Are people dying of Covid, or with Covid?

[lightand]

As they are different things.

Does anyone actually know?

There will always be people dying with Covid, as the elderly, especially, die, and some of them, like the rest of us, will always die whilst having Covid.

So could 180 per day per winter be an average number going forward, forever now? [and the NHS should well be into the process of gearing up for that?]

I did say I wasn't necessarily talking about this thread

But you clearly are.

You think Google’s the safest place to get information on Covid?

@Cornettoninja

I did say I wasn't necessarily talking about this thread

But you clearly are.

Oh hush. Stop trying to pick a fight with me. It's so bloody unnecessary.

👆👆 @Skysblue

It means that the whole dismissal of covid death figures as dying "with" not dying "of" is dangerous nonsense propagated by people who want to minimise the pandemic.

Re the bus, it is possible that someone could be run over by a bus and catch covid a few weeks later and then die of covid, isn't it?

From the article

In 90% of certificates where covid-19 is recorded, it does so in part 1 as the cause contributing directly to death.

and

The government’s daily press releases ... report “deaths within 28 days of a positive test result”—a definition repeated faithfully by broadcast and print journalists and on social media.2 This approach probably under-recognises the real number of deaths from covid-19 by around 20%.3

Of. I'm a Covid HDU nurse.

Have some respect for peoples lives. Being elderly doesn't mean a Covid death is expected. Any more than anyone dying from Covid. And Covid deaths are not pleasant.

@TinaYouFatLard

Of course it matters when the government policy in reaction to these deaths has affected every facet of our lives for the better part of two year. FFS.

Exactly! It does bloody matter!

Here you go OP. This is the Covid 19 Actuaries response group weekly update, detailing excess deaths for the current week vs average age-adjusted death rates comparing with deaths registered on the certificate as having Covid 19 as a cause. Their website contains fuller details of calculation method if you're interested.
www.actuaries.org.uk/system/files/field/document/Mortality%20summary%20pandemic%20monitor%20Week%2040%202021%20v01%202021-10-19.pdf

Yes we know. If you want to do a quick and dirty double you can do what I've done and check the weekly ONS recorded deaths against 5 year weekly averages and see the impact of the various waves of the pandemic on the various age groups.

TDLR: yes Covid 19 is currently causing a visible level of excess deaths of people before their time, which is roughly similar to the number of deaths reported by PHE.

You're welcome, and I'm sure you'll be pleased to know that the work you wanted done is indeed being done carefully by knowledgable and impartial professionals.

@Badbadbunny

The other question is how many caught covid IN hospital? I'm still hearing of friends/relatives who went into hospital for, say, tests or an operation, and caught it IN hospital. I know of far more people who've caught it in hospital than anywhere else. You'd have thought they'd have sorted the infection control in hospitals by now, after 18 months!

Short of rebuilding every hospital this isn’t going to happen. Without extra money the best we can do is open a few windows.

If cases outside of hospitals are going to be astronomically high, people will just have to take the risk that when they go into hospital they’ll have to put up with the risks involved with being inside with other people for an extended period of time. Testing will pick up some cases but with an incubation period of up to 10-14 days there’s not much you can do apart from managing outbreaks quickly when you get them. Being covid free on admission doesn’t mean you will stay covid free if you’ve been out mixing with other people or other household members have and you’ve had contact with them.

@herecomesthsun, yep brain probably too fried.

I can see how Covid with and Covid by arguments can make Covid seem less deadly, but I still think we need to have a clear understanding of the differences, so we know if all the restrictions are absolutely necessary.

If of 130k, 30k deaths were Covid then death by bus, should restrictions be less? No cause that’s still 100k directly caused by Covid. If we’re saying Covid then hit by bus deaths are 60k then that’s a different kettle of fish. That would be a little over half of deaths put down to Covid, that could mean we don’t have to socially distance or wear a mask. Maybe more freedoms.

It wouldn’t matter to me I’ve always socially distanced long before Covid and wearing a mask at this time of the year is perfect for protecting your skin against the elements.

I guess ultimately what Im saying is how deaths are calculated does matter and possibly downplaying discrepancies is equally as dangerous as minimising “with Covid” v “by Covid”.

So some people have covid and then get better quickly. Other people die. A relatively small % but enough people die for there to have been several millions of deaths worldwide. They die "of" covid. Not "with" covid.

Not referring to any particular post of course.

Yes it matters, even though it's slightly distasteful to ask (just as the "with" prostate cancer vs "of" prostate cancer distinction matters when you're deciding on testing and treating strategy for older men).

That's why the excess deaths calculations are so important and have been carried out throughout the pandemic. It's also helpful when comparing between countries with very different testing and death recording regimes. The data is all there for you to look at and has been analysed in depth.

[quote Faultymain5]@herecomesthsun, yep brain probably too fried.

I can see how Covid with and Covid by arguments can make Covid seem less deadly, but I still think we need to have a clear understanding of the differences, so we know if all the restrictions are absolutely necessary.

If of 130k, 30k deaths were Covid then death by bus, should restrictions be less? No cause that’s still 100k directly caused by Covid. If we’re saying Covid then hit by bus deaths are 60k then that’s a different kettle of fish. That would be a little over half of deaths put down to Covid, that could mean we don’t have to socially distance or wear a mask. Maybe more freedoms.

It wouldn’t matter to me I’ve always socially distanced long before Covid and wearing a mask at this time of the year is perfect for protecting your skin against the elements.

I guess ultimately what Im saying is how deaths are calculated does matter and possibly downplaying discrepancies is equally as dangerous as minimising “with Covid” v “by Covid”.[/quote]
Actually, what the guy is saying in the BMJ article is that we have probably underestimated covid deaths by up to 20%.

So we should be taking it more seriously rather than less seriously. And taking more rather than less precautions.

I think this sums up what the issue is - a letter to the Times

There have been many coroners throughout all of this extremely skeptical about how we are recording deaths

This is why we use three methods of calculating Covid deaths hamstersarse

Deaths within 28 days of a positive test: very fast but incomplete and may over-count in some cases

Deaths with Covid entered on the death certificate by the attending doctor. Slower, more detailed, may overcount and undercount in specific cases.

Excess deaths vs the average for the week in question. Slower, less detailed but internationally comparable and will show where the first two methods are systematically over or under counting.

Comparing all three suggests that methods 1 and 2 seriously undercounted Covid deaths in the first wave of the pandemic and are now roughly accurate.

Yes and the BMJ article says that covid appears on the part 1 in 90% of covid deaths.

It also says that 20% covid deaths happen after 28 days and we don't count those, so overall figures err a bit on the side of being too low.

mrswarren What are the chances that the OP will engage with your post, I wonder.

@herecomesthsun

It means that the whole dismissal of covid death figures as dying "with" not dying "of" is dangerous nonsense propagated by people who want to minimise the pandemic.

Re the bus, it is possible that someone could be run over by a bus and catch covid a few weeks later and then die of covid, isn't it?

From the article

In 90% of certificates where covid-19 is recorded, it does so in part 1 as the cause contributing directly to death.

and

The government’s daily press releases ... report “deaths within 28 days of a positive test result”—a definition repeated faithfully by broadcast and print journalists and on social media.2 This approach probably under-recognises the real number of deaths from covid-19 by around 20%.3

Thanks (not just for this post but for your tireless common sense and patience in the face of...well, lots of things really )

See now that is helpful information and why we should be in Plan B? I’m planning on doing plan B so I get Christmas this year. Just need to explain that to new employers who want me in everyday when everyone else gets to work from home 3 days a week.

The problem with this is that yes, elderly people die. But covid 19 may have robbed them of the happy years they had left.

My grandad, for example, was 82 when he caught it. It was just before we went into lockdown, when we didn't know how bad it was. We just thought he'd got a virus, but he got worse and worse, weaker and weaker, ended up in hospital, where a test confirmed he had it. It never entered our head that that's what he had.

We spoke to his doctor who told us he'd had a DNR put on him because he's so elderly and frail and it would be too cruel to ventilate him.

But he was only seeing the man in the bed. What he wasn't seeing was the 82 year old who was living completely independently just a few weeks earlier, driving everywhere, doing his own decorating, walking into town for a few pints with his mates (not a particularly short journey!), going on holiday abroad 4 times a year. We couldn't get it through to them that it was only because he was ill that he was old and frail. He was an independent man, and a hugely valuable part of our family.

Thank god he recovered. It was slow, it took months and months, but he is now back to normal again, driving and walking into town, painting his garden fences.

Yet, if he had died in that hospital, people would have said oh he's 82, he had a good life. Or they'd assume that he would have died soon anyway.

But without covid he wouldn't have died then. Probably not for a long time. I am so thankful that he got better.

Okay, so there may be some elderly people (perhaps who are already in hospital or care homes, very weak or unwell) who might have died soon. But a lot wouldn't have. And even those that would shouldn't have their last few months written off for them.

@Tillysfad

mrswarren What are the chances that the OP will engage with your post, I wonder.

Well I for one am glad that the post was asked. I’ve downloaded the bmj article for after my exams and am more convinced (than ever) that this virus has not and continues not to be taken seriously enough. So even if OP didn’t get anything out of it I did.

I think that people are definitely dying of COVID, or COVID is certainly a contributing factor.

Looking at excess deaths and how correlated they are to positive tests tells you the effect COVID is having; it is a nasty illness.

However, if you are 88, you do need to die if something. I don’t think recognition of mortality makes one blasé.

We have to walk the narrow path between destroying everything due to restrictions, and having too few restrictions and allowing COVID to overwhelm our medical system.

@Tillysfad

mrswarren What are the chances that the OP will engage with your post, I wonder.

Strange isn't it. I often post helpful replies to people's questions about shopping or travel or parenting on MN and normally they say thank you.

But on the several occasions I've answered this particular question they never seem to come back. Baffling. The inclusion of the phrase "excess deaths" always seems to act as an invisibility cloak to my entire post.

@TheReluctantPhoenix

I think that people are definitely dying of COVID, or COVID is certainly a contributing factor.

Looking at excess deaths and how correlated they are to positive tests tells you the effect COVID is having; it is a nasty illness.

However, if you are 88, you do need to die if something. I don’t think recognition of mortality makes one blasé.

We have to walk the narrow path between destroying everything due to restrictions, and having too few restrictions and allowing COVID to overwhelm our medical system.

I wouldnt say Covid is certainly a contributing factor, in perhaps lots of cases.

I would probably agree with the rest of your post.

The problem with this is that yes, elderly people die. But covid 19 may have robbed them of the happy years they had left.

I don't want to sound awful, but really the same could be said of any infectious illness which kills an elderly person, couldn't it? When a person gets old and frail, a cold can kill them. You could say that cold was unnecessary as well, or the flu, or whichever illness caused their death ultimately.

I'm not minimising covid. I'm not saying older people don't matter, of course I'm not, though I expect some people will think I am. But 82 (for example) is a decent age whichever way you look at it. All my grandparents had died by that age.