How are COVID-19 deaths counted?

[admin]

Most COVID-19 deaths are easy to diagnose, but sometimes the immediate cause of death is not so clear, leading to accusations of politically-motivated falsification of death certificates.

How are COVID-19 deaths counted? : Read more

 

[DS in Bellaire]

The real problem with this overcount/undercount/whatever is that decisions to open or close the economy, various classes of business, church services, etc., are being made based on what are provably squishy numbers. The supposed metric "14 days of decreasing (cases, deaths, or whatever)" has become the criteria for granting more (already constitutionally guaranteed) freedoms. But the weekend reporting lag seen in the data cause a spike on Mondays, resetting the clock. Unfortunately, these criteria have been accepted by empowered people who have no statistical background, and no real inclination to look at the details behind the numbers...

 

[LivingMan]

Ok, so a guy catches the flu but dies of pneumonia. Nobody gives a crap but his death is counted as caused by pneumonia. Another guy catches corona but dies of a heart attack. His is counted as corona. Another guy had underlying issues that he died of but because the government is handing out tax money like candy and all you have to do is check the cause of death as corona, and hey, cha-ching! CBS does a special on all the huge numbers of people getting tested which is "flooding" a hospital and the hospital obliges by pulling nurses and techs from their jobs taking care of patients and making them go through a line pretending they are getting tested, thus inflating the numbers. Dr. Deborah Birx said 'there is nothing from the CDC that I can trust'. I call BS on the way they counted the deaths! America, you've been scammed so bad and all you can say is "Thank you, Sir, may I have another!"? Wake up you simple doofuses while your children still have a free(ish) country to call home!

 

[kaiserdr]

Florida Governor Ron DeSantis has made it impossible to trust ANY of the state's statistics or the special panel he appointed.

Florida's "statistics" mean absolutely nothing. In April, DeSantis directed ALL Florida's county coroners to STOP releasing cause-of-death statistics involving Corona virus. Citrus County, where I live, shares one coroner with several counties, it often takes a long time for the coroner to come here to determine the cause of death!

The same month, the governor set up a committee of "experts" to determine how to respond to the virus. The only medical representative on that committee is an administrator and does not know anything at all about virology, its treatment or control.

The decision to open Florida is totally political and is ignoring the potential of hundreds or even thousands of Floridians and tourists dying from the virus in Florida. Committee members have no idea what the medical consequences of opening up the state will be!

As seen in Miami Beach this weekend, no one kept their distance, many people at the beach probably were exposed to the virus and quite possibly spread it to everyone they later associated with. No one will show symptoms for two or tree weeks and will end up in more casualties.

Due to DeSantis muzzling coroners, those deaths will not be registered as due to Corona Virus and thousands of Floridians and any tourist who visits Florida could increase the number of deaths, while none of them will be recorded.

Committee members on such panels should be medical experts, not businessmen whose only concern is THEIR bottom line.

 

[Ratwrangler]

Considering the nature of this new virus, overreporting of deaths may be better than underreporting, with some caveats. One, if the death is reported as COVID-19-related, the patient must have tested positive for the disease. We should not have doctors just able to say, "fever and congestion, must be coronavirus," and write that down. Show proof of infection first. Two, if the patient has the virus, but dies of something the virus cannot cause, the virus cannot be listed as a cause. That would leave out trauma due to car accidents, firearms incidents, or ingesting aquarium supplies. The biggest problem with the numbers is that they are horribly inaccurate and will remain so until we test a much larger percentage of the population. As it is now, if you catch it, you have a 6.5% chance of dying, and a 19% chance of getting over it, based on present published numbers.

 

[Quantum]

Florida Governor Ron DeSantis has made it impossible to trust ANY of the state's statistics or the special panel he appointed.

Florida's "statistics" mean absolutely nothing. In April, DeSantis directed ALL Florida's county coroners to STOP releasing cause-of-death statistics involving Corona virus. Citrus County, where I live, shares one coroner with several counties, it often takes a long time for the coroner to come here to determine the cause of death!

The same month, the governor set up a committee of "experts" to determine how to respond to the virus. The only medical representative on that committee is an administrator and does not know anything at all about virology, its treatment or control.

The decision to open Florida is totally political and is ignoring the potential of hundreds or even thousands of Floridians and tourists dying from the virus in Florida. Committee members have no idea what the medical consequences of opening up the state will be!

As seen in Miami Beach this weekend, no one kept their distance, many people at the beach probably were exposed to the virus and quite possibly spread it to everyone they later associated with. No one will show symptoms for two or tree weeks and will end up in more casualties.

Due to DeSantis muzzling coroners, those deaths will not be registered as due to Corona Virus and thousands of Floridians and any tourist who visits Florida could increase the number of deaths, while none of them will be recorded.

Committee members on such panels should be medical experts, not businessmen whose only concern is THEIR bottom line.

The above post is so political as to be very suspicious. You see a lot of invective and Democratic Party talking points. The author makes no mention of the fact that the number of patients has been low, and the hospitals have not been over-run. The dire predictions have not come true. Yet, the author just throws out talking points, with no data or reasons, just political talking points. The author should be scrutinized, perhaps not a true scientist or commentator.

 

[Quantum]

The above post is so political as to be very suspicious. You see a lot of invective and Democratic Party talking points. The author makes no mention of the fact that the number of patients has been low, and the hospitals have not been over-run. The dire predictions have not come true. Yet, the author just throws out talking points, with no data or reasons, just political talking points. The author should be scrutinized, perhaps not a true scientist or commentator.

 

[DRH]

Most COVID-19 deaths are easy to diagnose, but sometimes the immediate cause of death is not so clear, leading to accusations of politically-motivated falsification of death certificates.

How are COVID-19 deaths counted? : Read more

The Covid19 death count is an utter mess. The CDC uses very antiquated systems and methodology and there is no truly uniform counting from State to State. The biggest issue is NOT whether or not deaths are attributed to Covid19 (even if not directly a result of the infection) BUT, deaths being counted as Covid19 when there is no actual infection of such. This was predicted to be a very bad Flu year - but amazingly the thousands of flu deaths reported in March fell to near zero for April. Gov Cuomo opened the door to the 'presumptive' Covid19 deaths in early April by dumping almost 4000 cases from the flu and bacterial pneumonia category into the Covid19 category of deaths. NYC is a special outlier in numbers of Covid19 deaths from any other locality in the world. And, it is looking suspiciously like what one would expect if you added the flu deaths to the Covid19 deaths as they had been materializing prior to the addition of the 'presumptives'.
Doctors across the country have complained that they have been pressured into listing Covid19 as the cause of a death (whether direct or indirect cause) without proof of Covid19 infection even occurring. Corpses can be swabbed for Covid19 or influenza, but there has been pressure to simply list it as such. Usually it is a matter of 'follow the money', since States and localities see more Covid19 deaths as more Federal funding - and cities and counties competing for greater shares of the States' allotments. But, there are also those who are determined to construct as dire a landscape as possible to justify their policies.
It was incumbent upon the CDC to get as accurate a count with any and all special factors for the deceased for a true picture, given a new pathogen and need for a better determination of lethality for the general populace and special sub groups . There are many in the CDC ranks who have their own preconceived ideas of what the landscape should look like with death counts, and their agendas work their way into the system. Ask Dr. Redding what the real 'flu' count is - and he cannot tell you. It was always an 'estimate'. Now, it is imperative that before a death is attributed to a Covid19 - it must be lab proven that the infection existed. This is a criteria that should have been demanded by the CDC, given the extreme ramifications this outbreak has exacted.
Bottom line -- the count is highly inflated. The Covid19 death toll is conflated with flu and streptococcal pneumonia deaths. Even Dr Brix, whose judgement and paternalistic approach at times with which I've taken issue, says she cannot believe any of the statistics coming out of the CDC. She estimated that the count was inflated by 25%. By my 35 years of experience in this field - and what the flu and pneumonia count ought to have been - even conservatively - the Covid19 death count appears to be off by as much as 35%.
Dr H

 

[The Fabulous Greenbean]

The Covid19 death count is an utter mess. The CDC uses very antiquated systems and methodology and there is no truly uniform counting from State to State. The biggest issue is NOT whether or not deaths are attributed to Covid19 (even if not directly a result of the infection) BUT, deaths being counted as Covid19 when there is no actual infection of such. This was predicted to be a very bad Flu year - but amazingly the thousands of flu deaths reported in March fell to near zero for April. ..........

Doctors across the country have complained that they have been pressured into listing Covid19 as the cause of a death (whether direct or indirect cause) without proof of Covid19 infection even occurring. Corpses can be swabbed for Covid19 or influenza, but there has been pressure to simply list it as such. Usually it is a matter of 'follow the money', since States and localities see more Covid19 deaths as more Federal funding - and cities and counties competing for greater shares of the States' allotments.

First of all, flu deaths did not drop to near zero in April. (See latest CDC flu surveillance report.) Second: doctors "across the country" have not come out and said they were being pressured to put Covid on the death certificates. There are two doctors in California who made a vague accusation of this happening (with no details). It's fraud to falsify a death certificate. My guess is it may happen in isolated instances, in which the local people involved need to take their specific accusations to authorities. No one has done that with the exception of one case in Colorado recently.
A lot of assumptions here, including that deaths are overcounted. Excess overall mortality rates indicate the opposite. In addition, Covid causes death in various ways, including heart attack (regardless of pre-existing condition). If Covid was in the US prior to March, there would have been no testing, but certainly deaths that would not have been counted as Covid deaths. Many states are not adding nursing home deaths and/or deaths at home, to their Covid death counts.
If I have diabetes and pass away with lungs full of fluid and multiple organ failure, that's not going to be a diabetes death. That is a likely Covid death, and the doctor has to make that call. That's what they're trained to do. Blanket accusations of fraud are nothing but political posturing without specifics.

 

[DRH]

First of all, flu deaths did not drop to near zero in April. (See latest CDC flu surveillance report.) Second: doctors "across the country" have not come out and said they were being pressured to put Covid on the death certificates. There are two doctors in California who made a vague accusation of this happening (with no details). It's fraud to falsify a death certificate. My guess is it may happen in isolated instances, in which the local people involved need to take their specific accusations to authorities. No one has done that with the exception of one case in Colorado recently.
A lot of assumptions here, including that deaths are overcounted. Excess overall mortality rates indicate the opposite. In addition, Covid causes death in various ways, including heart attack (regardless of pre-existing condition). If Covid was in the US prior to March, there would have been no testing, but certainly deaths that would not have been counted as Covid deaths. Many states are not adding nursing home deaths and/or deaths at home, to their Covid death counts.
If I have diabetes and pass away with lungs full of fluid and multiple organ failure, that's not going to be a diabetes death. That is a likely Covid death, and the doctor has to make that call. That's what they're trained to do. Blanket accusations of fraud are nothing but political posturing without specifics.

I know only too well what doctors are trained to do. Respectfully Greenbean, you are mistaken. There was certainly NO accusation of fraud on the doctors' parts. And, I do not refer to the 2 CA doctors who complained, regarding incorrect death certificates - but to others who specifically note that they are willing to 'swab' a deceased to determine if a Covid19 infection actually existed. That their local officials were pressuring them to close out the 'call' strictly on a clinical 'presumption', which is not good enough for a new pathogen death tracking. A LIKELY death is just not good enough in gathering important data for a new pathogen. Pneumonia or other organ failure is just not 'specific' enough to be able to clinically rule a death due to Covid19. It is easy enough to swab a patient or deceased to 'prove' Covid19 was on board.

As for influenza counts -- again, you are mistaken - look particularly at NY reporting. Coincidentally, it was after Cuomo announced in early Apr that his State would be adding about 4000 'presumptive' deaths to Covid19 (these were NOT proven to have even had the infection), NY's flu deaths fell from several thousand for Mar to less than 200 for April.

Yes, a doctor may 'certify' the cause of death and contributing factors - BUT, the clinical and imaging picture alone is not enough for an accurate call. I have inherited a number of patients who were misdiagnosed both ways - some presumptively with Covid19 and others with another respiratory contagion - whose clinical and imaging presentations were NOT an absolute. Despite best efforts to determine unique clinical aspects to 'distinguish' influenza from Covid19 - there is too much overlap and variable presentation of flu to mimic Covid19 - unlike a case of smallpox that is unmistakable clinically.

The major point is - that lab confirmed presence of the virus MUST be required for this new pathogen. Presumptive diagnosis and 'presumptive' cause of death as due to Covid19 is just not good enough for a new outbreak and should not be included, especially since it is easy enough to swab for lab confirmation.

PS - I am also very well aware of how the CDC works, its antiquated systems and that we cannot count on it today for an accurate picture of Covid19 deaths. And, again for your edification -- the flu reports listed on the CDC Web site are 'estimates' not proven cases. This is just not good enough today. The estimate methodology was not great before, but okay when there was no competing predominately pneumonia viral pathogen. I have to side with Dr. Brix on her assessment of the CDC stats.

DR H

 

[Noeasyanswers]

Most COVID-19 deaths are easy to diagnose, but sometimes the immediate cause of death is not so clear, leading to accusations of politically-motivated falsification of death certificates.

How are COVID-19 deaths counted? : Read more
It's not the political motivation - it's the monetary motivation. Nowhere does this article mention the 20% add on in additional Medicare funds under the CARES act given to a hospital that treats a patient with the C19 diagnosis. Per the CDC guidelines, no testing is required and "presumptive positive" cases count. If a person has the C19 symptoms, they are likely reported as having C19. There is no downside - especially for hospitals that are hemorrhaging money right now. However, my husband had all of the symptoms of C19 last month - fever for five days, dry cough, chills, body aches, "like breathing fire" - they would not test him in CA because they were rationing tests at the time, but he was deemed presumptive positive. Two antibody tests have since come up negative. The point is that this financial incentive muddies the waters and messes with our data - something we really don't need right now.

How are COVID-19 deaths counted? : Read more