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This person is alleging that Florida is looking to understate deaths, presumably to support their reopening plans. There are also stories of states overstating

This person is alleging that Florida is looking to understate deaths, presumably to support their reopening plans. There are also stories of states overstating deaths as well (see https://www.freedomfoundation.com/washington/washington-state-over-reporting-covid-19-deaths/ https://www.freedomfoundation.com/washington/washington-stat...), presumably to support their intent to retain strict restrictions. I am guessing generally, there is less malice involved than people ascribe to these situations. We don't have all the facts or perspectives, so let's take things slowly, wait for more information to come out, and analyze the facts with the full picture in front of us. Jumping to outrage mode, which then becomes a hardened position we dig ourselves into, does not help us seek the truth.

FireBeyond 6y ago
Not so much. Even by their own article (with its own biases - show me an article on this site that has ever postulated that there might be merit to restrictions): > Completing each “cause of death worksheet” involves listing the “immediate cause” of death, the “underlying cause(s)” that initiated the events culminating with the immediate cause of death, and “(o)ther significant conditions contributing to death but not resulting in the underlying cause.” These fields are completed based on the “best medical opinion” of the certifier. Is not "overstating deaths ... to support their intent to retain strict restrictions". It's stating - as it would with _any other disease_ that the patient had other co-morbidities, just as if you had diabetes, or CHF, etc. It's not the exaggerated, grand standing hyperbole of "Patient in car accident had COVID-19, so COVID-19 was listed as the cause of death", which simply hasn't happened. "Contributing to death, but not the underlying cause, in the best medical opinion of the physician/ME". In contrast, Florida has numerous documented instances of government interference with this (restricting coroners from reporting _any_ data, pressuring law firms related to the media filing FOI requests).
- throwawaysea 6y ago
  Read further down. The article I linked mentions that Washington state said in a prior request that they only count confirmed COVID cases in mortality metrics: > In its May 8 response to the Freedom Foundation, DOH stated, “All of the deaths currently attributed to COVID-19 had a positive PCR (polymerise chain reaction) test at some point. A PCR test is required in order to classify something as a confirmed case.” However various other sources now seemingly contradict the answer previously given, since they do count “presumptive” cases in mortality metrics after all: > DOH’s “Preliminary Guidance for Reporting COVID-19 Deaths” provides: “Coronavirus Disease 2019 or COVID-19 should be reported on the death certificate for all decedents where the disease caused, or is assumed to have caused, or contributed to death.” (emphasis in original) > Another DOH COVID-19 fact sheet makes a distinction between “confirmed” cases of COVID-19 in which the patient tested positive and “probable” cases involving any of the following factors [...] So either the initial response was false or the definitions of the metrics changed at some point. The reason this matters is because WA’s governor, Jay Inslee, has instituted the nation’s most strict restrictions, going well beyond what other cautious states like CA have implemented. For example he has banned fishing, hunting, residential construction, prevented rural areas from advancing in reopening phases, etc. Even as some restrictions (like closing all state parks or banning fishing) were reversed, Inslee continues to retain strange nonsensical bans on activities like camping. Certainly there is motive to make the numbers look worse to justify policy overreach or missteps, and it deserves scrutiny.
  - FireBeyond 6y ago
    Those two statements are not contradictory: 1. A death _must_ have a positive PCR in order to be _attributed_ to COVID-19. This does not mean that a positive PCR means that the death _will_ be attributed to COVID-19. 2. Documentation of co-morbidities is standard, be it for COVID-19, or any other disease, "where the disease caused, or is assumed to have caused, or contributed to death". > The reason this matters is because WA’s governor, Jay Inslee, has instituted the nation’s most strict restrictions, going well beyond what other cautious states like CA have implemented. For example he has banned fishing, hunting, residential construction, prevented rural areas from advancing in reopening phases, etc. Even as some restrictions (like closing all state parks or banning fishing) were reversed, Inslee continues to retain strange nonsensical bans on activities like camping. The entirety of Eastern Washington is in Phase 2 or eligible (and the decision to go to Phase 2 in Adams and Spokane County is on those Counties, not the State, who has said they're eligible), which allows fishing, hunting, construction and camping: https://q13fox.com/2020/05/19/10-more-counties-including-thurston-kitsap-and-clallam-can-apply-for-phase-2-reopening/ https://q13fox.com/2020/05/19/10-more-counties-including-thu...
    - throwawaysea 6y ago
      I am not contesting that the documentation of comorbidities is reasonable or standard. I am however pointing out that the state has said contradictory things when it comes to which deaths are counted as COVID-caused deaths. Their guidance doc reads as follows: > “Coronavirus Disease 2019 or COVID-19 should be reported on the death certificate for all decedents where the disease caused, or is assumed to have caused, or contributed to death.” The phrasing "assumed to have caused" is key here and it suggests that at least some deaths were assumed to be COVID-caused even without explicit confirmation (via a PCR test). This means that this prior statement from the state was false: > “All of the deaths currently attributed to COVID-19 had a positive PCR (polymerise chain reaction) test at some point. A PCR test is required in order to classify something as a confirmed case.” If the standards for what counts as a COVID-death have changed to be more permissive, then that would have the effect of inflating mortality metrics. But either way the contradicting statements don't help with trust or confidence in their decision making. As for your statement about Eastern Washington... > The entirety of Eastern Washington is in Phase 2 or eligible This literally just came out today. These counties have been asking for this variance for at least a couple weeks and have been rebuffed without any clear reason. Inslee's reopening plans and conferences have historically been vague (without clear metrics or goals) despite claims of being data driven and science based. And then there's the question of why so many counties in central Washington are not given variances...
- ngcc_hk 6y ago
  To avoid this, the Italian has tried a side indicator, no of death over expected death. Not exact but could help.
  - KarlKemp 6y ago
    Not just Italy: "excess mortality" is being looked at for every country: https://www.economist.com/graphic-detail/2020/04/16/tracking-covid-19-excess-deaths-across-countries https://www.economist.com/graphic-detail/2020/04/16/tracking... It's widely regarded as the gold standard, but usually not available weeks or months later. And while it is very reliable, it is somewhat less precise, and therefore not useful to gain a nuanced picture of the disease's impact when there are few deaths.
    - odkamkfn 6y ago
      Excess mortality is not at all reliable for figuring out covid-19 deaths. The most obvious confounders are the effects of the various responses to the virus as well as global fear and panic.
    - rsynnott 6y ago
      It’s also extremely slow. Most places are very slow in reporting normal death, ie those from non-notifiable causes. This is very visible in the euromomo data.

FireBeyond 6y ago

Not so much. Even by their own article (with its own biases - show me an article on this site that has ever postulated that there might be merit to restrictions): > Completing each “cause of death worksheet” involves listing the “immediate cause” of death, the “underlying cause(s)” that initiated the events culminating with the immediate cause of death, and “(o)ther significant conditions contributing to death but not resulting in the underlying cause.” These fields are completed based on the “best medical opinion” of the certifier. Is not "overstating deaths ... to support their intent to retain strict restrictions". It's stating - as it would with _any other disease_ that the patient had other co-morbidities, just as if you had diabetes, or CHF, etc. It's not the exaggerated, grand standing hyperbole of "Patient in car accident had COVID-19, so COVID-19 was listed as the cause of death", which simply hasn't happened. "Contributing to death, but not the underlying cause, in the best medical opinion of the physician/ME". In contrast, Florida has numerous documented instances of government interference with this (restricting coroners from reporting _any_ data, pressuring law firms related to the media filing FOI requests).

throwawaysea 6y ago
Read further down. The article I linked mentions that Washington state said in a prior request that they only count confirmed COVID cases in mortality metrics: > In its May 8 response to the Freedom Foundation, DOH stated, “All of the deaths currently attributed to COVID-19 had a positive PCR (polymerise chain reaction) test at some point. A PCR test is required in order to classify something as a confirmed case.” However various other sources now seemingly contradict the answer previously given, since they do count “presumptive” cases in mortality metrics after all: > DOH’s “Preliminary Guidance for Reporting COVID-19 Deaths” provides: “Coronavirus Disease 2019 or COVID-19 should be reported on the death certificate for all decedents where the disease caused, or is assumed to have caused, or contributed to death.” (emphasis in original) > Another DOH COVID-19 fact sheet makes a distinction between “confirmed” cases of COVID-19 in which the patient tested positive and “probable” cases involving any of the following factors [...] So either the initial response was false or the definitions of the metrics changed at some point. The reason this matters is because WA’s governor, Jay Inslee, has instituted the nation’s most strict restrictions, going well beyond what other cautious states like CA have implemented. For example he has banned fishing, hunting, residential construction, prevented rural areas from advancing in reopening phases, etc. Even as some restrictions (like closing all state parks or banning fishing) were reversed, Inslee continues to retain strange nonsensical bans on activities like camping. Certainly there is motive to make the numbers look worse to justify policy overreach or missteps, and it deserves scrutiny.
- FireBeyond 6y ago
  Those two statements are not contradictory: 1. A death _must_ have a positive PCR in order to be _attributed_ to COVID-19. This does not mean that a positive PCR means that the death _will_ be attributed to COVID-19. 2. Documentation of co-morbidities is standard, be it for COVID-19, or any other disease, "where the disease caused, or is assumed to have caused, or contributed to death". > The reason this matters is because WA’s governor, Jay Inslee, has instituted the nation’s most strict restrictions, going well beyond what other cautious states like CA have implemented. For example he has banned fishing, hunting, residential construction, prevented rural areas from advancing in reopening phases, etc. Even as some restrictions (like closing all state parks or banning fishing) were reversed, Inslee continues to retain strange nonsensical bans on activities like camping. The entirety of Eastern Washington is in Phase 2 or eligible (and the decision to go to Phase 2 in Adams and Spokane County is on those Counties, not the State, who has said they're eligible), which allows fishing, hunting, construction and camping: https://q13fox.com/2020/05/19/10-more-counties-including-thurston-kitsap-and-clallam-can-apply-for-phase-2-reopening/ https://q13fox.com/2020/05/19/10-more-counties-including-thu...
  - throwawaysea 6y ago
    I am not contesting that the documentation of comorbidities is reasonable or standard. I am however pointing out that the state has said contradictory things when it comes to which deaths are counted as COVID-caused deaths. Their guidance doc reads as follows: > “Coronavirus Disease 2019 or COVID-19 should be reported on the death certificate for all decedents where the disease caused, or is assumed to have caused, or contributed to death.” The phrasing "assumed to have caused" is key here and it suggests that at least some deaths were assumed to be COVID-caused even without explicit confirmation (via a PCR test). This means that this prior statement from the state was false: > “All of the deaths currently attributed to COVID-19 had a positive PCR (polymerise chain reaction) test at some point. A PCR test is required in order to classify something as a confirmed case.” If the standards for what counts as a COVID-death have changed to be more permissive, then that would have the effect of inflating mortality metrics. But either way the contradicting statements don't help with trust or confidence in their decision making. As for your statement about Eastern Washington... > The entirety of Eastern Washington is in Phase 2 or eligible This literally just came out today. These counties have been asking for this variance for at least a couple weeks and have been rebuffed without any clear reason. Inslee's reopening plans and conferences have historically been vague (without clear metrics or goals) despite claims of being data driven and science based. And then there's the question of why so many counties in central Washington are not given variances...
ngcc_hk 6y ago
To avoid this, the Italian has tried a side indicator, no of death over expected death. Not exact but could help.
- KarlKemp 6y ago
  Not just Italy: "excess mortality" is being looked at for every country: https://www.economist.com/graphic-detail/2020/04/16/tracking-covid-19-excess-deaths-across-countries https://www.economist.com/graphic-detail/2020/04/16/tracking... It's widely regarded as the gold standard, but usually not available weeks or months later. And while it is very reliable, it is somewhat less precise, and therefore not useful to gain a nuanced picture of the disease's impact when there are few deaths.
  - odkamkfn 6y ago
    Excess mortality is not at all reliable for figuring out covid-19 deaths. The most obvious confounders are the effects of the various responses to the virus as well as global fear and panic.
  - rsynnott 6y ago
    It’s also extremely slow. Most places are very slow in reporting normal death, ie those from non-notifiable causes. This is very visible in the euromomo data.