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This is completely anecdotal, but my good friend’s brother is an ER doctor. He said the hospital required them to label the cause of death for all patients in t

This is completely anecdotal, but my good friend’s brother is an ER doctor. He said the hospital required them to label the cause of death for all patients in the hospital as covid if there was as much as one symptom. I don’t want to downplay the sadness of the deaths, but I think it is a bit foolish for us to base our number of deaths of off untested patients...

azinman2 6y ago
Except you can see the excess total deaths compared to previous years and how well it correlates and is otherwise unexplained [1]. A lot of the labeling occurred because people couldn’t get tested yet presented symptoms that indicated covid. In that situation, you can’t say 100% without a test, yet it’s the reasonable conclusion in a pandemic. [1] https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm
- verylittlemeat 6y ago
  Something worth keeping in mind is how many fewer people died of other causes compared to previous years [1]. Yes, the data will show an excess number of people died versus previous years but I believe the parent comment is saying we should pay close attention to what the cause of death really means in terms of age and comorbidity. [1] https://i.imgur.com/HfaMhcK.jpg https://i.imgur.com/HfaMhcK.jpg
  - SifJar 6y ago
    One further thing to bear in mind here is that some causes of death can be expected to be decreased on account of lockdowns e.g. accidents - less people out and about, less people driving etc. will naturally lead to less accidents. Of course on the flip side, more people stuck at home & using the time to do renovation work etc. could lead to an increase in e.g. power tool related accidents. Other causes of death such as flu can likely also be assumed to be decreased as a side-effect of lockdown
    - leereeves 6y ago
      Contrariwise, people are avoiding treatment for other illnesses for fear of catching COVID in a hospital. Many people are depressed or even suicidal. And people are less active, which aggravates other health problems. All of these factors could increase the number of deaths.
      - kolinko 6y ago
        If it was significant in comparison, we would not see a sharp drop in deaths after the lockdowns. Do people get depressed and die because of a lovkdown? Sure, I got depressed as well. But the numbers show that this issue is far less than the number of people that would die otherwise.
        deleted 6y ago
        [deleted]
      - addicted 6y ago
        3 months of lower activity is not killing people in those 3 months. Any effects will be felt on a much longer timeframe. Most office workers have very sedentary lives anyways, that didn’t become significantly more sedentary when they replaced their drive with a walk to another room and working in an office with working in that room. Throw in the fact that they are likely cooking more because restaurants and all were shut and not just having lunch delivered to their office, they may even be getting more activity in.
        SifJar 6y ago
        Plus no commute leaves more free time in the evenings for exercise etc. Obviously not everyone will be doing that, but anecdotally a few people I've talked to from work are going for more walks & cycles etc.
- zaroth 6y ago
  Curious if we know specifically what caused the tens of thousands of excess deaths that showed up around January 2018? Was that a particularly bad flu season?
pjc50 6y ago
The most reliable number is "excess deaths", since that's hard to fake even if it's not specific.
unlikelymordant 6y ago
You can just look at the all cause excess deaths and see that the number of people that have died so far this year is much higher than previous years in New York. So whether you agree that person A died from covid or not, there were many more deaths due to something.
- jakeogh 6y ago
  What is the effect of fear? Cortisol spikes and avoiding going to the doctor for what would normally be a good reason need to be researched.
  - majewsky 6y ago
    That is something worth researching, but even then, it's still justifiable to count a death by fear as a death by pandemic, given that it wouldn't have happened without the pandemic.
    - fastball 6y ago
      You can have a pandemic without fear though.
      - vertex-four 6y ago
        Really? Has there ever been one? Or is the fear a natural human response to an invisible, omnipresent killer?
        fastball 6y ago
        Well, I guess I should say you can have a pandemic without a fear-mongering news media that significantly exacerbates it. I personally am not "fearful" of COVID-19, as are many (most) people I know, so it is clearly possible for the general human.
        vertex-four 6y ago
Isinlor 6y ago
Based on excess deaths - the difference between how many deaths from all causes would you exec and how many were reported - USA is very likely under counting deaths. Also all case mortality coincide very well with reports of COVID-19 cases. USA is very likely to significantly under count deaths from COVID-19. See: Preliminary Estimate of Excess Mortality During the COVID-19 Outbreak — New York City, March 11–May 2, 2020 https://www.cdc.gov/mmwr/volumes/69/wr/mm6919e5.htm https://www.cdc.gov/mmwr/volumes/69/wr/mm6919e5.htm
ageitgey 6y ago
How you label the deaths is not that big of a deal in the larger scale. If you want to know the true toll of the epidemic, just look at this year's deaths vs. an average of previous years. It's simple and transparent. Here's that data for England: https://imgur.com/sxoolBX https://imgur.com/sxoolBX I get why everyone is questioning everything, but there isn't some big conspiracy here. Lots of people died of COVID. Most of them were 80+. You probably don't know any of them if you don't hang out with 80-90 year olds.
- ddxxdd 6y ago
  But then we get to the question of whether those deaths were caused by COVID or other causes. We know that traffic fatalities in some areas have risen drastically due to the lockdowns: https://abc7.com/traffic-fatalities-california-highway-patrol-speeding-covid-19/6198603/ https://abc7.com/traffic-fatalities-california-highway-patro... We also know that doctor visits have gone down due to the coronavirus, leading to medical staff being laid off: https://www.npr.org/sections/health-shots/2020/04/02/826232423/covid-19-hits-some-health-care-workers-with-pay-cuts-and-layoffs https://www.npr.org/sections/health-shots/2020/04/02/8262324... We also know that hospitals are financially incentivized to diagnose a patient as COVID positive: https://www.usatoday.com/story/news/factcheck/2020/04/24/fact-check-medicare-hospitals-paid-more-covid-19-patients-coronavirus/3000638001/ https://www.usatoday.com/story/news/factcheck/2020/04/24/fac... And there are German serological studies that suggest a COVID death rate of 0.39%, in contrast with the NYC study that claims a death rate of 1% Taking this altogether, and we have plenty of wiggle room to suggest that even the excess deaths don't necessarily imply that COVID is extremely deadly.
  - ageitgey 6y ago
    You are conflating a lot of different things. Traffic fatalities were actually down overall (total numbers), but up per mile driven. In other words, people were driving much less and dying in lower total numbers, but the people who were driving were driving faster and thus a bit more likely to die. That article is poorly written to generate headlines and clicks. Arguing over a specific IFR is also kind of pointless because the disease is so age and condition dependent. Whether the true overall IFR in a population is 1% or 0.4% doesn't really matter - it's a bad representation of the overall situation. COVID is a disease that kills a very large percentage of 80+ but is quite low risk for younger people. A single number doesn't capture or represent that. Demographic differences between 2 cities could easily cause a large skew in actual IFR. Hospitals are (possibly) financially incentivized to diagnose COVID in the US. But this is a world-wide disease and no other country has the insane US healthcare system where that would matter. > Taking this altogether, and we have plenty of wiggle room to suggest that even the excess deaths don't necessarily imply that COVID is extremely deadly. That's not correct. It's absolutely clear from the numbers across many countries that COVID is extremely deadly if you are 80+ and not deadly at all if you are 15. Make of that what you will. Arguing over IFRs and hospital reimbursement is missing the point. It's simultaneously true that COVID is very deadly for some groups but may not be deadly at all for you and your friends. There's a good argument to be made over how much of the excess death is due to secondary effects (untreated heart attacks, delayed cancer treatments, etc). But there's no way to arrange the numbers such that COVID doesn't obviously kill a lot of old people. Just look at the death rates in care homes / retirement homes. It was like a plague ravaging them.
globular-toast 6y ago
Similarly, several people I know have self-diagnosed themselves with COVID-19 due to just one symptom. In some cases the symptoms have disappeared the next day. In many cases the people are the "usual suspects" who seem to get ill several times a year anyway. I'm not aware of a single person who has definitely had COVID-19.
deleted 6y ago
[deleted]
mcv 6y ago
I also read that in Florida, the number of COVID-19 deaths is fairly low. Instead, the death rate from regular pneumonia is sky-rocketing.
chimprich 6y ago
> my good friend’s brother is an ER doctor I've seen a number of rumours from brothers of friends or friends of brothers, but no actual doctors saying this.

azinman2 6y ago

Except you can see the excess total deaths compared to previous years and how well it correlates and is otherwise unexplained [1]. A lot of the labeling occurred because people couldn’t get tested yet presented symptoms that indicated covid. In that situation, you can’t say 100% without a test, yet it’s the reasonable conclusion in a pandemic. [1] https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm

verylittlemeat 6y ago
Something worth keeping in mind is how many fewer people died of other causes compared to previous years [1]. Yes, the data will show an excess number of people died versus previous years but I believe the parent comment is saying we should pay close attention to what the cause of death really means in terms of age and comorbidity. [1] https://i.imgur.com/HfaMhcK.jpg https://i.imgur.com/HfaMhcK.jpg
- SifJar 6y ago
  One further thing to bear in mind here is that some causes of death can be expected to be decreased on account of lockdowns e.g. accidents - less people out and about, less people driving etc. will naturally lead to less accidents. Of course on the flip side, more people stuck at home & using the time to do renovation work etc. could lead to an increase in e.g. power tool related accidents. Other causes of death such as flu can likely also be assumed to be decreased as a side-effect of lockdown
  - leereeves 6y ago
    Contrariwise, people are avoiding treatment for other illnesses for fear of catching COVID in a hospital. Many people are depressed or even suicidal. And people are less active, which aggravates other health problems. All of these factors could increase the number of deaths.
    - kolinko 6y ago
      If it was significant in comparison, we would not see a sharp drop in deaths after the lockdowns. Do people get depressed and die because of a lovkdown? Sure, I got depressed as well. But the numbers show that this issue is far less than the number of people that would die otherwise.
      - deleted 6y ago
        [deleted]
    - addicted 6y ago
      3 months of lower activity is not killing people in those 3 months. Any effects will be felt on a much longer timeframe. Most office workers have very sedentary lives anyways, that didn’t become significantly more sedentary when they replaced their drive with a walk to another room and working in an office with working in that room. Throw in the fact that they are likely cooking more because restaurants and all were shut and not just having lunch delivered to their office, they may even be getting more activity in.
      - SifJar 6y ago
        Plus no commute leaves more free time in the evenings for exercise etc. Obviously not everyone will be doing that, but anecdotally a few people I've talked to from work are going for more walks & cycles etc.
zaroth 6y ago
Curious if we know specifically what caused the tens of thousands of excess deaths that showed up around January 2018? Was that a particularly bad flu season?

pjc50 6y ago

The most reliable number is "excess deaths", since that's hard to fake even if it's not specific.

unlikelymordant 6y ago

You can just look at the all cause excess deaths and see that the number of people that have died so far this year is much higher than previous years in New York. So whether you agree that person A died from covid or not, there were many more deaths due to something.

jakeogh 6y ago
What is the effect of fear? Cortisol spikes and avoiding going to the doctor for what would normally be a good reason need to be researched.
- majewsky 6y ago
  That is something worth researching, but even then, it's still justifiable to count a death by fear as a death by pandemic, given that it wouldn't have happened without the pandemic.
  - fastball 6y ago
    You can have a pandemic without fear though.
    - vertex-four 6y ago
      Really? Has there ever been one? Or is the fear a natural human response to an invisible, omnipresent killer?
      - fastball 6y ago
        Well, I guess I should say you can have a pandemic without a fear-mongering news media that significantly exacerbates it. I personally am not "fearful" of COVID-19, as are many (most) people I know, so it is clearly possible for the general human.
        vertex-four 6y ago

Isinlor 6y ago

Based on excess deaths - the difference between how many deaths from all causes would you exec and how many were reported - USA is very likely under counting deaths. Also all case mortality coincide very well with reports of COVID-19 cases. USA is very likely to significantly under count deaths from COVID-19. See: Preliminary Estimate of Excess Mortality During the COVID-19 Outbreak — New York City, March 11–May 2, 2020 https://www.cdc.gov/mmwr/volumes/69/wr/mm6919e5.htm https://www.cdc.gov/mmwr/volumes/69/wr/mm6919e5.htm

ageitgey 6y ago

How you label the deaths is not that big of a deal in the larger scale. If you want to know the true toll of the epidemic, just look at this year's deaths vs. an average of previous years. It's simple and transparent. Here's that data for England: https://imgur.com/sxoolBX https://imgur.com/sxoolBX I get why everyone is questioning everything, but there isn't some big conspiracy here. Lots of people died of COVID. Most of them were 80+. You probably don't know any of them if you don't hang out with 80-90 year olds.

ddxxdd 6y ago
But then we get to the question of whether those deaths were caused by COVID or other causes. We know that traffic fatalities in some areas have risen drastically due to the lockdowns: https://abc7.com/traffic-fatalities-california-highway-patrol-speeding-covid-19/6198603/ https://abc7.com/traffic-fatalities-california-highway-patro... We also know that doctor visits have gone down due to the coronavirus, leading to medical staff being laid off: https://www.npr.org/sections/health-shots/2020/04/02/826232423/covid-19-hits-some-health-care-workers-with-pay-cuts-and-layoffs https://www.npr.org/sections/health-shots/2020/04/02/8262324... We also know that hospitals are financially incentivized to diagnose a patient as COVID positive: https://www.usatoday.com/story/news/factcheck/2020/04/24/fact-check-medicare-hospitals-paid-more-covid-19-patients-coronavirus/3000638001/ https://www.usatoday.com/story/news/factcheck/2020/04/24/fac... And there are German serological studies that suggest a COVID death rate of 0.39%, in contrast with the NYC study that claims a death rate of 1% Taking this altogether, and we have plenty of wiggle room to suggest that even the excess deaths don't necessarily imply that COVID is extremely deadly.
- ageitgey 6y ago
  You are conflating a lot of different things. Traffic fatalities were actually down overall (total numbers), but up per mile driven. In other words, people were driving much less and dying in lower total numbers, but the people who were driving were driving faster and thus a bit more likely to die. That article is poorly written to generate headlines and clicks. Arguing over a specific IFR is also kind of pointless because the disease is so age and condition dependent. Whether the true overall IFR in a population is 1% or 0.4% doesn't really matter - it's a bad representation of the overall situation. COVID is a disease that kills a very large percentage of 80+ but is quite low risk for younger people. A single number doesn't capture or represent that. Demographic differences between 2 cities could easily cause a large skew in actual IFR. Hospitals are (possibly) financially incentivized to diagnose COVID in the US. But this is a world-wide disease and no other country has the insane US healthcare system where that would matter. > Taking this altogether, and we have plenty of wiggle room to suggest that even the excess deaths don't necessarily imply that COVID is extremely deadly. That's not correct. It's absolutely clear from the numbers across many countries that COVID is extremely deadly if you are 80+ and not deadly at all if you are 15. Make of that what you will. Arguing over IFRs and hospital reimbursement is missing the point. It's simultaneously true that COVID is very deadly for some groups but may not be deadly at all for you and your friends. There's a good argument to be made over how much of the excess death is due to secondary effects (untreated heart attacks, delayed cancer treatments, etc). But there's no way to arrange the numbers such that COVID doesn't obviously kill a lot of old people. Just look at the death rates in care homes / retirement homes. It was like a plague ravaging them.

globular-toast 6y ago

Similarly, several people I know have self-diagnosed themselves with COVID-19 due to just one symptom. In some cases the symptoms have disappeared the next day. In many cases the people are the "usual suspects" who seem to get ill several times a year anyway. I'm not aware of a single person who has definitely had COVID-19.

deleted 6y ago

[deleted]

mcv 6y ago

I also read that in Florida, the number of COVID-19 deaths is fairly low. Instead, the death rate from regular pneumonia is sky-rocketing.

chimprich 6y ago

> my good friend’s brother is an ER doctor I've seen a number of rumours from brothers of friends or friends of brothers, but no actual doctors saying this.