4 ms·

No. You are not representing the article or the study accurately. There are many other reasons for excess deaths than the two you mentioned. From the article:

No. You are not representing the article or the study accurately. There are many other reasons for excess deaths than the two you mentioned. From the article: >there were 96% more diabetes-related deaths than experts predicted. For heart disease, the figure was 89%; for Alzheimer’s disease, it was 64%; and for stroke, it was 35%. >As well as people not being able to get the necessary treatment due to hospitals being overloaded, the study authors also speculate that people may have stayed at home due to the virus despite experiencing worsening symptoms of another condition they may have had. >They also believe that the pandemic’s effects on people’s mental health may have played a part. >As Prof. Woolf notes: “We can’t forget about mental health. A number of people struggling with depression, addiction, and very difficult economic conditions caused by lockdowns may have become increasingly desperate, and some may have died by suicide. People addicted to opioids and other drugs may have overdosed.”

e40 6y ago
Just on the heart disease alone, I understand these deaths were due to the virus causing clots in the arteries near the heart. That seems directly related to the virus.
- thu2111 6y ago
  At this point it seems like basically everything and anything is being attributed to this virus, often without any kind of study or robust evidence. Occam's Razor can help here. We know that there are treatments for these ailments that can help people. We know these treatments stopped due to lockdown and people being afraid to go to hospitals. We know this must, but implication, increase deaths from these ailments. The alternative explanation is far more complex, actually it's of unbounded complexity because as far as I know there isn't any clear known mechanism of action that shows how this type of virus can cause all these different kinds of problems. Is there even a robust set of studies that show how this type of virus causes blood clots? As far as I know there is some evidence that blood thinners can help a bit with flu, sometimes, so it's not entirely implausible, but I think it's also unknown what exactly happens there and why. And people keep saying this virus is totally unlike flu so that similarity should maybe be discarded.
  - vikramkr 6y ago
    The mechanism of action behind the broad symptoms we see is actually reasonably straightforward- the ace2 receptor the virus uses to enter cells is everywhere in your body. In vitro, they replicate in pancreatic cells and intestinal cells, which lends a mechanistic explanation for the link to gastrointestinal distress and diabetes seen in correlative findings. Heart muscle also has high concentrations of the ACE2 receptor. One of the mechanistic hypothesis for clotting [0] proposed is that the complement system and immune cascades trigger clots, since they saw evidence of the virus binding to an element in the complement cascade. This could turn out to be entirely wrong of course, but that's a hint at the other key aspect of this that allows varied results - your immune system can react poorly and is capable of screwing up in fascinating and varied ways. It could be the virus killing pancreatic cells, or an autoimmune response triggered by the virus that causes pancreatic cell death since the virus infects them and marks them for destruction. Are these the driving forces behind increased clots etc? Maybe not. Maybe its contributing equally with people staying at home, or maybe not at all. But the mechanistic reasons for the broad symptoms are there and they're relatively straightforward, driven by the ability of the virus to infect lots of different cells and the variability of the human immune system [0]https://news.weill.cornell.edu/news/2020/07/what-is-known-about-covid-19-and-abnormal-blood-clotting https://news.weill.cornell.edu/news/2020/07/what-is-known-ab...
treeman79 6y ago
Went through a few years of suffering minor strokes, only finally got stabilized back in January. Had several bad scares that I didn’t go in that I really should have. Finally had a bad enough scare that I went to ER. Apparently heart isn’t doing great, or heading in that direction. I was stable enough to go home. With strict instructs to get additional testing in day’s. Yet I’m Having major problems getting access to a cardiologist due to everything. So yea, i lucked out in getting stable right before things shut down. But having a seriously hard time getting any follow up care. So at a certain point this shutdown will kill me. And I’m fairly young. So I have to balance virus risk with the more likely death due to lack of care.
- zdragnar 6y ago
  If you find yourself needing to go in again (or able to get the follow up appointment) I wouldn't hesitate to go in. At least in my area, hospitals are nearly over-the-top in terms of separating people who have symptoms, going in for tearing, and those going in for anything else. Separate entrances, separate waiting areas, no visitors, multiple tests required prior to non emergency treatments, etc. Of course, if you can't find a specialist at all, that is a very different story.
- amanaplanacanal 6y ago
  If in your location shutdown policies are preventing you from getting healthcare, they are doing their shutdown wrong. This is very sad.
  - MaxBarraclough 6y ago
    This is known to be happening in the UK too. The expectation is for thousands of 'excess' cancer deaths due to reduced cancer-related medical services. https://www.bbc.co.uk/news/av/health-53310007/they-paused-my-chemo-because-of-covid https://www.bbc.co.uk/news/av/health-53310007/they-paused-my... https://www.bbc.co.uk/news/health-53300784 https://www.bbc.co.uk/news/health-53300784
  - treeman79 6y ago
    What’s sad is it took 3 years to find out I have a clotting disorder. Despite many trips to Er and doctors complaining of stroke symptoms. A simple blood thinner resolved so many problems for me. Turns out there’s a big range of clot sizes. From micro ones that have very brief problems, to the sort that kill you in minutes. Hospitals can only really catch them when they are about to kill you, or just after.
projektfu 6y ago
But the article also says that they’re just going by records, so if a death was attributed to heart disease, it may have been COVID-19
- jtbayly 6y ago
  Right. May have been. That's why I commented elsewhere about how we are really unable to figure out what percent of this 35% is actually caused by Covid-19, and what percent is caused by the shutdown or people being overly fearful.
aesh2Xa1 6y ago
>As well as people not being able to get the necessary treatment due to hospitals being overloaded, the study authors also speculate that people may have stayed at home due to the virus despite experiencing worsening symptoms of another condition they may have had. OK, I read this as two separate things that should not be described in the same "35%" statistic. In the former, the virus caused hospital overload specifically due to rising cases of the virus, or virus-related exacerbation of underlying disease. In the latter, people's perception of the threat of hospitals, which were hotbeds for the virus, caused them not to seek treatment in hospitals. Case #1 is attributable to the virus. Case #2 is indirect, but I'd argue that those same people would have also been somewhat impacted given that A) it's possible the hospital they avoided was overloaded and B) it's possible the hospital they avoided was a hotbed where they could have contracted the virus. There's also that C) they could have received successful treatment, but how can we measure that? For (A) and (B), the outcome was still death.
- jtbayly 6y ago
  For (B), the outcome is not necessarily death. Getting Covid-19 is not an automatic death sentence. Better to risk getting it and have a chance of living than stay home and die of a stroke.
  - aesh2Xa1 6y ago
    True, the patient could receive treatment. The risk, given a pre-existing condition, to become infected with the virus is still an additional burden, but perhaps not death. Conversely, some number of people with pre-existing conditions, who chose to avoid hospitals and who did not die as an outcome, could have also died had they visited. I imagine that the people who chose to stay home are in a set where it wasn't obvious that staying home meant death. Thus, I think it was a good bet given what we know about coronavirus complications, spreadability, and virulence.
ouid 6y ago
Since all of these things are comorbidities to covid, it sure seems possible that they just tested negative, despite having the disease. 35% seems to be about the false negative rate. Maybe the author is forgetting that this is the reason people wanted to track excess deaths in the first place.
- jtbayly 6y ago
  Suicide is not a comorbidity. Nor can you assume that all of these deaths are simply undetected Covid-19 deaths. We simply don't know what percent of the 35% are caused by Covid-19 and what percent are caused by the lockdown and/or people being too scared to seek treatment. All we know is that there is an additional 35% in excess deaths.
  - ouid 6y ago
    well, there are lots of diseases that aren't comorbid with covid, and the author pointed to no spikes in deaths from those diseases. Suicide is not responsible for any appreciable fraction of that 35%. The article doesn't mention suicide at all, and it would be so extraordinarily anomalous if suicides were suddenly on par with heart disease that that would be the only possible title of this article if they were.
    - jtbayly 6y ago
      FTA: "and some may have died by suicide" Also, I already quoted it above. You said all of the things mentioned were comorbidities. They aren't.
gpderetta 6y ago
it should be possible to actually verify these speculations? Many nations locked down completely, but the virus was still mostly confined in some regions, so by comparing the regional excess deaths with the virus prevalence it should be possible to discriminate between deaths caused directly and indirectly from the virus and deats caused by the lockdown itself. Anedoctaly there are nations in Europe that are/were in lockdown and see no excess mortality at all.

e40 6y ago

Just on the heart disease alone, I understand these deaths were due to the virus causing clots in the arteries near the heart. That seems directly related to the virus.

thu2111 6y ago
At this point it seems like basically everything and anything is being attributed to this virus, often without any kind of study or robust evidence. Occam's Razor can help here. We know that there are treatments for these ailments that can help people. We know these treatments stopped due to lockdown and people being afraid to go to hospitals. We know this must, but implication, increase deaths from these ailments. The alternative explanation is far more complex, actually it's of unbounded complexity because as far as I know there isn't any clear known mechanism of action that shows how this type of virus can cause all these different kinds of problems. Is there even a robust set of studies that show how this type of virus causes blood clots? As far as I know there is some evidence that blood thinners can help a bit with flu, sometimes, so it's not entirely implausible, but I think it's also unknown what exactly happens there and why. And people keep saying this virus is totally unlike flu so that similarity should maybe be discarded.
- vikramkr 6y ago
  The mechanism of action behind the broad symptoms we see is actually reasonably straightforward- the ace2 receptor the virus uses to enter cells is everywhere in your body. In vitro, they replicate in pancreatic cells and intestinal cells, which lends a mechanistic explanation for the link to gastrointestinal distress and diabetes seen in correlative findings. Heart muscle also has high concentrations of the ACE2 receptor. One of the mechanistic hypothesis for clotting [0] proposed is that the complement system and immune cascades trigger clots, since they saw evidence of the virus binding to an element in the complement cascade. This could turn out to be entirely wrong of course, but that's a hint at the other key aspect of this that allows varied results - your immune system can react poorly and is capable of screwing up in fascinating and varied ways. It could be the virus killing pancreatic cells, or an autoimmune response triggered by the virus that causes pancreatic cell death since the virus infects them and marks them for destruction. Are these the driving forces behind increased clots etc? Maybe not. Maybe its contributing equally with people staying at home, or maybe not at all. But the mechanistic reasons for the broad symptoms are there and they're relatively straightforward, driven by the ability of the virus to infect lots of different cells and the variability of the human immune system [0]https://news.weill.cornell.edu/news/2020/07/what-is-known-about-covid-19-and-abnormal-blood-clotting https://news.weill.cornell.edu/news/2020/07/what-is-known-ab...

treeman79 6y ago

Went through a few years of suffering minor strokes, only finally got stabilized back in January. Had several bad scares that I didn’t go in that I really should have. Finally had a bad enough scare that I went to ER. Apparently heart isn’t doing great, or heading in that direction. I was stable enough to go home. With strict instructs to get additional testing in day’s. Yet I’m Having major problems getting access to a cardiologist due to everything. So yea, i lucked out in getting stable right before things shut down. But having a seriously hard time getting any follow up care. So at a certain point this shutdown will kill me. And I’m fairly young. So I have to balance virus risk with the more likely death due to lack of care.

zdragnar 6y ago
If you find yourself needing to go in again (or able to get the follow up appointment) I wouldn't hesitate to go in. At least in my area, hospitals are nearly over-the-top in terms of separating people who have symptoms, going in for tearing, and those going in for anything else. Separate entrances, separate waiting areas, no visitors, multiple tests required prior to non emergency treatments, etc. Of course, if you can't find a specialist at all, that is a very different story.
amanaplanacanal 6y ago
If in your location shutdown policies are preventing you from getting healthcare, they are doing their shutdown wrong. This is very sad.
- MaxBarraclough 6y ago
  This is known to be happening in the UK too. The expectation is for thousands of 'excess' cancer deaths due to reduced cancer-related medical services. https://www.bbc.co.uk/news/av/health-53310007/they-paused-my-chemo-because-of-covid https://www.bbc.co.uk/news/av/health-53310007/they-paused-my... https://www.bbc.co.uk/news/health-53300784 https://www.bbc.co.uk/news/health-53300784
- treeman79 6y ago
  What’s sad is it took 3 years to find out I have a clotting disorder. Despite many trips to Er and doctors complaining of stroke symptoms. A simple blood thinner resolved so many problems for me. Turns out there’s a big range of clot sizes. From micro ones that have very brief problems, to the sort that kill you in minutes. Hospitals can only really catch them when they are about to kill you, or just after.

projektfu 6y ago

But the article also says that they’re just going by records, so if a death was attributed to heart disease, it may have been COVID-19

jtbayly 6y ago
Right. May have been. That's why I commented elsewhere about how we are really unable to figure out what percent of this 35% is actually caused by Covid-19, and what percent is caused by the shutdown or people being overly fearful.

aesh2Xa1 6y ago

>As well as people not being able to get the necessary treatment due to hospitals being overloaded, the study authors also speculate that people may have stayed at home due to the virus despite experiencing worsening symptoms of another condition they may have had. OK, I read this as two separate things that should not be described in the same "35%" statistic. In the former, the virus caused hospital overload specifically due to rising cases of the virus, or virus-related exacerbation of underlying disease. In the latter, people's perception of the threat of hospitals, which were hotbeds for the virus, caused them not to seek treatment in hospitals. Case #1 is attributable to the virus. Case #2 is indirect, but I'd argue that those same people would have also been somewhat impacted given that A) it's possible the hospital they avoided was overloaded and B) it's possible the hospital they avoided was a hotbed where they could have contracted the virus. There's also that C) they could have received successful treatment, but how can we measure that? For (A) and (B), the outcome was still death.

jtbayly 6y ago
For (B), the outcome is not necessarily death. Getting Covid-19 is not an automatic death sentence. Better to risk getting it and have a chance of living than stay home and die of a stroke.
- aesh2Xa1 6y ago
  True, the patient could receive treatment. The risk, given a pre-existing condition, to become infected with the virus is still an additional burden, but perhaps not death. Conversely, some number of people with pre-existing conditions, who chose to avoid hospitals and who did not die as an outcome, could have also died had they visited. I imagine that the people who chose to stay home are in a set where it wasn't obvious that staying home meant death. Thus, I think it was a good bet given what we know about coronavirus complications, spreadability, and virulence.

ouid 6y ago

Since all of these things are comorbidities to covid, it sure seems possible that they just tested negative, despite having the disease. 35% seems to be about the false negative rate. Maybe the author is forgetting that this is the reason people wanted to track excess deaths in the first place.

jtbayly 6y ago
Suicide is not a comorbidity. Nor can you assume that all of these deaths are simply undetected Covid-19 deaths. We simply don't know what percent of the 35% are caused by Covid-19 and what percent are caused by the lockdown and/or people being too scared to seek treatment. All we know is that there is an additional 35% in excess deaths.
- ouid 6y ago
  well, there are lots of diseases that aren't comorbid with covid, and the author pointed to no spikes in deaths from those diseases. Suicide is not responsible for any appreciable fraction of that 35%. The article doesn't mention suicide at all, and it would be so extraordinarily anomalous if suicides were suddenly on par with heart disease that that would be the only possible title of this article if they were.
  - jtbayly 6y ago
    FTA: "and some may have died by suicide" Also, I already quoted it above. You said all of the things mentioned were comorbidities. They aren't.

gpderetta 6y ago

it should be possible to actually verify these speculations? Many nations locked down completely, but the virus was still mostly confined in some regions, so by comparing the regional excess deaths with the virus prevalence it should be possible to discriminate between deaths caused directly and indirectly from the virus and deats caused by the lockdown itself. Anedoctaly there are nations in Europe that are/were in lockdown and see no excess mortality at all.