Mini-Throughput: Cause of Death Edition

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Michael Siegel

Michael Siegel is an astronomer living in Pennsylvania. He is on Twitter, blogs at his own site, and has written a novel.

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6 Responses

  1. Avatar Oscar Gordon
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    says:

    In short, people do not generally die of COVID-19 itself. They die of the pneumonia it causes.

    I’ve heard that before, let me see if I can remember where…

    In short, people do not generally die of HIV/AIDS itself. They die of the pneumonia they catch because they have no immune system left.

    Report

  2. Avatar superdestroyer
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    says:

    Anecdotal story: The first night of working as an overnight administrator at a large medical center, there was an DOA in the emergency department. A elderly man was found unresponsive at his home by his son and the son called 911. EMS drove the non-breathing, no pulse individual to the nearest emergency department even though our Emergency Department was not a trauma center. Following the SOP for reporting and recording deaths, I contacted the administrator that dealt with deaths, death certificate, and the accompanying paperwork (referred to as a death packet). That administrator came in to use the paperwork to complete a death certificate. The attending physician in the Emergency Department wrote on the death reporting form that the patient died from cardiac arrest. We all had a laugh about the cause and told the physician to be more specific. So the physician added pulmonary failure and rental failure. So the individual died because his heart stopped and he stopped breathing. In other words, the physician and the rest of us had no clue what he died of and no one cared. That is why epidemiologist do not use death certificate data to perform mortality studies.

    As a side note, when I was trained on the procedure to release remains to a funeral home, everyone involved said that the mortician would look exactly like what one would believe how they should look. That turned out to be true.Report

  3. Avatar Kazzy
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    says:

    The legitimate mischaracterizations of death aren’t helping with the conspiridiots. I’m sure you could count them on one hand, but so long as you have car crash victims showing up on the list of Covid deaths, you’re going to enable questions of the legitimacy of the counts.

    We seem to oscillate between overstating and understating the risk of Covid. Which may just be how we make sense of something so new and unknown.

    I do think delineating those with co-morbidities (or multiple co-morbidities) from those without is important. It isn’t black-and-white, if-you-have-a-comorbidity-you-didnt-really-die-from-Covid-so-Covid-isn’t-bad. But it also isn’t irrelevant. The truth lies somewhere in the middle. The risk that Covid presents isn’t evenly distributed. That’s true of ALL diseases. So knowing individual risk profiles can be really, really helpful.

    It does matter that NY and NJ didn’t know (or didn’t care, depending on who you ask) that the elderly were particularly vulnerable to Covid because there policies increased the risk to a highly vulnerable group, resulting in many deaths that probably could have been avoided. That doesn’t mean that Covid isn’t bad. It does mean that Covid (as a ‘thing’) can be made less bad by good policies informed by good science and data.Report

  4. Avatar Pinky
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    says:

    This is a pretty good article. Probably better than I’m giving it credit for. The under-estimators are misrepresenting the data and the news stories, and I’m glad people are calling them out, with supporting information.

    But excess deaths are something that the over-estimators are relying on too much, and I wish the article hadn’t cited it. I’m only interested in balls and strikes. The 6% obviously died from coronavirus. The 94% had other ailments either before or after catching the virus, and the vast majority of them wouldn’t have died if they didn’t have the virus. But as near as I can tell, the “excess deaths” are called that because they aren’t classified. The difference between the 200k and the 180k could be because covid tests weren’t run, or because people are avoiding doctors and hospitals and not getting checked, or because doctors and hospitals have in a few cases been overwhelmed, or because of indirect effects of the shutdown (in particular, depression, substance abuse, and violence).

    Another complaint: “The path of COVID-19 is not that you live or you die. Most people won’t die. But a huge fraction of those that survive will endure serious hospitalizations with all the stress that entails (you can read Andrew’s post on what it’s like to survive that sort of thing).” From what I understand, the largest fraction of those who survive won’t even realize they had it. The next largest fraction will have something like, dare I say it, a case of flu.

    Two additional complaints. (I’m sorry I’m going hard on this article. I really do think it’s a net positive.) You probably shouldn’t say that hydroxochloroquine doesn’t work. It’s more complicated. But the bigger objection I have is your reading of the motives of the, let’s call them deniers. You accuse them of thinking “that people with pre-existing conditions deserve to die”, and I don’t think that’s fair at all. People are questioning if the commonly accepted total deaths are accurate. No one wants an 89-year-old with one lung to die, and no one’s blaming him (unless he was a smoker), but they’re saying that he wasn’t going to live much longer anyway. If it weren’t for the virus, he might only average a year. I note in this article you discuss the dangers to “healthy young people”, and only once mention the old, in the mouth of a denialist. But social policy involves making brutal choices. It’s natural to consider the death of a healthy young person a higher price than the death of a sick old person – every sick old person I’ve known thought so. So the deniers suspect the numbers are being padded, and that the numbers don’t reflect the reality that we should be looking at to make the right policy decisions.
    So please, more balls and strikes, and less characterization of opponents.Report

  5. Avatar Fish
    Ignored
    says:

    Thank you for writing this, Michael. Really good stuff.Report

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