s Complicated” and move on to my comment at the end.”
So the other day when I read the state by state rate of covid deaths with Wyoming with the fewest and New Jersey with the most and Wisconsin in the middle of the pack with about a 1 in 5,000 chance of dying because of covid, that number in real terms is significantly less than 1 in 5,000. How much so apparently is up for grabs. Thanks for a great post and the last comment.
Steve Case ==> Thanks, I do try to educate in essays. I use my Author’s Comment section to express my opinions.
Thanks for the reply (-:
Non medical layperson, (Allegedly) at risk (63) from Wisconsin.
I don’t like being lied to. And having followed this debacle since about March of ’20, I am not very happy with the dearth of understandable information. I see lots of “cases, cases, cases” and lots of push back on social media. This article of Mr. Hansen presented much about the “death” issue. Even so, per the Wisconsin Dept. of Health website…
The first five numbers are “official” from that website. The rest are my spreadsheet calculations using those five numbers.
Examining the claims about Covid-19 ☣
As of: 11/28/20
2,509,537 Tested
375,837 Tested Positive
3,257 Dead
16,715 Hospitalized
301,541 Recovered
———————————————
80.23% Ratio Recovered to Tested Positive.
4.45% Ratio Hospitalized to Tested Positive
19.49% Ratio Deaths to Hospitalized
0.13% Ratio Deaths to Tested
0.87% Ratio Deaths to Tested Positive
5,822,434 Population per official guesses (census)
0.056% Ratio Deaths to Wisconsin Population
14.98% Ratio Tested Positive to Tested
7,557 Extrapolated Statewide Deaths
My GP has taken the issue very seriously. I’m starting to take the mask mandates as tyrant overreach. I am of above average intelligence and I still am not sure what to make of this entire “living in interesting times” reality.
Back to reading the rest of the comments.
Unpicking the statistics in years to come is going to be hard for deconstruction, reporting and analytics. Thank you for taking the trouble to write this post, it is a worthy read for anyone interested.
Clinton Jones ==> You are right there — as in many fields, once the data is collated and tabulated, some of the original information is lost. In this case, Cause of Death, the death certificates (on paper or their digital copies) will disperse into the archives of Vital Statistics and may not be able to be recovered and re-tabulated. This happen in CliSci as well, where very pure raw date (never touched and adjusted or averaged or anything) disappears into some black maw — sometimes intentionally for various “very good” reasons and sometimes just because its value to Science is denigrated or ignored — attempts to “save space” on servers (a total absolute nonsense idea these days — my little music playing tablet has enough digital storage to save all the text of all the books in most libraries).
Here’s a question – COVID is killing about 200k people per year in the US. Smoking kills more than twice that amount every year. Why have we destroyed our economies and freedoms to reduce some of those 200k deaths whereas we could save 1/2 a million deaths by banning smoking ? I’m a smoker. I’ve tried quitting many times. To be honest, one of the easiest ways for people like me to quit would be if the product was banned. If our governments and media were truly concerned about deaths (and not using COVID for political purposes), then why have those same government and media not called for the banning of smoking ?
ggm ==> I can just see it now — in Rocky-Mountain-High Colorado, illegal tobacco cigarettes being sold on the sly, under the counter, in Marijuana Shops.
No way are weed shops risking their cash cow by violating any mandate, try and buy weed with a loose mask. A big dude will introduce you to the door faster than you can say wutt!
because?
TAX
which govts cant do without
In Aus our tax on baccy is huge
if we all quit the damned treasury would have a fit, and be broke!
funny the smaller taxes on alcohol get kept low
its an “important” business…
but the misery from drunk drivers domestic abuse rapes hospitalisations from PFO(pissed n fell over) injuries diabetes kidney liver etc failures ,would tally as high or higher than baccy
IF they cared to look
I say because this a friend is an alcoholic who manages to hide it well
her docs treat her copd from smoking and other work related causes ie dust chemical use etc
but they have NO idea of her grog intake at all and dont ask, and Im damned sure its affecting her medication outcomes , she has a dud hip but was it the hip that caused her first( of many) bad falls or being drunk and falling that stuffed her hip, creating numerous recent falls with emergency visits for sutures?
but if she died tonight the cause of death will be labelled as smoking related, even if a clot from a recent fall is the cause for it for eg.
Kip, thank you for the very interesting information about how “cause of death” attributions are made in the United States. However, it is not correct that you can be “classified as a Covid-19 case” without compelling evidence that you were infected. (By now, that generally means a positive Covid-19 test result.)
Simply admitting that you don’t wear a face mask when you are driving your car, or mountain biking, etc., would never qualify you “as a Covid case epidemiologically.” Even evidence of exposure to a known Covid case will not qualify you as a Covid case. Only evidence that you are actually infected with Covid-19 will do that.
If you test negative for Covid-19 and then die, then your death will not be blamed on Covid. That fact almost completely precludes erroneously attributing hospital deaths on Covid, for patients who were not infected with it, because American hospitals are now routinely testing all admitted patients for Covid-19. Around here they get the results in about four hours. (Occasional exceptions could happen due to an erroneous test results, but false positives on Covid-19 tests are rare.)
(Aside: If you get tested for Covid-19 outside of a hospital, here in NC, you’ll be fortunate if you get the results back in four days, because of the catastrophic, mind-boggling, inexcusable incompetence of our State officials — but that’s a rant for another day.)
There is no circumstance in which your hospital death could be blamed on Covid-19 if your Covid tests were negative, on the specious theory that “I might not be positive ‘yet’.”
It is true that, for a time after exposure, a newly infected person will test negative. (That’s why someone who’s believed to have been exposed, may need to be tested twice, before we’re confident enough that they’re uninfected that they can be released from self-isolation.) But those “false negatives” generally occur while the infected people are still asymptomatic. If your infection is so recent that you still aren’t shedding enough virus to be detected by the tests, then your infection is almost certainly also too recent to be causing significant symptoms, let alone life-threatening symptoms.
It also is not true that, “any illness or condition that leads to breathing problems is prone to being classified as a Covid case, and thus a Covid-19 death in ‘a clinically compatible illness, in a probable or confirmed COVID-19 case’.” The requirement for “clinically compatible illness” when attribiuting a death to Covid-19 is in addition to the requirement of having a Covid-19 diagnosis.
Of course, some people who die “with Covid” do not die “from Covid,” but instead from some other cause. Some of those deaths are probably mistakenly attributed to Covid, but it is easy to demonstrate that their number is not high enough to much affect Covid-19 death statistics. That means:
The great majority of Americans who die “with Covid” were killed by it.
That is according to “the general everyday use” of the terminology, meaning that the Covid-19 infection “directly causes the death of a person [and] if it hadn’t happened, they wouldn’t have died” (or at least they would not have died as soon).
We can demonstrate that fact with some simple math. First, we need to establish a few facts:
According to worldometers, 5,250,361 Americans are currently known to have Covid-19. However, many cases in which the disease is not serious enough to require hospitalization are not being diagnosed, so the true number of active cases could be twice that. 10 million active cases would mean that about 3% of all Americans are currently infected with Covid-19 (a rough but reasonable estimate).
On an average day, when there’s no epidemic, 7000-8000 Americans die of all causes. If 3% of the American population is currently infected with Covid-19, right now, then you would expect that, very roughly, 3% of those people who die today due to other causes happen to coincidentally also be infected with COVID-19. But 3% of 7500 is only 225 people.
That’s a rough estimate of the approximate number of people who die on an average day in the United States, from some other cause, while coincidentally infected with Covid.
However, that includes deaths from many causes which are never attributed to Covid-19. Automobile accident, suicide, murder, fire, drowning, etc., are never attributed to Covid, regardless of whether the victims were infected. Those deaths are not attributed to Covid-19 even when they arguably should be, e.g., when neurological effects of Covid cause dangerous behavior, which results in a person’s death (as was probably the case with George Floyd).
It also includes many people who die outside of hospitals, and were never tested for Covid, so they were not counted as Covid deaths. Depending on whose statistics you believe, only 35% (according to the CDC) or 60% (according to a Stanford group) of American deaths occur in hospitals.
So, if half of those 225 were misattributed to Covid-19, because of a positive test result, that would be only ≈112 cases.
Compare that small number to the number of detected Covid-19 deaths in the U.S. (an average of 1659/day, calculated over one week, Nov 17-24). 112 is just 6.8% of 1659.
So the answer is that only a few (much less than 10%) of the approximately 1659 deaths/day in the United States attributed to Covid-19 could possibly have been erroneous attributions of people who actually died from another cause, while coincidentally also infected with Covid-19.
That’s not enough to affect the statistics very much. It is almost certainly less than the number of undiagnosed Covid-19 deaths, which occur outside of hospitals. That means the reported number of Covid-19 deaths (271,038, as of a few minutes ago) is an undercount.
The “life expectancy at birth” figures are also tricky, because they are averages, which are heavily distorted by infant mortality. The statement that people born during or before 1935 “had a life expectancy at birth of less than 61 years,” really means that they had an average life expectancy of 61 years. The number seems low largely because quite a few people died very young, pulling down the average.
Remember, there were no antibiotics available at that time. The first sulfonamide drug was introduced in 1935, and penicillin was not widely available until nearly a decade later. So infant mortality and childhood diseases claimed many lives.
Americans born in the early 1930s, who survived infancy and childhood, generally had good life expectancies. Americans who were born in 1935 and lived to 65 (turned 65 in 2000) had an average life expectancy of almost 83 years.
Dave Burton ==> You and I are not going to agree, I guess. The definitions insisted on by WHO and CDC are what they are — and are mostly being followed.
I suggest a bit more reading of the links supplied — the deep data on how to diagnose a Covid case and how to designate a Covid Death.
I don’t see what there is to argue about. The text you quoted in your article is clear:
That says:
1. A death from “clinically compatible illness” should not be classified as a Covid-19 death unless there was also “a probable or confirmed COVID-19” infection.
That rules out someone who tested negative, and it also rules out someone who was not tested because Covid-19 wasn’t suspected.
The requirement for “clinically compatible illness” when attributing a death to Covid-19 is in addition to the requirement of having a probable or confirmed Covid-19 diagnosis.
2. A death from “clinically compatible illness” should not be classified as a Covid-19 death if the death appears to have been due to trauma, or due to some other cause unrelated to Covid.
That rules out the infamous “motorcycle case.” Indeed, the article on that case which you cited reports that the motorcyclist was erroneously included in the Covid death count, and has been removed from that count:
It is possible that the motorcyclist’s illness caused his accident. Nevertheless, his death was not attributed to Covid-19.
A few months ago a generally healthy 40yo friend of my physician felt ill, and got a telemedicine consultation with her doctor (not my doctor). He told her that she had all the symptoms of a serious Covid-19 infection, and she should immediately go to the ER. However, she tarried a bit: she took a shower, and packed some clothes, before driving herself to the hospital. She parked her car, began walking to the hospital building — and collapsed and died in the parking lot.
My doctor is confident that she was killed by Covid-19, but he believes that, because she died before being tested, her death is not including in the Covid death statistics.
Dave ==> I don’t think I am going to change your mind, but I will try here for the benefit of other readers who may have the same confusion:
A “clinically compatible illness” is defined by the “Clinical Criteria” quoted in the essay. Nothing in the definition of a the Clinical Criteria for declaring a Covid case ( and thus any “clinically compatible illness” ) requires a positive Covid-19 test of any sort. There is only a “rule out” statement — “unless there is a clear alternative cause of death that cannot be related to COVID disease (e.g. trauma).” So, unless one was hit by a bus, or sledgehammered to death by a spouse, or was killed in a motorcycle accident, anyone who had an illness that meets the Clinical Criteria, carefully defined, can and is declared a Covid case.
You are mis-reading the quote on “DEFINITION FOR DEATHS DUE TO COVID-19 ” — it does not say “unless there was also ‘a probable or confirmed COVID-19’ infection.” (quoting your comment) It says “in a probable or confirmed COVID-19 case, unless there is a clear alternative cause of death that cannot be related to COVID disease (e.g. trauma).” The Clinical Criteria for a “probable or confirmed Covid-19” infection is given in the essay — The Covid case can be with anything that looks like Covid-19 — meeting the Clinical Criteria — UNLESS there is an alternative…that CANNOT be RELATED to Covid disease — for example TRAUMA.
Re-read the section on Clinical Criteria.
I only mentioned the media reports motorcycle accident victim incorrectly labelled a Covid case as part of the confusion surrounding the issue.
I cannot account for your anecdotal “my doctor” story, which makes no sense. A dead person can be nasal swabbed easier than a live person for testing. Such a scenario does not sound like a typical Covid-19 case nor a typical Covid-19 death.
Kip, it is not correct that “There is only a “rule out” statement.” There are two “rule out” statements.
You wrote, “it does not say ‘unless there was also “a probable or confirmed COVID-19″ infection.'”
That’s inverted. What it says is, “in a probable or confirmed COVID-19 case.”
What that means is, “only if there was also a probable or confirmed COVID-19″ infection.”
Perhaps our disagreement boils down to your misinterpretation of this phrase:
“a death resulting from a clinically compatible illness, in a probable or confirmed COVID-19 case, unless…”
That refers to someone:
1. whose death resulted from a clinically compatible illness, AND
2. who was a probable or confirmed COVID-19 case, AND
(3. not the “unless” clause)
You seem to have overlooked the first implied “AND”.
A confirmed Covid-19 case is one which has been confirmed by a positive test result. (I assume we’re in agreement about that.)
A probable Covid-19 case is one in which there’s no test result (or perhaps, rarely, two conflicting test results), but there is other convincing evidence of Covid-19 infection: e.g., an untested person, with typical Covid symptoms, and confirmed Covid diagnosis of a close family member.
According to the WHO guidelines that you quoted, a “probable or confirmed” Covid-19 infection is insufficient basis to blame a death on Covid-19. There are two additional requirements:
a. “Clinically compatible illness” AND,
b. Absence of “a clear alternative cause of death that cannot be related to COVID disease (e.g. trauma)”
Only if all three requirements are met is a death supposed to be counted as a Covid-19 death.
The motorcycle article you referenced mentions “b.” It says, “instances such as trauma, homicide and motor-vehicle accidents are supposed to be excluded from the COVID-19 death rates.”
That requirement is in addition to the other two requirements: for “clinically compatible illness” and for “probable or confirmed” Covid-19 infection.
If you want to write it symbolically, then:
X = “A Covid death”
A = “Death from a clinically compatible illness”
B = “Confirmed Covid-19 diagnosis”
C = “Probable Covid-19 case”
D = “a clear alternative cause of death that cannot be related to COVID disease (e.g. trauma)”
The WHO recommendation is:
X = A and (B or C) and (not D)
Logical “and” is associative, so it does not matter whether which way you group them:
X = (A and (B or C)) and (not D)
is equivalent to:
X = A and ((B or C) and (not D))
Either way, X is true if and only if all three clauses are true:
A = “Death from a clinically compatible illness” AND
(B or C) = (“Confirmed Covid-19 diagnosis” or “Probable Covid-19 case”) AND
D = not “a clear alternative cause of death that cannot be related to COVID disease (e.g. trauma)”
I agree with you that the 40yo who died in the hospital parking lot was an atypical case. I assume she was not considered a “hospital death,” even though she died in a hospital parking lot, because she’d not been admitted.
Covid-19 does seem to produce quite a few atypical cases. Sometimes it kills in unexpected ways. NC lost a healthy, athletic 19yo college student to Covid-19 in September. Note the unusual, delayed, deadly symptoms:
https://nypost.com/2020/09/30/nc-basketball-player-dies-of-neurological-problems-from-covid-19/
Dave ==> Well, I told you I wasn’t going to be able to change your mind. You and I simply do not agree about the ““in a probable or confirmed COVID-19 case.” phrase. The requirements to be considered a “”probable Covid-19 case” are so broad that nearly all patients dying could be considered at least a “probable” (suspected by clinical criteria or epidemiological criteria or lab test including RT-PCR “positive”)….the definition is so broad and nearly all encompassing (excluding only trauma and things that just could’t possibly be Covid) that other points are moot.
Are you reading all the comments? There are nurses, doctors, and coroners supporting, from real medical experience, what I have been saying here.
It is easiest for doctors and medical examiners to include Covid-19 on death certs — at least as a “contributing condition” — that is driving up the numbers so high.
I doubt that you would accept these loosey-goosey-style definitions for matters related to Sea Level rise….
Hello, Mr. Burton. George Floyd’s erratic behavior was triggered by his having had COVID? That’s pretty whimsical, I think. Floyd had dangerous drugs in his system and his death (from a heart attack, not asphyxiation, as so many people have been made to believe) may have been a direct consequence of swallowing his drugs in a hasty attempt to avoid being caught with them. Wait for the trial of Derek Chauvin, and that theory will probably be a cornerstone of Chauvin’s defense.
And you just watch: Derek Chauvin will almost certainly be acquitted, which will result in widespread rioting. That’s the way to bet.
You’re talking about fentanyl. I’m no expert, but I don’t think that’s plausible.
Fentanyl is a strong analgesic. At high levels, it can depress autonomic breathing, causing patients to die in their sleep, but it doesn’t generally cause conscious people to die, or to behave irrationally.
However, the converse is possible: irrational behavior due to the neurological effects of a Covid infection (and malaise) might cause a someone who had been clean and sober for many years to “fall off the wagon” and “self-medicate” with prescription pain killers.
The coroner’s autopsy report said that the fentanyl level in Floyd’s blood was 11 ng/ml, and it also said that, “It is reported that patients lost consciousness at mean plasma levels of fentanyl of 34 ng/mL when infused with 75 mcg/Kg over a 15 min period; peak plasma levels averaged 50 ng/mL”
I very much doubt that Chauvin will be acquitted. If he’s lucky he’ll get only a manslaughter conviction, rather than murder.
The other officers might get acquitted, especially the two rookies. I hope that doesn’t result in widespread rioting.
I’ll have to concede your superior knowledge of the effects of fentanyl, Dave, but it is going to be very hard to avoid reasonable doubt in the trial of Derek Chauvin. The cause of George Floyd’s death is going to be front and centre in forming that doubt in jurors’ minds.
It cannot be said conclusively that Chauvin caused Floyd’s death. At first, like everyone else, I thought that Chauvin had suffocated Floyd. But that was wrong. Floyd (who was in appearance vigorous and strong) did resist arrest, and Chauvin applied a restraint that was approved by the Minneapolis police. Floyd then had a heart attack and died, and the severity of the attack was exacerbated by drugs in Floyd’s system. Which is to say, George Floyd died accidentally in the process of a legal arrest, as a direct result of his own resistance to arrest, and from the effects of drug abuse. Chauvin cannot be faulted for intent to kill, but only for failure to realize that Floyd was in danger of death which, under the circumstances, was an honest mistake.
Chauvin’s only vulnerability is that he continued to kneel on Floyd after Floyd’s death. But even that does not obviate the defense that Chauvin could not have expected that Floyd would die, and in fact it can be argued that, because Chauvin did not realize that Floyd had died, he must also not have realized that Floyd was in lethal distress.
Adding to my argument, the question at first was, why did Derek Chauvin kill George Floyd when he knew, not only that the killing was being witnessed by many people, but was being recorded? Was Chauvin so recklessly heedless of his own guilt that he ignored the consequences of murdering a man in front of witnesses? No. Chauvin was acting in the reasonable knowledge that he was doing nothing illegal.
If the Minneapolis police allowed the restraint that Chauvin used on Floyd, it can only be that it had been applied many times before without killing the people to whom it was applied. Once again, this supports the proposition that Chauvin could have had no intent to kill Floyd.
it cannot be shown that Chauvin was motivated by racism. At no time did any of the arresting officers reference Floyd’s race. The rush to judgement that, because Chauvin was white and Floyd was black, that this was a race-based hate crime, cannot be sustained in law.
Another point: Chauvin decided to arrest Floyd, not because he had attempted to pass a counterfeit bill, but because he was about to operate a motor vehicle while under the influence of a drug, which is of course a serous offence.
And another point: Floyd was insisting that he couldn’t breathe even before he was restrained. This would have predisposed Chauvin to dismiss Floyd’s claims that he couldn’t breathe as lies.
Now add to all this the violent protests of Floyd’s killing, which were unpunished criminal acts. How hard is it going to be to find jurors who will be predisposed to find for Chauvin?
Bottom line: If Chauvin gets a fair trial he will be acquitted. This will not be an obvious miscarriage of justice, like O.J. Simpson’s acquittal. This will be a morally and legally supportable verdict. Derek Chauvin will then have grounds to sue for malicious prosecution, since that prosecution will have been motivated by political considerations and not the merits of the case.
Floyd was a total loser who died after committing two felonies
He had spent many years in prison for other crimes.
Chauvin is an abusive cop who should have been thrown off the force years ago.
However, his knee alone DID NOT kill Floyd.
The world would be a better place without those two people.
Floyd had a drug overdose and resisted arrest.
He was complaining of breathing difficulty in the back of the cop car while stretched out and to prevent the cops from closing the car doors. He was a big guy and no gentle giant.
The cops could not get him in the back of the police cruiser.
They put Floyd on the ground and probably called for a police truck.
It was a mistake to place Floyd or any other suspect face down afert he was handcuffed.
Especially dangerous if there were breathing problems.
The store owner who called the police said Floyd was high on something.
He needed an ambulance for a drug overdose, not a police cruiser.
If one of the cops was holding his back down while he was have breathing problems then that was WRONG and could have contributed to the heart attack.
But a knee on the side of the neck, although I saw no reason for it, did NOT suffocate Floyd. You know he could breath because he continued to talk.
Lessons Learned:
Don’t take illegal drugs.
Don’t commit crimes to get money for your illegal drugs.
Don’t resist arrest.
The cop you chose to fight with may be the meanest cop on the force.
Hello, Richard Greene. Derek Chauvin was a policeman. George Floyd was a citizen with a record of serious criminality, whose arrest on the day he died was clearly supported in law. Derek Chauvin did not violate any police procedures, and in fact did not attempt to injure Floyd. Only restrain him. Chauvin could not have known that Floyd, who was only 48, was so fragile.
Of course I don’t know either man but I’ll bet this month’s whisky bill that none of the middle class people who are so upset about George Floyd’s death would have been especially comfortable in his presence when he was alive. Robin DiAngelo would have flinched from his presence. Ibram X. Kendi would have shunned him as a coarse, crude thug. His main claim to being a worthy man is that he died while being arrested by a white policeman.
Derek Chauvin is a veteran police officer who was performing his paid labour in accordance with the statues of the State of Minnesota at the time of the incident that has now ruined his reputation. You pick whom you want to support. I pick Chauvin.
Hey Coldman
Chauvin had a huge number of citizen complaints about rough behavior before the Floyd incident. There were also complaints about his second job as a security guard.
There was no need for any cop to hold Floyd face down when he was already handcuffed and complaining of breathing problems (even before he was placed face down on the pavement).
That position would have been okay if there was only one cop there, and Floyd was trying to get up. But there were four cops there. Floyd should have been seated on the curb or laying on his back.
This was not a murder or a homicide.
It was an accidental death from a drug overdose, and the stress of resisting arrest, leading to a heart attack that was also encouraged by WRONG police actions. You are a fool if you think the police did everything right.
Well, I don’t think Chauvin did everything right, Mr. Greene. Floyd died. I do think that Chauvin did nothing illegal, and must be acquitted.
And of course the whole thing has been tainted by race. The simple and pernicious idea that has taken root is that Chauvin killed Floyd because he was Black, which is a narrative that has been so eagerly and unquestioningly been accepted that it emphasizes that terrible state of race relations in the United States. A tragic accident has become evidence of systemic disregard in the justice system for Black lives.
“However, that includes deaths from many causes which are never attributed to Covid-19. Automobile accident, suicide, murder, fire, drowning, etc., are never attributed to Covid, regardless of whether the victims were infected. ”
Sorry, but this is trivially incorrect. Just go to the CDC’s website, and look for deaths whose ICD codes include those for stabbing, shooting, vehicular accidents, drowning, etc. Conveniently, the CDC sums up all of these codes for you, so you don’t even need to do it yourself.
Currently, there are about 8,500 of these, out of 236,000 total “COVID” deaths. That’s almost 4% – which is what it has been for the past several months.
Here are the statistics I found:
Total 2018 U.S. unintentional injury deaths: 167,127, which includes:
Falls: 37,455
Motor vehicle deaths: 37,991
Unintentional poisoning: 62,399
2018 suicides: 48,344
2018 homicides: 18,830
2005-2014 average, number unintentional drownings per year: 3870
Those four causes add up to about 8.4% of all U.S. deaths.
The sum of those figures is 238,171 (over 12 months), compared to 272,828 known Covid-19 cases, so far. At the current rate, by end of 2020 there will have been nearly 330,000 recorded U.S. Covid-19 deaths, or about 138% of the total number of deaths from unintentional injuries, suicides, homicides, and drownings, combined.
CORRECTION:
I wrote, “…compared to 272,828 known Covid-19 cases.”
I meant, “…compared to 272,828 known Covid-19 deaths.”
Sorry about that!
Of course, if you don’t want COVID-19, don’t go to hospital. It appears that the NHS had got the proportion of infections they caused down to just 17.6% of the total infections in England at the end of October, though it had been as high as 25%. When you consider that those being infected will largely be receiving treatment for a co-morbidity, the percentage of covid deaths due to the NHS is likely higher.
https://www.cebm.net/covid-19/the-ongoing-problem-of-hospital-acquired-infections-across-the-uk/
There used to be isolation hospitals for TB and for (scarlet)fever and smallpox when those diseases were pandemic. We seem to have forgotten that wisdom from times past, and now General Hospitals generate their own work.
There is a complete “non sequitur” in your post you set of a whole set of exsuses and end with
>>>> Any NO qualifies me as a Covid case epidemiologically <<<<>>> Any NO qualifies you as a second hand smoke case epidemiologically <<<<<
So you have a clear "non sequitur" that you the dead person probably qualifies for a dozen different deaths as defined by the CDC it does not follow you would be recorded as covid one.
LbD ==> I don’t get your comment, sorry. I didn’t mention second-hand smoke….
The issue is the person who dies in the situation you describe qualifies for probably 10 different CDC classifications … you don’t explain why covid is chosen over the others. It simply doesn’t follow that would happen … the definition of “non sequitur”.
You nee to explain why covid over the other 9 CDC categories.
LdB ==> Ah, get it now. It is that Covid would be listed in parts I or II on ghe Death Certificate by decree from CDC and WHO — even of suspected Covid, assumed, possible, probable, Covid cases. The definitions include such vague combinations of symptoms that lead to a Covid case — and RT-PCR testing leads to “cases” that are not really cases . . . .” clinically compatible illness” — a cough and fever, etc. Hospitals get extra money for each Covid case, government assistance, so including Covid-19 as a “contributing condition” is a no brainer for any ER physician or hospital coroner — especially rushed and panicked doctors.
For god’s sake Hansen, don’t confuse me with facts.
⭐⭐⭐⭐⭐ × 1,000,000
(Thank you for the usual stellar Kip Hansen marshaling of research, logic, analysis and prose)
John ==> Thanks….
Kip my go to page for COVID deaths is Table 2 at https://www.cdc.gov/nchs/nvss/vsrr/covid19/index.htm
If you back out the excess deaths relative to the average deaths in previous three years, it looks like their all-deaths-involving-COVID total pretty much accounts for the 12 percent increase in 2020.
Ralph Dave Westfall ==> All Cause deaths — see Genevieve Briand’s stuff linked in the Addendum.
Ralph David Westflail:
The US population is both increasing and aging.
The annual number of deaths should be in a rising trend for those two reasons alone.
Add the rising drug overdoses and rising homicides.
Look at back at annual deaths for several decades and you will see the total can vary by plus or minus one percent in any year versus the prior year
So if the wild guesses “COVID deaths” in 2020 were one percent of total deaths in 2020, and 2020 total deaths were up one percent from 2019, how can we be sure only COVID 19 deaths accounted for that one percent increase. We can’t be sure.
That should be plus or minus 10 percent, not plus or minus one percent.
2020-11-28 Calling BS
It’s not complicated folks; Social Security does not pay dead people.
Postoperative wound infections and surgical face masks: a controlled study
Effectiveness of Adding a Mask Recommendation to Other Public Health Measures to Prevent SARS-CoV-2 Infection in Danish Mask Wearers
Physical interventions to interrupt or reduce the spread of respiratory viruses
Let’s Make It Clear and Simple
Ivermectin
HCQ
The FDA-approved drug ivermectin inhibits the replication of SARS-CoV-2 in vitro
New insights on the antiviral effects of chloroquine against coronavirus: what to expect for COVID-19?
The multiple molecular mechanisms by which chloroquine can achieve such results remain to be further explored. … preliminary data indicate that chloroquine interferes with SARS-CoV-2 attempts to acidify the lysosomes and presumably inhibits cathepsins, which require a low pH for optimal cleavage of SARS-CoV-2 spike protein
Zn2+ Inhibits Coronavirus and Arterivirus RNA Polymerase Activity In Vitro and Zinc Ionophores Block the Replication of These Viruses in Cell Culture
Didn’t Floyd test positive for SARS-CoV-2 earlier in the year? A Covid-19 case, a probable fentanyl overdose, and comorbidities, coded as politically congruent to socially justify “protests”.
Kip;
Thanks for the article and the effort.
True mortality will need to wait for many months, but my supposition is that the virus time-shifted mortality by some number of months and that it evens out over the course of a year or so. Put another way, all deaths all causes has a spike and a decline and graphs out as a smooth line over time.
The one surprising issue is prevention or mitigation, so a bit off topic. Early on the role of Vitamin D was discussed, with low levels having bad outcomes and higher levels having less bad outcomes. UV-B and sunshine appear to have a significant effect on flu season, as does air conditioning in desert hot climates. Think Legionnaires Disease and the AC units. The health authorities are silent on prevention/mitigation except for the lockdowns and mask mania.
Given US’s annual death rate is around 868/100,000, and given it’s population growth is around 2,040,000/yr, the “normal” number of 2020 US deaths (had COVID19 not occurred), should be around 2,875,000.
Whatever the total number of US 2020 COVID19 deaths end of being purported (300,000+?), the total number of 2020 US deaths better be darn close to 3,175,000 (2,875,000 +300,000), or else these reported COVID19 death numbers are completely bogus…
We’ll see soon enough.
History will look back on this “Pandemic” as a problem caused by the Information Age. If we had not read about it on the Net and in the papers, would anyone have actually noticed it? It is the flu. This one is harder on old people with co-morbidites. If younger than 65, the lockdowns only hurt you. And the lockdowns hurt young people, a lot, going broke is not funny at all.
And when I go out, because of the masks, I cannot see the young ladie’s faces, makes it hard to remember their names.
Destroying a prosperous economy to save the lives of those with a few months to live, ask those people who know their days are numbered. Should we cause chaos to get them three more weeks? Universally they will say “No, It happens to everyone else, it will happen to me. Soon I will find out what comes next, if anything. This having someone help me to eat and take a shower, not all that much fun anyway.” I watched both my parents go through that. My mom was not having any fun at all. My dad was though, until the end.
Strangest event in human history, largest failure of governments imaginable…..
Michael Morn sez:
“And when I go out, because of the masks, I cannot see the young ladie’s faces, makes it hard to remember their names.”
Admit it, you were NEVER looking at their faces before !
“Destroying a prosperous economy to save the lives of those with a few months to live, ask those people who know their days are numbered.”
My in-laws were both in nursing homes before they died, for WAY longer than a few months. They both contributed a lot to this country, including military service, government service, and creating my wife.
They EARNED the right to be comfortable in the last years of their lives. You may be in a nursing home some day, not necessarily your choice, and once you are there, you should volunteer for euthanasia to avoid those “three more weeks” you mentioned in your comment.
Mean Richard Greene,
I in no way implied that people in their last months had not, in their previous lives, contributed to society. You have inferred something that simply was not there. Being old and sick is a real drag, are you contradicting me?
Wow. In terms of volunteering for euthanasia, you first.
Michael Moore
Your actual words — the quote follow — were very insensitive, no matter what you really meant:
“Destroying a prosperous economy to save the lives of those with a few months to live, ask those people who know their days are numbered. Should we cause chaos to get them three more weeks?”
And thank you remembering my professional wrestling career as Mean Richard Greene, the best 4 foot 10 inch 395 lb. wrestler in the history of the Upper U.S. Wrestling Federation. Those were my good old days.
Riffing on Mean Joe Green genius.
Suicides are up. Domestic abuse is up. Child abuse is up. Opoid addiction, alcohol abuse, all ‘way up. Clearly the cure is worse than the disease. Now we are hearing that All-Cause Deaths in the USA are not up at ALL!
You think destroying a prosperous economy to save no lives was a good idea?
Michael Moons
The US economy was not “destroyed” but much 2020 economic damage was going to happen with or without partial lockdowns, just as it did in Sweden where most of the behavior changes were voluntary. Businesses still suffered for three months there.
The pandemic is still in progress so conclusions are temporary and could be wrong.
I think all behavior changes in response to COVID should have been voluntary.
And the partial lockdowns have caused more damage, both economic and health, than the disease itself.
But I consider nursing home deaths to be important deaths, even if you don’t.
Hello, Mr. Moon. I agree with what you’ve written here (and my own parents died of diseases of old age, and would have been better off without the last year each of their lives), but the problem started because COVID-19 pandemic was thought to be similar to the 2009 SARS epidemic. That disease was lethal to many more of its victims, who were identifiable before they became infectious, so quarantining them worked to suppress and then eradicate the spread. COVID-19 is of course very different, and the viral suppression protocols not only didn’t work but caused economic disaster. The generals were fighting the last war and this war was different.
The government and medical leaders cannot admit that the terrible damage they have caused (and to little positive effect) was the result of a mistake. The damage is just too great, and nobody can take the blame for it. So now they’re going to keep making the mistake, because if they try something different they will be admitting that it was a mistake.
Donald Trump (of all people) was the leader whose initial response to the pandemic was the wisest. Unfortunately, the spectre of a million American deaths forced him to go along with the panic and the lockdowns.
+6%
“largest failure of governments imaginable…..”
You just had to post that segue…
We all know that extortion is when somebody is told “Do what we tell you to do or we will hurt you.” We all know that extortion is what a bad person, a criminal, does to a victim.
Organized crime syndicates use a method of extortion called a protection racket. “If you don’t pay us to protect you, we won’t protect you (from us).” “From us” may be brazenly stated or only implied.
To govern is to control. To extort is to control. To govern is to extort.
Elected politicians write rules. These politician’s rules are written demands to be obeyed under threat of being hurt if you don’t obey. This part of the politician’s rules are called “penalties” or “fines”. Thus rules of politicians, dictators, and monarchs are all extortion. Do what they tell you to do or be hurt.
Ergo, Government is an organized criminal syndicate that can not be defended by logic or by morality.
Dale Earnhardt American Stock Car race driver,
I do not understand what you intend here. “To govern is to extort,” you sound angry, but I don’t get it.
Thank you for the inquiry.
You wrote, ➽ I do not understand what you intend here.
I did call your words that I quoted a “segue”. “A segue is a smooth transition from one topic or section to the next. The term is derived from Italian segue, “follows”. More at Wikipedia”
“[F]ailure of governments” Government… That is the single segue term.
That you observed a “failure” of government… That tells me that you took the propaganda hook, line, and sinker; that you have a “belief” in the myths of government. And that, my good Sir, is why you do not understand what I “intend”.
Like I wrote, “segue”. Sort of like a “that reminds me” in a conversation.
Yes… I am angry. Though you perceptively and correctly determined that from my words, that is NOT the intended message.
There’s some very intelligent people having a discussion here… Following a very intelligent post by the good doctor. About a topic that is safe to say, has the world’s attention.
There’s some not so intelligent tyrants in government destroying people’s lives. And using CV-19 as an excuse to feed their megalomania.
I can understand very easily that you “don’t get it.”
If you actually care to spend the time understanding where I am coming from and why, you only need to click my name which should take you to my website. (Just like your name should take me to a New Tech Tire website. It takes me to a broken page.) If you do and you are not posting from a country where I have been forced to block large chunks of IP addresses because of spammers, you will see the same five paragraphs I posted here, is the first five paragraphs of my website.
As I wrote, I can understand very easily that you “don’t get it.” And I understand why. I also know that as a matter of my having had “a few” conversations on this topic, percentages are very high that I will just piss you off. I have that effect on people when I gore their sacred oxen.
I have come to the conclusion that I must preface those five paragraphs with the words, “Prove me wrong” as a challenge to statists to get their focus on the concepts presented. Even you have missed the point of those words. That is on me as the author of those words. I will be making a new meme for FecesBook and other social media platforms with that challenge.
If the remainder of the folks discussing the CV issue don’t want to read any more, I’m fine with continuing the discussion elsewhere.
And that is my segue back to what else I posted, not yet knowing if anybody with medical knowledge has made comment…
Examining the claims about Covid-19 ☣
As of 11/28/20
2,509,537 Tested
375,837 Tested Positive
3,257 Dead
16,715 Hospitalized
301,541 Recovered
80.23% Ratio Recovered to Tested Positive.
4.45% Ratio Hospitalized to Tested Positive
19.49% Ratio Deaths to Hospitalized
0.13% Ratio Deaths to Tested
0.87% Ratio Deaths to Tested Positive
5,822,434 Population per official guesses (census)
0.056% Ratio Deaths to Wisconsin Population
14.98% Ratio Tested Positive to Tested
7,557 Extrapolated Statewide Deaths
I am no wiser
I’m willing to spend the time attempting to explain… If you want that interaction.
It’s definitely off topic for the med issues (CV19) being discussed. Which I am reading because… Well, polite and on topic. Unlike FecesBook discussions.
I have my own narrative and agenda that has nothing to do with the medical only discussion.
synapticsparks.info for my narrative and agenda.
What causes the comorbid conditions? Anyone interested?
Attempting to run ourselves on glucose, as we did ~3-6 million years ago. We evolved ~3 million years ago to run on ketones. We should pay attention to that.
Thanks Kip, an interesting overview of the issues surrounding the reporting of death, and the reasons why it is so simple to introduce Covid into the already complex mix of issues resulting in a death.
I am even more convinced now, than I was prior to reading your piece, that Covid is being over hyped for reasons, we may discover as time passes.
I will continue to take a vit D tablet to help keep my immune system as primed as I can. Take exercise and fresh air whenever the English weather allows. I will continue avoiding listening to the BBC or any other news bulletins associated with Covid reports, and hope our political class rediscover risk is a useful part of life.
Stay well, we need all the detailed sound thinkers we can get.
Rod ==> Thanks, eventually — years from now — this will all be sorted out — maybe when the world realizes that the Climate Panic was just a mass mania.
So what you’re saying is….. it wasn’t the cough that carried ‘im off, it was the coffin they carried ‘im offin 🙂
Very interesting article.
Climate believer -=> Haven’t heard that one since I was a kid….makes it an oldie but a goodie.
I note that the UK government is to provide vitamin D to the elderly and those at risk free of charge starting in January. With the advice, if you can buy your own asap until deliveries start.
A pack of vitamin D tablets is really cheap anyway so I don’t see why the shambles that is our government needs to give them away other than to be seen doing something while they flounder completely.
Somebody is waking up???
Not really, I believe it is only a really low dose 10mcg / 400IU, so when the general population is already normally deficient in winter, the elderly who tend to stay covered and indoors are severely deficient. Better than nothing, but only just. The NHS recommended maximum which is 10 times this would be better at raising levels, even if just given daily for a week, then once weekly for maintenance. Almost the entire UK is above the 50th parallel, while most Canadians live below the 50th – for perspective.
I. Am 81 years old I have never had a cold or flu but a year ago I suffered from bronchitis, (ok now) at 81 I think that the world has gone crazy Did they ban sex with HIV,/AIDS?
vincenzo mamone ==> The would-be-kings missed their chance on that one….
I know of only one person who has died from Covid and that was because she was infected with Covid in one of our wonderful NHS hospitals. While it is true she was in her mid 80s and had recently suffered a broken shoulder from a fall, than a gashed leg as she has a thin skin, followed by a broken hip, but the failure to isolate Covid patients and keep them away from everyday hospitals – as China did – has caused thousands of nosocomial deaths. This has also led to people wanting to avoid hospital for treatment if they are vulnerable and so die in due course. How are all these numbers to be dealt especially with a government and NHS determined to keep them from view?
This can be reduced to a much simpler statement. More data does not necessarily mean better data.
This is increasingly a problem with government reporting requirements. There is so much mandatory reporting of data, with ambiguities and variabilities in reporting, and so little in the way of QA of the data, that most government data is pretty much junk that you can make say whatever you want it to say–a bureaucrats dream come true.
I once had a discussion with a completely honest person at a major corporation about the massive amount of environmental reporting that was required and how easy it would be to deliberate falsify records and get away with it, precisely because there are too many records for agencies to review. Even electronic reporting has problems; there is always some information that must be manually entered.
Think about it: How could the CDC possible QA all the death records they receive?
Thomas Gasloli ==> They don’t QA them — they just tabulate them. In the long run, they are only concerned with “How many Death Certificates mentioned Covid-19 (U07.1) anywhere in the form?” This results in the number they count and report “Total Deaths Involving Covid-19″
“More data does not necessarily mean better data.”
As an aside here I was reminded of that with my son who buys renovates and onsells mainly units and apartments. To protect the innocent vendors are now required to furnish buyers with a Form1 statement ostensibly to protect them from shonky dealing with a cooling off rights period to peruse it here-
https://lawhandbook.sa.gov.au/ch23s09s01.php
The last RE industry ass covering proforma he received was 186 pages long and it’s gone from the sublime to the ridiculous as it wanders through just about every Act and Regulation you can possibly think of from indigenous land rights to nuclear/asbestos/yada contamination. You name it. So much so that if you really wanted to hide relevant problems you’d only have to stick it two thirds the way in and the reader would have dozed off long before. Think of it like listing possible side effects with pharmaceuticals and please consult your doctor should they occur. It certainly is an eye opener as to the amount of Law and Regulation we’re inundated with but the irrelevant information overload has quite defeated the original purpose.
My sister had Type 1 diabetes. She contended with the many health issues that a lifetime of diabetes causes until she died at home in 2017. There were two causes of death listed on the paperwork: first was “heart failure” and the second was “diabetes”. I found it curious that diabetes wasn’t the the one and only cause, but at the time it was a minor detail, easily ignored.
PaulH ==> Another doctor might have listed it the other way around, or listed just one or the other. Any combination would have been regarded as the doctor’s best medical opinion — and truthfully, one commenter here, who was a coroner for years, reports that he and his superiors often disagreed on which and in what order diseases, causes, conditions, were listed.
Kip,
A very good explanation of a complicated system. I’m a public health physician and you did a great job explaining the process and many of the reasons why one thing or another is labelled as the cause of death. The first COVID death in a county where I was living at the time was in hospice care waiting to die. She is now in the stats as a COVID death though she was in hospice for another reason.
The one little nitpick was that you didn’t mention the financial benefit hospitals get from treating COVID patients, which given human nature, helps improve the odds that a patient has COVID.
Steven Finder ==> Thanks for the supportive comment from a professional on the front lines — I am fighting off a couple of detractors (as usual on any topic here at WUWT).
I understand that financial benefit to hospitals might play a role. I just didn’t/don’t have any evidential details on which governments are giving what financial benefits to which hospitals in which countries and states…. I try to be as accurate as I know how.
Like you, several other comments here do allude to hospitals receiving payments to help with costs based on Covid cases and Covid deaths in their facility.