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> But death numbers and hospitalization numbers don't lie. Well... there is some indication hospital staff are being directed to assume all cases are COVID19 u

> But death numbers and hospitalization numbers don't lie. Well... there is some indication hospital staff are being directed to assume all cases are COVID19 until proven different. Patients that die with presumptive COVID19 are reported as COVID19 deaths. So agree, numbers don’t lie. But... handling emergencies effectively can lead to problematic numbers.

jeremyjh 6y ago
This is so tiresome. Someone has cancer for six months, gets COVID and dies 17 days later and now Tucker Carlson is here telling me not to count that death. How often do you really think it happens that someone is hospitalized with COVID (otherwise, they'd not even be getting tested most places in the world) and dies of something else a week later? I'm sure it has happened a few times, but what has also been happening hundreds of times every day is people die untested and are not included in the official numbers. Its ridiculous to even have this discussion, and the motivations for it are absolutely disgusting.
- ngcc_hk 6y ago
  It could be an information problem. Is the medical system even allow 2 causes of death. Underlying condition and ...
  - nradov 6y ago
    Most death report forms have fields for a primary cause and contributing causes.
    - kevin_thibedeau 6y ago
      For influenza, the CDC includes deaths by pneumonia during flu season as part of the official death count because the certificates don't reliably list the true cause of death. We see this happening now in the US with unofficial deaths getting lumped into the C19 deaths, some of which may very well have been flu.
      - cycomanic 6y ago
        Actually at least in Germany the numbers for influenza are entirely based on statistics. In particular the 25000 people died of influenza in 2017 number that is thrown around is based on looking at the usual statistics over the same period and everything above that is attributed to influenza. I think we will only have only have accurate statistics about the death rates etc in maybe a year
- easytiger 6y ago
  > and the motivations for it are absolutely disgusting. What are those?
  - TylerE 6y ago
    Desperation to reopen and juice corporate profits/wall street
    - easytiger 6y ago
      Not a desire for a better understanding of the issues?
- sfj 6y ago
  > Someone has cancer for six months, gets COVID and dies 17 days later and now Tucker Carlson is here telling me not to count that death. If someone has cancer and then gets a bad cold and dies, what should the cause of death be? Or what if they fell, etc.?
  - mattkrause 6y ago
    The OECD definition for a cause of death is the “disease or injury that initiated the train of morbid events leading directly to death...” They also recognize a a contributory cause of death, defined as “a significant condition that unfavourably influences the course of the morbid process and thus contributes to the fatal outcome, but which is not related to the disease or condition directly causing death.”
  - projektfu 6y ago
    If someone had AIDS and died of pneumocystis pneumonia, the latter is the cause of death, and the former is the cause of the latter.
    - sfj 6y ago
      So, if there was an epidemic of pneumonia going around, would you count that as a death due to pneumonia, and then use that statistic to help justify lock downs and enforced social distancing? Because that is what is happening when you take an extremely sick person who finally died and slap a "death by covid-19" label on them.
      - bigbob2 6y ago
        Yes, just like when someone suffers life-long health complications because of pneumonia, and then dies of something which otherwise may not have killed them, the cause of death is counted as the most recent event, not pneumonia. I think it suffices to say it goes both ways.
      - projektfu 6y ago
        There wouldn’t be an epidemic of pneumocystis pneumonia without an epidemic of immunodeficiency so I’m not sure that applies. But I see what you’re getting at. And, yes, e.g. if a COPD sufferer died of pneumonia of the pandemic strain I would call that a death attributable to the pandemic, noting that the COPD probably made them more susceptible. When influenza deaths are estimated each year, the models assume that a lot of people will die due to the virus but the cause will be recorded as heart failure or pneumonia without etiology. From the perspective of the epidemiologist, they are influenza deaths, even if they were old and frail with bad hearts.
- cycomanic 6y ago
  Especially because the same people always compare the numbers with influenza, which are almost entirely based on statistics and comparison to previous years. For example in Germany in 2017 25000 people died of influenza (the bad flu year), but people which had a confirmed death due to influenza (i.e. Being tested positive and died of it) were something like 300 IIRC. Don't get me wrong I think it's perfectly valid to use statistics for estimating the impact/IFR but you can't like many people with an agenda pick and choose your counting methods.
kaitai 6y ago
I'd like some evidence for this -- can you provide some? When it comes to wearing surgical masks, yes, hospital staff are to assume that everyone's got it because it's pretty annoying to get it from a guy who came in for toenail fungus or a lady who came in for a prenatal screen and then be out of work for 2+ weeks. This is literally what has happened across Italy, China, New York, and other places. It's not like you write down in some electronic medical record "Man comes in with complaint of unattractive toenails. Presumed to be infected with COVID-19 without evidence." That's too damn much work. On the other hand, when people die, some are being listed as presumed to have COVID-19 even in the absence of a positive test. Here's what the doctor sitting across from me says about how he's directed to fill out death certificates (yes, we're drinking Scotch, but this ought to still be accurate): On death certificates you are supposed to write a primary cause of death and then the interval between death and preceding underlying causes. For instance, if someone dies of ARDS preceded by dry cough, fever, difficulty breathing, you can say that they died of ARDS with presumed COVID-19 infection as an underlying cause. (You're apparently not really supposed to write "cardiac arrest" as a primary cause of death, because by definition, when you die your heart stops... so it's tautological in some sense and thus useless.) Another example: you could write "pneumonia" as primary cause of death, preceded by lung cancer preceded by asthma, and you could check a box for smoking but you couldn't write smoking down as a cause of death. If you were hit by a bus and died of injuries, but you'd had COVID-19 symptoms beforehand, the certifying physician would need to write down "injuries from being hit by a bus", or rather in medicalese, "motor vehicle accident, pedestrian (ICD-10-CM subfamily V04)" [1]. COVID-19 in that case is not a cause of death, and that rando legislator from Minnesota who claims it is has a reading comprehension problem. My mom who works in the death certificate department will definitely be checking anything he signed..... Why not only write down confirmed COVID-19 cases? Because, for instance, at the hospital at which the physician across from me works (in the COVID clinic, in fact), they serve about 100,000 patients but are allotted 25 rapid COVID tests a day. Since each patient needs two tests because of the high false-negative rate, that's 12 rapid-tested patients a day. Wowza. Yeah, let's use that on the guy who walked into the ER and got intubated within 20 minutes. Why bother? Anyhow, interested to hear about your experiences. [1] https://www.icd10data.com/ICD10CM/Codes/V00-Y99/V00-V09/V04- https://www.icd10data.com/ICD10CM/Codes/V00-Y99/V00-V09/V04-
btilly 6y ago
So agree, numbers don’t lie. But... handling emergencies effectively can lead to problematic numbers. My brother and I discussed this at length. He claims (and I have no reason to doubt) that New York has 5x the usual death rate right now. About 2x the usual death rate is clearly COVID-19, another 1x is probably COVID-19 but not tested, another 1x is unclear and the rest are people who likely would have died anyways. An example of that unclear bucket are people dying from heart attacks. COVID-19 stresses the heart which can cause that. However thanks to COVID-19, EMTs have moved to "Do not do CPR and if we cannot revive, do not take to the hospital." This procedure makes sense because CPR on a COVID-19 patient sprays the whole room with COVID-19. And taking someone with it to a hospital likely will cause them to get it, and it is particularly bad in people with heart problems. However it also means that heart attacks have a higher likelihood of killing you than usually. So..people die of heart attacks. Is that heart attack attributable to COVID-19? Is it fatal just because COVID-19 has overwhelmed the health system? We don't know and aren't trying to find out because knowing isn't the priority in a world where our health care system is stretched to the breaking point. All we really know is that people are dying.

jeremyjh 6y ago

This is so tiresome. Someone has cancer for six months, gets COVID and dies 17 days later and now Tucker Carlson is here telling me not to count that death. How often do you really think it happens that someone is hospitalized with COVID (otherwise, they'd not even be getting tested most places in the world) and dies of something else a week later? I'm sure it has happened a few times, but what has also been happening hundreds of times every day is people die untested and are not included in the official numbers. Its ridiculous to even have this discussion, and the motivations for it are absolutely disgusting.

ngcc_hk 6y ago
It could be an information problem. Is the medical system even allow 2 causes of death. Underlying condition and ...
- nradov 6y ago
  Most death report forms have fields for a primary cause and contributing causes.
  - kevin_thibedeau 6y ago
    For influenza, the CDC includes deaths by pneumonia during flu season as part of the official death count because the certificates don't reliably list the true cause of death. We see this happening now in the US with unofficial deaths getting lumped into the C19 deaths, some of which may very well have been flu.
    - cycomanic 6y ago
      Actually at least in Germany the numbers for influenza are entirely based on statistics. In particular the 25000 people died of influenza in 2017 number that is thrown around is based on looking at the usual statistics over the same period and everything above that is attributed to influenza. I think we will only have only have accurate statistics about the death rates etc in maybe a year
easytiger 6y ago
> and the motivations for it are absolutely disgusting. What are those?
- TylerE 6y ago
  Desperation to reopen and juice corporate profits/wall street
  - easytiger 6y ago
    Not a desire for a better understanding of the issues?
sfj 6y ago
> Someone has cancer for six months, gets COVID and dies 17 days later and now Tucker Carlson is here telling me not to count that death. If someone has cancer and then gets a bad cold and dies, what should the cause of death be? Or what if they fell, etc.?
- mattkrause 6y ago
  The OECD definition for a cause of death is the “disease or injury that initiated the train of morbid events leading directly to death...” They also recognize a a contributory cause of death, defined as “a significant condition that unfavourably influences the course of the morbid process and thus contributes to the fatal outcome, but which is not related to the disease or condition directly causing death.”
- projektfu 6y ago
  If someone had AIDS and died of pneumocystis pneumonia, the latter is the cause of death, and the former is the cause of the latter.
  - sfj 6y ago
    So, if there was an epidemic of pneumonia going around, would you count that as a death due to pneumonia, and then use that statistic to help justify lock downs and enforced social distancing? Because that is what is happening when you take an extremely sick person who finally died and slap a "death by covid-19" label on them.
    - bigbob2 6y ago
      Yes, just like when someone suffers life-long health complications because of pneumonia, and then dies of something which otherwise may not have killed them, the cause of death is counted as the most recent event, not pneumonia. I think it suffices to say it goes both ways.
    - projektfu 6y ago
      There wouldn’t be an epidemic of pneumocystis pneumonia without an epidemic of immunodeficiency so I’m not sure that applies. But I see what you’re getting at. And, yes, e.g. if a COPD sufferer died of pneumonia of the pandemic strain I would call that a death attributable to the pandemic, noting that the COPD probably made them more susceptible. When influenza deaths are estimated each year, the models assume that a lot of people will die due to the virus but the cause will be recorded as heart failure or pneumonia without etiology. From the perspective of the epidemiologist, they are influenza deaths, even if they were old and frail with bad hearts.
cycomanic 6y ago
Especially because the same people always compare the numbers with influenza, which are almost entirely based on statistics and comparison to previous years. For example in Germany in 2017 25000 people died of influenza (the bad flu year), but people which had a confirmed death due to influenza (i.e. Being tested positive and died of it) were something like 300 IIRC. Don't get me wrong I think it's perfectly valid to use statistics for estimating the impact/IFR but you can't like many people with an agenda pick and choose your counting methods.

kaitai 6y ago

I'd like some evidence for this -- can you provide some? When it comes to wearing surgical masks, yes, hospital staff are to assume that everyone's got it because it's pretty annoying to get it from a guy who came in for toenail fungus or a lady who came in for a prenatal screen and then be out of work for 2+ weeks. This is literally what has happened across Italy, China, New York, and other places. It's not like you write down in some electronic medical record "Man comes in with complaint of unattractive toenails. Presumed to be infected with COVID-19 without evidence." That's too damn much work. On the other hand, when people die, some are being listed as presumed to have COVID-19 even in the absence of a positive test. Here's what the doctor sitting across from me says about how he's directed to fill out death certificates (yes, we're drinking Scotch, but this ought to still be accurate): On death certificates you are supposed to write a primary cause of death and then the interval between death and preceding underlying causes. For instance, if someone dies of ARDS preceded by dry cough, fever, difficulty breathing, you can say that they died of ARDS with presumed COVID-19 infection as an underlying cause. (You're apparently not really supposed to write "cardiac arrest" as a primary cause of death, because by definition, when you die your heart stops... so it's tautological in some sense and thus useless.) Another example: you could write "pneumonia" as primary cause of death, preceded by lung cancer preceded by asthma, and you could check a box for smoking but you couldn't write smoking down as a cause of death. If you were hit by a bus and died of injuries, but you'd had COVID-19 symptoms beforehand, the certifying physician would need to write down "injuries from being hit by a bus", or rather in medicalese, "motor vehicle accident, pedestrian (ICD-10-CM subfamily V04)" [1]. COVID-19 in that case is not a cause of death, and that rando legislator from Minnesota who claims it is has a reading comprehension problem. My mom who works in the death certificate department will definitely be checking anything he signed..... Why not only write down confirmed COVID-19 cases? Because, for instance, at the hospital at which the physician across from me works (in the COVID clinic, in fact), they serve about 100,000 patients but are allotted 25 rapid COVID tests a day. Since each patient needs two tests because of the high false-negative rate, that's 12 rapid-tested patients a day. Wowza. Yeah, let's use that on the guy who walked into the ER and got intubated within 20 minutes. Why bother? Anyhow, interested to hear about your experiences. [1] https://www.icd10data.com/ICD10CM/Codes/V00-Y99/V00-V09/V04- https://www.icd10data.com/ICD10CM/Codes/V00-Y99/V00-V09/V04-

btilly 6y ago

So agree, numbers don’t lie. But... handling emergencies effectively can lead to problematic numbers. My brother and I discussed this at length. He claims (and I have no reason to doubt) that New York has 5x the usual death rate right now. About 2x the usual death rate is clearly COVID-19, another 1x is probably COVID-19 but not tested, another 1x is unclear and the rest are people who likely would have died anyways. An example of that unclear bucket are people dying from heart attacks. COVID-19 stresses the heart which can cause that. However thanks to COVID-19, EMTs have moved to "Do not do CPR and if we cannot revive, do not take to the hospital." This procedure makes sense because CPR on a COVID-19 patient sprays the whole room with COVID-19. And taking someone with it to a hospital likely will cause them to get it, and it is particularly bad in people with heart problems. However it also means that heart attacks have a higher likelihood of killing you than usually. So..people die of heart attacks. Is that heart attack attributable to COVID-19? Is it fatal just because COVID-19 has overwhelmed the health system? We don't know and aren't trying to find out because knowing isn't the priority in a world where our health care system is stretched to the breaking point. All we really know is that people are dying.