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...
There is an aspect that is missing in this article's analysis: what counts as a COVID-caused death.
In Italy, for example, all in-hospital deaths of COVID-positive patients are recorded as COVID deaths.
If you're 85 years old, with emphysema, heart disease, diabetes, and COVID, and you die of acute respiratory distress... did COVID kill you?
In Italy, it did, 100%
In New York, it is up to the doctor who declares you dead, but it probably did.
In Germany, it most likely didn't.
That is not to say that Germany isn't doing a good job -- they are. They are doing a lot of testing, isolating, and contact tracing. They are also going full-speed-ahead with the experimental hydroxychloroquine/azithromycin treatment, offering it everyone without contraindications, starting almost from the beginning of the outbreak.
Both of those things contribute to the low death rate.
They are also detecting a higher percentage of cases, which automatically lowers the apparent mortality (since every country detects most of the hospitalizations, more testing means finding more inherently non-lethal cases, meaning more detected recoveries)
Unfortunately, it is hard to get those numbers correctly. COVID patients die because of multiple organ failure and unless the deceased was already tested and verified for it, you can't attribute the death to COVID officially. A lot of people pass away without showing visible symptoms or without realizing they need immediate medical attention for COVID.
It would be good to have that attribution and that will require testing the deceased, but given the load on the system, everybody can extrapolate the scale and act accordingly.
Some places list patients who died as a coronavirus death if they have the symptoms. Some of this was prior to the increase in available tests. Some of this is to conserve the limited numer of gears for use by the living. It doesn't hurt them to list it a coronavirus death since they can get additional funding for coronavirus patients.
This is strongly reminiscent of https://www.buzzfeednews.com/article/nidhiprakash/coronaviru... that anecdotally reported that COVID deaths are being severely underreported in the USA because doctors were told to only test if it would change the care given because tests were in short supply. But that means that if the person goes on to die, they are not actually counted as a case.
Just because they're tested positive for Covid and later die in the hospital, doesn't mean that the death certificate will state Covid as cause of death.
Similar story here - a family member contracted COVID in a nursing home, was sent to the hospital due to low blood oxygen levels, and was discharged. They passed away 2 weeks later, but the cause of death was not listed as COVID. I live in a red state, and for some reason, people are very hesitant to admit COVID can kill.
No, because without tests, doctors didn’t uniformly attribute deaths correctly to covid, and often the official causes of death even in cases of cancer are often “pneumonia” or sepsis, or organ failure — the literal thing that killed them at the moment of death, not the cause of the symptom that overwhelmed the body.
> Then there is the problem of deaths being attributed to covid any time the person who died has a positive covid test in the month prior to their death. It's easy to find numerous examples of people who died in car crashes or from suicide being reported as covid deaths, even still.
I never understood the reasoning behind this. I understand that pinpointing the cause of death is hard, especially with overcrowded hospitals, but I'm guessing that any doctor could circle the "high or low probability of covid causing the death" on the forms after the death of the patient. Covid+pneumonia, intubation, heart failure... sure, it's 99% it really was covid and not an unrelated undiscovered heart issue. Car crash... pretty sure it wasnt directly covids fault. The suicides would be a bit more touchy though.
There may be a financial incentive for hospitals, but hospitals don't mark these deaths, doctors do. I think it at the very least borders on a conspiracy theory to suggest that doctors are making a coordinated effort to falsely label deaths as COVID related.
There may be cases where people get mislabeled (it's hard to determine what the exact source of death is, especially since COVID doesn't kill directly), but I would be hesitant to ascribe intentional mislabel to people.
It's more skeptisism where I see stories about elderly people dieing from old age, but because they tested positive for Covid it was counted as a covid death. Or died in a car accident, gun shot wound, fell off a ladder, etc. I've seen endless stories where these direct causes of death were counted as covid deaths because they tested positive.
Hospitals were encouraged to label people as positive/covid deaths because that's how they got funding for the last two years (since no one were getting optional surgeries, how hospitals normally get their funding). If hospitals are incentivized by money to label someone as a covid patient...they'll do everything possible to do it.
I know of one specific case where the person was a diabetic, went to work (outside, in the sun) and was really exhausted, got home, felt sick, called the ambulance, he died. Then they tested him for covid, he was positive and they recorded that as covid death.
I know it would help them for funding, but that is skewing the data on death rate, I guess.
a family member who is a doctor at a hospital told me that any patient that dies of a respiratory illness is being marked as covid19 even if they were never tested for it. dead truly means dead. dead by covid19 does not.
Prior to April 2020 the diagnostic criteria for a covid death required 0 testing whatsoever. Combine that with financial incentives to record something as covid, and the lack of other income for hospitals as patients wouldn't come for minor things and elective operations were cancelled and you have a perfect storm for bad data
I know of deaths at the local hospital ER with overlapping symptoms but not being officially counted as the deceased were never tested. On a county level there’s maybe one or two recorded. This testing debacle is hurting everybody in more ways than one.
I might have the numbers off a bit, but it's something like...
If you have a patient at your hospital and you are able to give them a covid diagnosis, you get $8k from the federal government. If you can put them on a ventilator for a few minutes, you get $35k from the federal government. This is intended to help offset the costs of care for covid patients to healthcare providers. You can get a covid diagnosis by having some of the sympoms... like coughing, weakness, shortness of breath, etc. I imagine it's difficult to die from anything without some weakness or shortness of breath. So it is very easy to say the patient had "covid-like" symptoms, and put covid as the cause of death.
Now, keep in mind that at the same time, healthcare providers are furloughing and laying off workers. Since "non-essential" care is on hold, there's not enough work for people to do in most places in the country. This places healthcare providers in a difficult moral position where they can inflate a number and keep their employees on payroll, or strictly follow it and lay everyone off.
One easy way to help with this data issue is to simply differentiate the deaths where a person had covid-like symptoms vs a death where a person actually tested positive for covid.
In most cases we can't even figure out where the top is though like all the doctors that are being encouraged to mark deaths unrelated to covid-19 as related simply because of the time that it happened in.I heard one doctor say oh yeah that patient did die of the virus because we couldn't get supplies here for their condition even though it was completely unrelated they still are calling tons of deaths cause covid-19
To further underline what you're saying is both true and OK; once they started doing that, death tallies started at least getting close to excess deaths, although (IIRC, and I might have misremembered) despite diagnosing covid without PCR, excess deaths always exceeded diagnosed cases - i.e. almost certainly the doctors etc were being fairly conservative.
(Although they didn't try to diagnose people that died before even reaching the hospital, which were thousands - and would have contributed to excess deaths, but not covid numbers).
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...
reply