Lady calls in, her 450lb 57 year old son with uncontrolled type 2 diabetes and COPD is found dead at his home. Post-mortem test shows he's positive for COVID. You're the doctor, your hospital has had to furlough a quarter of their staff because nobody is coming in for any outpatient care, there's an ICU full of people on vents and you've been there for 18 hours already.
The guys mom is there and you're working up her son's case. You have to fill in the blank for cause of death. What are you going to do? Order an autopsy and possibly cut this family out of government aid for COVID-related expenses and deaths?
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.
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...
In the recent past, we were grieving the sudden passing of my father who collapsed unconscious as soon as he got off a motorcycle on which he was a pillion rider. We rushed him to the hospital where he was pronounced dead upon arrival. He had had no significant medical problems to speak of. They couldn't determine the cause of death as the facility was understaffed and overrun with patients battling the Covid-19 pandemic or other infectious diseases. We had to get out of there in no time.
A week after my father's untimely demise, my mother suffered a massive stroke and went into a coma. We brought her home after the doctors treating her at the hospital had declared her brain dead. During the hospitalization, she was diagnosed with Covid-19, which we were told caused her the ischemic stroke.
Of note, we live in a village where we have no access to healthcare at all.
As her caregivers at home, my wife (42) and I (48) were exposed to my mother while she was still comatose and recovering from the infectious disease, and subsequently both my wife and I tested positive for the coronavirus. With no one else around to help us except my daughter who we had kept in isolation, we continued caring for my mother, giving her nothing but thin liquids via a feeding tube.
The symptoms my wife and I experienced through our recovery lasting a week to 10 days included a low-grade fever, loss of taste and smell. It took us about a month to regain the latter. Even my mother, who is 68 and otherwise healthy, regained consciousness and her ability to communicate over a month or so and she began taking in food orally after I had no choice but to go ahead and remove her feeding tube myself. She is still paralyzed and bedridden, though.
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.
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.
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.
> 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.
Except it's not a straightforward answer at all. I'm not even in medicine and I can intuitively see how unclear the answer to that question could be. Take someone who is a lifelong smoker and gets COVID and dies from COPD/Chronic Respiratory Failure. What killed them, the COVID or the smoking? This is probably one of the most elementary examples of how complicated determining cause of death can be, I am sure there are many many more that someone who is a professional in that field could cite.
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.
Exactly what kind of death due to covid do you think shouldn't be classified as a covid death, and what are your medical credentials or evidentiary basis to justify such a stance?
Even the Fox news comment doctor said it's a reasonable stance, because the examples given about kidney and heart problems which are supposed to seem obviously unrelated to general public are clearly not to someone with medical background.
> “The way in which we code deaths in our country is very generous in the sense that all the people who die in hospitals with the coronavirus are deemed to be dying of the coronavirus.
How else could deaths be recorded? It would seem negligent to not record someone who died with coronavirus as dying of coronavirus.
Personal anecdote: I do have a family member that passed away and the cause was mislabeled as COVID(He never tested positive). So one sympathizes with the 38%
Not to mention the fact that the nurses and doctors are exhausted from treating Covid cases. Even if he hadn’t caught the virus, there’s a good chance the diminished quality of care he received from the overburdened medical professionals contributed to his death. Thus, it’s definitely fair to list Covid as the cause of death.
Indeed, it’s obvious and not fairly deniable that but for Covid, all 100-year olds hospitalized with pneumonia would have every reason to think they would live for several more decades.
The guys mom is there and you're working up her son's case. You have to fill in the blank for cause of death. What are you going to do? Order an autopsy and possibly cut this family out of government aid for COVID-related expenses and deaths?
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