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Thanks for the links about Dr Taban SA. A remarkable man. If there has been one good thing about this virus it has been the focus on making discoveries like this, which have a much wider impact. This will be of great benefit to all respiratory patients, pneumonia being a common cause of death throughout the world.
‘when asked why we had an exceptionally bad record whereas some Asian countries did so well’
Perhaps those Asian countries didn’t have such an all-encompassing definition of a covid-death. Obviously, if you include in the death toll all those who died with rather than of covid, you will record higher mortality rates than those countries which are more discriminating. That this factor is never included in comparisons of national covid death statistics smacks of deliberate obfuscation.
‘Perhaps those Asian countries didn’t have such an all-encompassing definition of a covid-death.’
That is a very good point. There has been such a wide diversity in the methods of collecting almost all the data, deaths, recoveries, cases, that it is surely impossible to make meaningful evaluations of anything at all.
“…it is surely impossible to make meaningful evaluations of anything at all”
Yes, yet the media and politicians studiously ignore this glaring inconsistency. Why doesn’t Boris Johnston say “I have not made a mess of handling the virus, it’s just the way the statistics are compiled”? Instead we are led to believe that our supposedly high death rate is attributable to lax measures and we demand stricter ones, like Christmas turkeys demanding the abattoir lorry gets a move on.
Appendicitus can kill you. Having surgery to remove an infected appendix is interfering with nature. Cancer is a nasty but natural process. Having surgery, radiotherapy, chemotherapy interferes in that “natural” process. Pretty much all modern medical practice interferes with nature in some way. Childbirth is a natural event yet it is dangerous. Go back 100 years and every street would have had some woman who had died in childbirth. Now, because of various improvements, hygine, water, food supply, antibiotics etc etc I’ll bet most don’t know someone who knows someone who knows someone who died in childbirth. It is a (thankfully) rare event in modern times.
Is it really interfering in nature? Humans evolved from nature and consequently so did their intellectual apparatus. Is it not nature that has allowed humans to engineer their way out of some natural calamities? When the pack of sabre toothed tigers was circling camp some thousands of years ago our ancestors didn’t say to themselves, that’s nature. Instead they picked up some sticks and stones and defended themselves. A natural choice one could argue.
Natural calamities occur often. Famines, droughts, floods, disease, earthquakes, volcanos, meteors to name some. Humans (and other species) do their best to either adapt to new circumstances or contrive to mitigate or stop the calamity itself or the effects of such calamities. Unfortunately, humans have added a few of their own.
The sars-Cov-2 pandemic is one of many such pandemics to have occurred throughout history. Whether caused by US or by a natural event it IS still up to US to mitigate or stop it. Perhaps it would go away in time by itself but like the sabre toothed tigers we can and should pick up sticks and stones and defend ourselves. We may not have mastery of nature but we have somne understanding of it. We get better at understanding nature by studying it. We should use our understanding to our best advantage.
Do you disbelieve the statistics on cancer deaths? Do you disbelieve the statistics on heart disease deaths? Or perhaps alcohol related deaths?
“Do you disbelieve the statistics on cancer deaths? Do you disbelieve the statistics on heart disease deaths? Or perhaps alcohol related deaths?”
If that question is directed at me, then no, I have no reason to doubt those statistics.
ET. Not really sure what point you are trying to make here. All living things try to ‘survive’, of course! The question is the best way to do it, is it not?
Duck
Your answer to my question“Perhaps those Asian countries didn’t have such an all-encompassing definition of a covid-death.”
smacks of orientalism – i.e. the belief that those less worthy foreigners don’t know how to do things properly. Unluckily for you, there are some very advanced Asian countries that actually know much better than us in these matters. Nevertheless, this canard regarding dying from rather than with the virus has been in circulation widely amongst covid deniers and skeptics and has also been applied to our own figures in the oh so advanced west..
Steph
E.T. is merely pointing out that human progress is part of a natural phenomenon which is the human brain which has led to advances such advances that has made us able to control many factors in ‘nature’. This is not arrogance as you put it. Also if you actually were to tell your clients who ask for a garden to encourage wildlife to just close their backdoor and not go out, you may in time run out of clients. There is nothing wrong in us aspiring to bring some form of nature nearer our dwellings and thereby have an interaction otherwise not possible with nature. I for example believe in gardens as potential nature reserves on a small scale rather than the manicured gardens that are the hallmark of most English gardens with sterile lawns, well behaved bushes cut to shape and weedless perfectly proportioned borders.SA
“Your answer to my question …. smacks of orientalism – i.e. the belief that those less worthy foreigners don’t know how to do things properly.”
LOL. Just the opposite. I am suggesting that perhaps those Asian countries have a more accurate method than us of recording covid deaths, and that we are the ones who are not doing it properly.
“Nevertheless, this canard regarding dying from rather than with the virus has been in circulation widely amongst covid deniers and skeptics and has also been applied to our own figures in the oh so advanced west..”
Why do you call it a canard? It is verifiable. And yes it HAS been widely circulated so why are the media and politicians behaving as though they don’t know about it?
I don’t believe that Duck was guilty of orientalism. In fact I got the distinct impression he was suggesting the opposite, i.e. the west is guilty of inaccurately recording deaths.
Obviously I don’t actually tell clients that! My point is that we humans imagine that we can control everything, even down to ‘bringing some form of nature into our gardens’. The problem is we don’t know nearly enough to control everything, for every good intention there may be an unforseen consequence. You mention the fashionable, and in my opinion rather snobbish, view that ‘sterile lawns and well-behaved bushes’ are somehow bad, but butterflies don’t care what shape your bushes are and there is nothing a green woodpecker likes better than a well-manicured sward (which is incidentally far from sterile!) It is simply your preference. Wildlife generally prefers us not to be out there at all, but whether a garden is maintained in a ‘naturalistic’ or ‘immaculately tended’ style makes little difference to nature. The clients I like best are the ones who actually love their gardens, whatever their taste may be.
Duck
Apologies what you said was not orientalism, just the reverse in fact. However I still stand by my statement about dying of, rather than eith the virus.Surely the method of recording covid deaths is hugely important though? Have I missed something in the great debate? Surely it matters if a person who died from, say heart disease, is then counted as a covid-19 death? I genuinely don’t understand why ‘skeptics’ should be condemned for making this point?
Steph…….
If someone has advanced Stage 4 lung cancer and gets run over by a bus and killed, what killed them? The bus accident or cancer? A little dramatic but it serves to illustrate a point. What is written into death certificates as significant co-morbidties has to be something that made a significant contribution to the actual cause of death.
Medics don’t just write in causes of death and significant co-morbidities contributing to cause of death without thinking (least most don’t). If covid is on the death cert then it is likely to have made a significant contribution to the cause of death.
Also, a large percentage of people over a certain age are going to have one and often two co-morbidities. If someone has hypertension and/or ischaemic heart disease (15-20% of UK population over age 65) and gets infected with Sars-Cov-2 they may be less able to compensate for that further insult but the insult is covid.ET – ‘If someone has advanced Stage 4 lung cancer and gets run over by a bus and killed, what killed them? The bus accident or cancer?’
That is a very good argument, and I accept what you are attempting to convey, although by your own admission it is a dramatic example. However, to carry forward your analogy, what if it is vitally important to know exactly how many people are killed by buses because the future of buses in the public transport system depends upon it? Clearly this person will be counted as ‘killed by a bus’, even though their cancer might have caused them to stumble in front of an otherwise impeccably driven vehicle. And so was the blind person knocked down yesterday, and the careless drunk the day before, and the child that ran out into the street the day before that etc etc. If you are trying to establish how lethal buses are you cannot simply count every single person knocked over, you need to know on which occasions the bus was actually at fault. It seems haphazard at the very best to count all the death certificates containing the words ‘covid-19’ and then use this figure to calculate its lethality. Even less can we use such a figure to make comparisons with other countries when, as Duck pointed out, the systems for recording may differ.
Steph
So someone running out in front of a bus is not killed by a bus? The potential of lethality by bus is inherent in the bus if there was no bus there would be no death.“If you are trying to establish how lethal buses are you cannot simply count every single person knocked over, you need to know on which occasions the bus was actually at fault.”
Yes, but before you get to that step you need to know all fatalities in which a bus was involved.
It is a good example because it is precisely this kind of evaluation that has led to seat-belts, side impact beams, laminated windscreens, anti-lock brakes, crumple zones and a host of other safety features on modern vehicles.The point I am trying to make about death certificates is that covid 19 won’t appear on it unless it directly caused death or played a significant role in contributing to the actual cause of death as it is worded in the death certificate.
Above are guidelines for filling out death certificates. Please have a look Steph and satisfy yourself that a deal of thought goes into filling them out. Doctors won’t enter covid 19 unless they have good clinical reasons to consider it was the cause of death or significantly contributed to the cause of death which will usually be backed up by confirmatory lab work.
I am trying to counter the notion that if someone simply tested positive for Sars-Cov-2 it’s gong to appear on the death cert. It won’t unless it played a direct or significant role in that death.Also, most countries use the WHO classification system.
“The MCCD is set out in two parts, in accordance with World Health Organisation (WHO) recommendations in the International Statistical Classification of Diseases and Related Health Problems (ICD)”
It is a pretty well thought out guidance and worth your time reading it. It is not nearly as arbitrary as is being alleged by some. It is a legal document and docs are mostly a fairly conscientious lot.
SA & ET – I think you miss my point. I was trying to demonstrate, very poorly it seems, how important it is to have the correct information in order to make the right decisions, not that being knocked down by a bus is not lethal or that you do not need to know how many fatalities involved buses. But if we simply say everyone hit by a bus would still be alive if buses were removed then clearly our only option is to remove buses. Even though, by doing so we will create more traffic congestion, increase pollution and cause more road accidents as people use private transport instead, it will be worth it because people hit by buses die. But what if we know that for every 10 killed by a bus, 2 were using the pedestrian crossing, whereas the other 8 died as a result of stumbling or straying into the road. In those cases the type of vehicle which killed them was actually irrelevant. It might have been a lorry or a car or a motorcycle, the result is the same. Does it still make sense to simply ban all buses and lose their many advantages? It’s not going to prevent some people from stumbling in front of dangerous things, which is what the actual problem is. Wouldn’t having the correct information lead us to make better choices about saving lives? I appreciate that this is indeed becoming a rather ludicrous analogy but hope you get my drift.
ET – With regards to the guidance for issuing death certificates, I read these quite carefully some time ago. You will have seen the section in that document relating to the sequencing of conditions on a death certificate. I think you will agree that, using those guidelines, covid-19 would rarely, if ever, be given as an underlying cause of death where co-morbidities are listed. That is to say covid-19 would not be the condition which gave rise to cancer or heart disease or diabetes, but would be at the top of the list, being the direct, or fairly close to the direct, cause of death. Looking again at the guidance for doctors you will see the sentence ‘If the certificate has been completed properly, the condition on the lowest completed line of part I will have caused all of the conditions on the lines above it’. Now, it obviously makes no sense to say cancer caused this person to get covid-19, but it does mean that the doctor considers cancer to be the initiating factor in a chain of events and conditions which ultimately led to death. It is argued by some that a patient would still be alive had they not been exposed to covid-19 and that therefore it is valid to count this as death from covid-19. But, given that people without serious health problems rarely die from covid-19, it is just as valid, perhaps even more logical. to argue that the patient would still be alive had they not suffered from cancer, or any other condition in that list. In these cases, it is neither covid-19 nor the underlying condition which has brought about the death, but the complete sequence of events starting with the ‘underlying cause’. The doctor would not list unrelated conditions, even if they were present. The ‘total number of covid deaths’ figure is therefore something of a misnomer and is misused. You can use the figures as they are compiled to say ‘covid-19 was a contributory factor in 60,000 deaths since 1st of March’ or ’13% of deaths since 1st of March had covid-19 mentioned on the death certificate’ etc. etc. But you cannot accurately use the figure to say ‘covid-19 has been the cause of 60,000 deaths’, as you would be selectively citing only one of several conditions which contributed to death. And you know how you hate it when the ‘sceptics’ do that!
ET
“I am trying to counter the notion that if someone simply tested positive for Sars-Cov-2 it’s gong to appear on the death cert. It won’t unless it played a direct or significant role in that death.”
Please check the credentials of Professor Carl James Heneghan, then read what he said about Public Health England’s (PHE) method of compiling covid death statistics in July at the height of the lockdown. Sample:
“By this PHE definition, no one with COVID in England is allowed to ever recover from their illness. A patient who has tested positive, but successfully treated and discharged from hospital, will still be counted as a COVID death even if they had a heart attack or were run over by a bus three months later.”
“But you cannot accurately use the figure to say ‘covid-19 has been the cause of 60,000 deaths’, as you would be selectively citing only one of several conditions which contributed to death. And you know how you hate it when the ‘sceptics’ do that!”
You can because if not for the fact that these 60,000 contracted SARS Cov2 at that point in thier lives they would not have died then but went on to live and died either of their cancer, heart disease or hit by a bus. It is that infection that caused the terminal event.
What it is that each condition is a predisposing factor and the addition of several predisposing factors will cause someone to die. This concept is also used to determine predicted survival used for example in life insurance.
Just to give an example, patients who have leukaemia and are being treated for it are susceptible to infections of the blood with bacteria that rarely cause death in normal people, they die of bacterial sepsis not with it as a passenger, as implied by some in relation to covid 19.
When does this discussion become relevant? When we realise that there is an increasing number of risk factors that can predispose to death from covid 19 and then you will find that say 20-30% of populations in the west suffer from these. These include age, heart disease diabetes, obesity, high blood pressure, cancer, diseases suppressing immunity. The problem is actually a very large one because taking individual conditions that can cause predisposition to death from covid 19 can be much more than just the occassional old people.
So to start with age:
22% of UK population are above the age of 60, that is 14.3 millions of whom 4. 3 million are above seventy and 3.1 million above 80 years. Then take diabetes. There is an estimated 4.8 million diabetics and heart disease and hypertension and obesity. You will soon find out that the disease can badly affect a much larger proportion of the population than what you want to believe.
I would like you to read this article written by a scientist. It is in relation to the SARS cov2 vaccine but also addresses some of what you say earlier about interfering with nature.On a final note, let me just conclude with a thought about the ridiculous claim that mRNA vaccines permanently alter your DNA or somehow make you “transhuman”. You have to remember that antivaxxers view vaccines as somehow “unnatural” to the point of altering what human beings are. They’ve been making that clear ever since I started paying attention to antivaccine pseudoscience two decades ago, and were doing so long before that. Of course, just because something is natural does not make it good, benign, or even just neutral. Nature is harsh, and the battle for survival brutal, and it’s completely “natural” for all manner of animals to be eaten by bigger, faster, and hungrier animals, and it’s just as natural for humans to die horrible deaths from infectious diseases. Indeed, just look at how horrible the deaths suffered by over 260K of my fellow Americans have been, and COVID-19 is entirely “natural”. Yet the mindset behind so much of “alternative” medicine and antivaccine views is that natural is always good and that anything synthetic should be viewed with extreme suspicion. (Come to think of it, that’s why COVID-19 denialists go to such enormous lengths to falsely portray SARS-CoV-2, the coronavirus that causes the disease, as somehow “unnatural” and bioengineered in a laboratory, with the pandemic being a “plandemic” initiated by global elites to control and subjugate the population.) It’s silly, because even “natural” nutrients and medicines are just as much chemicals as any synthetic nutrient or chemical. We have to judge whether such chemicals are harmful based on science and where the evidence leads us, not based on whether the chemical is “natural” or not. When considering claims about a novel disease such as COVID-19 and vaccines against it, we must also consider the totality of what we know about biology, especially molecular biology, and how a potential vaccine works in assessing the plausibility of alarmist claims about vaccines like those developed by Moderna and Pfizer. Claims that mRNA vaccines like these can “permanently alter your DNA” (or make you “transhuman”) fail miserably on that score.
I hope you are not an antivaxxer or a covid denier but unfortunately there is an increasing covid skepticism that is latching on to some of the pseudoscientific nonsense that is being spread around.
Duck
This issue which is problematic is not thought to overestimate the death from Covid 19 data but needs to be addressed. This is fully discussed here.Does it mean that the UK has far fewer deaths Covid-19 deaths than we thought?
In the wake of the news of the statistical anomaly, the reaction of some was to claim that coronavirus deaths – a statistic that has formed so much of our perception of the virus and been used to justify lockdown measures – were far lower than the government had told us.But the DHSC figures are not the only measure we have to understand the enormous impact of Covid-19 on the number of deaths in England and Wales. <\p>
The most recent excess figures data published by the Office of National Statistics (ONS) show that there have been 53,979 “excess deaths” in England and Wales in 2020 so far – that is, the number of people who have died this year over and above the average for the last five years.
Of the deaths registered by July 3, 50,548 of them mentioned Covid-19 on the death certificate, accounting for almost 15% of all deaths registered in 2020.
Yet the overall number of coronavirus deaths recorded by the Department of Health and Social Care (DHSC), which incorporates the PHE statistics that we now know to be affected by this statistical anomaly, currently stands at 45,119 for the entire UK – more than 8,000 lower than the ONS figures that cover just England and Wales.
Professor Walter Ricciardi, scientific adviser to Italy’s minister of health estimated that registering those who died with rather than of covid inflated their figures 8-fold. He said:
“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 […] On re-evaluation by the National Institute of Health, only 12 per cent of death certificates have shown a direct causality from coronavirus, while 88 per cent of patients who have died have at least one pre-morbidity – many had two or three,””
Moreover, substituting one questionable statistic for another isn’t addressing the problem. Excess death rates include those who died because of lockdown restrictions rather than covid – lack of access to routine medical care or emergency services, suicides, domestic violence, etc … How many? Nobody knows or is making any effort to find out. Why not?
Look, we can bandy about our favourite quotes till the cows come home but it is indisputable that different countries use different criteria to register covid-deaths, yet this factor is ignored when comparing how nations have fared. Like infection-mortality rates and excess death rates, national comparisons are obfuscated. What’s going on?SA – Thank you for your post. I’m afraid I continue to disagree with you. You are saying it is OK to say ’60,000 people have died from covid-19’ because it was covid-19 that was the terminal event. But I am trying to point out that without the other causes listed they would never arrive at that event. It is chicken and egg, you can’t have one without the others. You can’t just pluck covid-19 from the list and say ‘this was the cause of death because it was the last thing that happened’. It is not at all unrealistic to suppose that on many of those certificates, it was actually pneumonia that was listed at the top, and thus the ‘direct cause’ of death which terminated life. But it was superseded by a serious covid-19 infection. Which was serious because of a compromised immune system. Which had been caused by cancer. Are you happy to say that in these cases it was not covid-19 but pneumonia which was ‘the cause of death’ because if they hadn’t developed pneumonia they would have lived on and died of something else? I rather suspect not! In your system that would also be a death from covid-19. All causes of death listed must have played a part in the death if they appear on the certificate, there are no ‘incidentals’ and no single cause should be selected and stated as the cause of death if you want meaningful figures.
No, I am not an ‘antivaxxer’ or a ‘covid denier’ insofar as I don’t have any particular objection to vaccines per se or ‘deny’ the existence of covid-19. But I do note the popular use of those particular terms, and the derogatory manner in which they are applied. More examples of ‘slap on a label for instant dismissal’ in many cases I fear. Your Dr Gorski is simply dripping with smug scornfulness!
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