EzraS wrote:
Sounds like most every death in NY is being called a virus death.
That is what is happening.Well, we can understand how infectivity may be challenging to quantify, but surely death is easier – you are either alive or dead, a binary option. The difficulty in quantifying death begins the moment after all vital signs go to zero. Because death can be the result of a criminal act, it comes with regulations, the most important being that a physician must both certify and identify the reasons for death.
Quote:
“A cause of death is the morbid condition or disease process, abnormality, injury, or poisoning leading directly or indirectly to death. The underlying cause of death is the disease or injury which initiated the train of morbid events leading directly or indirectly to death or the circumstances of the accident or violence which produced the fatal injury. A death often results from the combined effect of two or more conditions. These conditions may be completely unrelated, arising independently of each other or they may be causally related to each other, that is, one cause may lead to another which in turn leads to a third cause, etc.
…He is requested to report in Part I on line (a) the immediate cause of death and the antecedent conditions on lines (b), (c) and (d) which gave rise to the cause reported on line (a), the underlying cause being stated lowest in the sequence of events. However, no entry is necessary on I(b), I(c) or I(d) if the immediate cause of death stated on I(a) describes completely the sequence of events.”
In the case of COVID-19, a certificate might state that the immediate cause was viral pneumonia due to Coronavirus, along with antecedent conditions, co-morbidities, like hypertension and coronary artery disease. There is a 216-page manual [2], that determines which among those immediate and antecedent causes is finally reported as the “cause of death.” That is usually a good thing because, for deaths in large hospitals, the duty to certify often falls to the first-year resident, who knows the least about any given patient. In community hospitals, it falls to the attending physician, and for deaths at home, to the patient’s primary care physician; but while they know the patient’s history better, it would be a rare case when they were specifically trained in completing a death certificate. And I seriously doubt that any physician, other than a pathologist who studies dead patients, has even a nodding acquaintance with that 216-page manual.
To further simplify the attribution of death in the time of pandemic, Italy’s overwhelmed health system decided that any deaths in the hospital were attributed to COVID-19. That, of course, increases the false-positive reports, increasing the deaths. It is balanced to some unknown degree by the physicians certifying deaths at home as not being due to COVID-19, the false negatives. This week, as reported by the New York Post, our federal government has opted for the same path, all deaths involving COVID-19 are attributable to COVID-19. As in Italy, it will mean higher death rates.
If you look at the current CDC data, you will find that a COVID-19 death does not require laboratory evidence, it is sufficient that “the certifier suspects COVID-19 or determines it was likely.” Another important limitation noted is this provisional information is incomplete, and “the level of completeness varies by jurisdiction, week, decedent’s age, and cause of death. … It is important to note that the true levels of completeness are unknown, and the estimates provided here are only a proxy.” It has taken, in the past, up to 2 months to gather and verify 72% of pneumonia deaths.
Source: [url=https://www.acsh.org/news/2020/04/13/covid-19’s-math-why-dont-numbers-add-14711]
COVID-19’S Math: Why Don't The Numbers Add Up?[/url]