Can someone please explain the “deaths WITH CV19” and why it’s not deaths “OF” CV19

[lentilcurl]

I can’t get my head round why if someone tests positive and then dies within 28 days of that test they are counted as a death even though they may have died of something completely unrelated? For example a car accident? The car accident has killed them not CV19?

Apologies if it’s really obvious. I struggle to get my head round the whole thing...

I don’t understand neither. It’s bollocks, scaremongering. If you dont die OF it, it should not be counted.

How many people do you imagine die of a completely unrelated cause within 28 days of testing positive? The number will be minuscule and more will be missed off because they died after the 28 days. It isn't a perfect system but none are when you are trying to collect data at any sort of speed.

Surely it's because in some, for example, elderly patients, or those with pre-existing conditions, there may be multiple factors involved in the death and no-one is going to put resources into a detailed study of which of those factors may have dealt the decisive blow, which may in any event be impossible to discern. A few deaths misallocated to COVID are neither here nor there, the direction of the curve is pretty indisputable.

Covid has to have caused or contributed to the death but not necessarily the main cause of death.

If the person died in a car crash it wouldn’t count.

If the person died from pneumonia and covid caused or contributed to the pneumonia then it was would.

It has to feature on the death certificate. And the death certificate can only feature what caused or contributed to the death.

Potentially quite a few people could die of something else but with covid depending on their pre exisiting health conditions.

Many deaths, especially among the elderly, have many factors and will have multiple things listed on the death certificate.

Also although we know more now than in the early days of covid, I think there is still a lot we don't know about how people can be affected.

Covid can cause stroke. It is the stroke which might be the primary cause of death, but if covid caused the stroke, it should certainly be on the certificate.

My mum had covid pretty much asymptomatically, and died a couple of weeks later after a fall. Seems pretty unconnected but mum had dementia and we know covid can cause delirium in elderly patients. She died after falling as she got up in the night, which was unusual behaviour for her. Was it related to covid delirium? We have no way of knowing but I don't think it's unreasonable that covid is on the death certificate as it may have been a contributing factor.

Because it is often difficult to say exactly what someone has died of. Eg. Someone dying of pneumonia after testing positive may have developed pneumonia unrelated to covid, but in all probability it WAS caused by covid.

If you remember the early 1980s when HIV/AIDS was killing large numbers of people, not one of them actually died of AIDS. They died of chest infections, rare cancers etc but they probably would not have had that cancer or chest infection without HIV.

Sorry, that last should read 'i don't think it's unreasonable if covid is on the death certificate'. I don't know exactly what was on the certificate but she would certainly have been recorded as dying within 28 days of a positive test. We're waiting for an inquest so it's all a bit complicated.

@Wtfdoipick not minuscule at all. A lot of older people with comorbitities have been recorded as Covid deaths even though they were dying in their care home / hospital before testing positive. My grandma died in April, having been in hospital for two months, aged 93 and on serious downhill slide since my father died last year. She was not on a Covid ward in hosp but was routinely tested and the test came back positive after she died. Death certificate says Covid as cause of death. She did not die of Covid. We didn’t bother challenging it but it was utter bollocks.

Would need careful but inevitably imperfect & incomplete yet complicated decision trees and reading thousands (each & every) of individual patient notes, and then you'd need a panel of doctors wasting time doing this each time to decide if it was complications from the heart attack the person had 2 months ago or the diabetes they have had for 15 years or really "the covid"... or the secondary pneumonia or the stroke (possibly caused by the covid, possibly caused by being 92 yrs old & history of hypertension), or the stage IV breast cancer they have been battling for 3 yrs & the covid just finished them off.

Need 3 doctors because there would be disagreements so go with majority. A different 3 doctor panel would make some different decisions.

All a waste of time & resources. One thing we know is covid never makes you better.

I believe that the typical death certificate of an old person who has died in hospital will contain several words of phrases that could by themself be a cause of death, as far as a computer doing a text search is concerned. The computer can spot the word "COVID" but it can't know for certain it was the main cause of death. In all likelihood the doctor writing the cause of death didn't know for certain, and just listed several things that probably contributed. But as COVID kills people faster than most other things, it's probably fair to blame COVID, even if they wouldn't have died if not for pre-existing conditions.

Because Covid puts strain of the entire body.

If there are any existing problems it will reduce the body's ability to cope with them, even if previously the body was coping fine.

Even with people with no preexisting conditions, you are likely to die of heart failure or whole body failure. Vivid doesnt kill you the strain on the body does

Therefore you may not die of Covid, but without Covid you wouldn't have died. So actually dying with covid is really important otherwise the real death toll will be missed.

Vivid = covid stupid auto correct I missed that one

Death certificates list more than one cause often.The Covid will be causing or exacerbating other conditions. It is a simple and mostly accurate way of gathering data. It will pick up anomalies of people who have Covid but die of unrelated causes. Others will be missed. The excess deaths figures are higher than deaths due to Covid so this system is not designed to inflate figures and scare people as I have heard people suggest.

Most people have always died because their heart stops beating. Anything else is generally a secondary cause.
Like now.
It's just that prepositions have become a conspiracy theorist's wet dream.

@Hazelnutlatteplease

Because Covid puts strain of the entire body.

If there are any existing problems it will reduce the body's ability to cope with them, even if previously the body was coping fine.

Even with people with no preexisting conditions, you are likely to die of heart failure or whole body failure. Vivid doesnt kill you the strain on the body does

Therefore you may not die of Covid, but without Covid you wouldn't have died. So actually dying with covid is really important otherwise the real death toll will be missed.

Far too sensible an explanation. The nutters won't like that. Get ready for the only-Covid-deaths are important bots.

How many people do you imagine die of a completely unrelated cause within 28 days of testing positive? The number will be minuscule and more will be missed off because they died after the 28 days.

This.

It's with because the contribution C19 makes isn't the same in every case. In some cases it may merely weaken the body so that it cannot fight something else.

C19 is still the proximal cause, even when it isn't the major one. We know there is nothing else causing this because the number of excess deaths in each age category maps exactly with the Covid death figures.

If you dont die OF it, it should not be counted.

They don't know whether people died of it, but it's a reasonable supposition that most of the time people who were dying anyway died sooner because of it.

If a death was only counted as a COVID death when COVID was proved beyond doubt to the main cause, most deaths caused by COVID would not be counted.

Also, if you are worried about the accuracy of the figures, the "died with COVID" figure is actually much lower than the overall number of people COVID is killing, so you are trying to move the statistic in the wrong direction. (The best statistic to reflect the overall impact is excess deaths, which is something like 50% higher.)

I always thought it was because Covid can cause various symptoms so not everyone dies in the same way.

For instance two people might die in a car crash, but one might die of blunt force trauma and the other might die of cardiac arrest. But they wouldn't have died if not for the car crash.

Older people with co morbid conditions who catch Covid will have their death hastened by Covid. That's why it's on the death certificate. If someone was terminally ill with cancer and in the end stage of the disease but caught Covid then died in the next few weeks, you wouldn't say "Oh well they had cancer anyway so the Covid they caught doesn't count" right?

Yes there may be a few people who recover from the effects of Covid and die within 28 days but this number is likely to be miniscule, and Covid (and the long term effects) likely cannot be ruled out as a factor in their death in many cases.

It is surprisingly often quite hard to decide what to write on an elderly person's death certificate. You are allowed a number of causes direct and indirect including just old
age which is a reflection of the truth. Most people don't die of just one thing.

A lot of old people have broncho pneumonia written sometimes without a huge amount of evidence and additionally maybe diabetes or ischaemic heart disease and old age. No-one wants some huge post mortem after an elderly person dies so a best guess cause is generally accepted.

Dying of more than one thing is the norm. I have no trouble believing that COVID contributes to the death of most people dying within 28 days of a positive test. The numbers dying in some totally unrelated way eg RTA must be tiny. If they die of old age or cancer it's still likely that having COVID was a factor in finishing them off.

How many people do you imagine die of a completely unrelated cause within 28 days of testing positive? The number will be minuscule and more will be missed off because they died after the 28 days

The number will not be minuscule, the ONS study says 1 in 40 or so have had the virus in the last 28 days across the general population, because people who require medical attention are in high risk environments for catching covid such as hospitals. So with high prevalence, there's quite a high chance.

However, it's not to be discounted, the covid may well have made the progression of their other causes worse, it would have made hospital care harder etc. It's not a perfect measure, but it's a better measure than any others that are available and it really doesn't matter if 20% or 30% of the deaths are misattributed.

The real problem I think is the obsession of tracking deaths only when it's covid, but tracking QALY's for every other condition, that's the distortion in the statistics.

Elderly people in general tend to have a number of causes on their death certificate. Covid could be just be one of a number of factors.

If someone died in a car crash they wouldn’t be tested for covid so wouldn’t be included.

It's not minuscule, I know no one who has died of covid. I know 2 people who have died of something unrelated to covid within 28 days of their test and thus had it on their death cert (ectopic pregnancy, pre existing inherited heart condition)

It's just a practical way of collecting data. There is no perfect way of doing it and all statistics are prone to error for this reason.

Whilst there is no way of knowing for sure what every individual actually died of, it should be possible to do a detailed study of say a few hundred people's deaths and get an idea of degree of bias of the estimate.

Anyway this deaths with covid statistic enables comparison between one week and another so it's useful for that, even if the exact numbers are off