Identifying the cause of death is not an exact science

I suppose that’s where “excess deaths” comes in.

I expect a slowing of the rate of decline

It’s already painfully slow – if it slows any more it’ll be increasing again !!

but at one point nearly everyone who died in a care home setting was apparently being classed as COVID19 death

Not true. Point me to any source claiming that, it sounds made up to me. At “one point” (beginning of May) we were at 18000 excess deaths in care homes compared to the 8000 recorded as being with Coronavirus.

Do any of your somewhat Convienant sources have a reason for the excess deaths then that are multiples of 5 and 10 year averages for the months of April and may ?

Something is causing it. It’s not natural selection

many of the deaths attributed to COVID19 are at best pure guesses,

Slurpy slurpy Kool-aid is the best.

Excess deaths btw as has been mentioned already

**** i forgot. It’s 5g isn’t it

Falls in the bath. Deadly. Especially in April. Don’t say I have not warned you.

 what I’ve heard from friends who work in coroners’ offices: many of the deaths attributed to COVID19 are at best pure guesses, at worst highly misleading.

It’s a fair assumption that many GPs are marking down Covid-19 as a contributory cause in CoD incorrectly as there is no post-mortem test being carried out. We know from this forum and elsewhere that many folk who think they have the symptoms come out negative in testing.

However, the whole point of the “excess deaths” figure is that it gives us an overall picture, taking account of these false-positives and all of the others who died untested. If you can’t come up with another reason that excess deaths is much higher than normal then you have to conclude that Covid-19 is the cause.

JJP –  out with his mates on the lash

Do you think Professor Van Tam might not be Bojo’s favourite scientist after today’s briefing?

"In my opinion, the rules are clear, and they have always been clear.
In my opinion, they are for the benefit of all.
And in my opinion, they apply to all."
Professor Van Tam, Deputy Chief Medical Officer for England.
👏🏾👏🏾👏🏾

— Naga Munchetty (@TVNaga01) May 30, 2020

I like the ad hominem attacks here – very mature.

I have no interest in conspiracy theories – I just think it’s ridiculous to take everything at face value.

Here’s an article from an NHS doctor (yes, I know the website it’s published on will be decried, but you can also look at the doctor’s own blog, which says the same):

https://www.rt.com/op-ed/490006-death-certificates-covid-19-do-not-trust/

Excess deaths is a red herring – there are all sorts of reasons that there might be more deaths than usual at the moment, particularly given that visits to A&E are miraculously low. Just think about it for a minute.

I know of several instances where deaths have been marked as COVID when the tests came back negative. I’m not making this up and I don’t believe it’s some sort of wide ranging conspiracy – it just undermines my faith in the data.

I note that in the chart showing deaths on today’s briefing the headline is ‘deaths where there was a positive test for COVID’ yet at the bottom of the graph it elaborates ‘where COVID was mentioned in the death certificate’. These are being conflated yet they self evidently aren’t the same thing.

We’ll see what happens in the end, but a year from now, when we find that the overall death rate over the year is relatively unchanged from the 5 year I’ll be back to remind you all how wrong you were.

JP

I should add that the BMJ has stated that only a third of excess deaths in care homes can be explained by COVID, so please find a better counter argument than this.

JP

Sorry but that is abject nonsense. All-cause mortality is the best estimator of death rate and changes in that death rate are informative. Even if one assumes NOBODY attended hospital for fatal heart attacks or strokes, this would not account for the difference. We have an excess that was 40 standard deviations from that expected. Other causes of mortality cannot account for this difference, not suicide (6k/year) cancer (4000 diagnoses per week). Nothing.

More tellingly, the standardised comparison with other countries provides a very clear and robust correlation between all-cause and covid19 deaths across all countries.

We are heading towards 70,000 excess deaths for the first half of 2020. That is most likely due to reduced life expectancy in the 85+ age group. Many of those will have died in nursing homes. Whether they died of or from COVID19 is not relevant. What is relevant is something has speeded their demise this year over all previous years. In history.

BTW 50% of excess mortality is in the over 85’s, 90% in the over 65’s. These are not people to normally not attend A&E. it may be true that more routine A&E visits are down, but the numbers just do not add up.

JJP – my post was related to having friends (plural) that work in coroner’s offices.

1 would be unusual, n is either very unfortunate or your circle of friends has weird hobbies

😉

So, sometimes its beyond belief what a complete cluster **** this is, but this quote from tonights party political broadcast really does bring it home.

“Next up, a journalist from Sky asks: “Who is catching coronavirus and how, given that we’re 10 weeks into lockdown?”

Van-Tam says: “That’s a difficult question. I can’t tell you who’s catching coronavirus.”

So how exactly will this world class track and trace system work then?

TiRed – why does the BMJ state that COVID can only explain a third of the excess deaths in nursing homes then?

I’m not pushing any theory here, I’m just puzzled as to why this is happening.

As to how I know a few people in coroners’ offices – my businesses, and those of my main business partner, over the years, have brought me into contact with a wide range of people, many of whom I have maintained some form of contact with.

As an aside, one of my business partners nearly died from COVID19 (he’s been interviewed for various press articles, and is on Desert Island Discs this Friday, weirdly enough) so I’m not some sort of COVID denier.

JP

I get the impression that the scientists and medical experts are trying to get the public to understand tbat the advice they give may not always tally with the decisions made by the government.

but at one point nearly everyone who died in a care home setting was apparently being classed as COVID19 death

why does the BMJ state that COVID can only explain a third of the excess deaths in nursing homes then?

Which is it? That nearly every death is being classed as a COVID19 death, or, that about a third of the excess deaths are… and that we can’t say for certain what the other two thirds are down to… well, I’ll answer for you… it’s close to the later, and the first assertion was utter made up nonsense. You were trying to make the claim that the number of people recorded of having died with the virus in care homes is overblown, when in fact it is highly likely that many more have died with it than have been recorded as such.

@jjprestidge

I know of several instances where deaths have been marked as COVID when the tests came back negative. I’m not making this up and I don’t believe it’s some sort of wide ranging conspiracy – it just undermines my faith in the data.

anecdotaly doctor colleagues have said that theyre fairly sure that people have died of COVID but test has come back negative & the test(well depending on type of test, there are more than 1) is not 100% accurate, but tests are too precious to waste on dead people, so not repeated & in some cases not done at all

theres also the problem that the accuracy of the test varies dependng on when they are tested,

https://coronavirusexplained.ukri.org/en/article/vdt0006/

and death certs have primary & ancilliary causes of death, which are often very difficult to deconvolute , especially in older patients with lots of comorbidities & with a disease as poorly understood as this cornoavirus & Ive been told of doctors disagreeing over which is primary & which is not……

so excess deaths are the best thing to use

I hope that allays some of your concerns

Kelvin – I didn’t realise that you were a noted epidemiologist and an expert in these matters. I’ll be sure to take everything you say as gospel in future.

JP

Have you got an answer for why there are so many multiples of excess deaths yet or are we just going to defend the point that someone told you that it can’t be covid?

I should add that the BMJ has stated that only a third of excess deaths in care homes can be explained by COVID, so please find a better counter argument than this.

JP

link please

I know of several instances where deaths have been marked as COVID when the tests came back negative. I’m not making this up and I don’t believe it’s some sort of wide ranging conspiracy – it just undermines my faith in the data

Nowhere near that easy

The reliability of the test is heavily dependent on the quality of the nasopharyngeal swab and that appears to be pretty patchy. In the hospital where I work we have had a whole bunch of patients with “COVID syndrome” (i.e. a barn-door obvious case of significant severity) who don’t test positive until we’ve done several tests over a week or more. Either the virus isn’t always detectable in the upper airways or (maybe and) the swabs aren’t all perfectly done

There may well be some others who die of a hearty/stroke/whatever but who do test positive on admission. Are they dying of it or with it ? (It does strange things to blood-clotting so actually may well be implicated even if their respiratory system doesn’t look all that bad)

I’ll be sure to take everything you say as gospel in future.

Just don’t post something that is made up and not even close to reality. At no point were … “nearly everyone who died in a care home setting — apparently being classed as COVID19 death”. Not even close. It’s make believe.

As your contradictory post hinted at… there are lots of excess deaths in care homes not diagnosed as Covid19 occurring throughout this health emergency. Sadly.

Absolute scenes as British common sense kicks in at local beauty spots.

*slow hand clap everyone*

https://twitter.com/emmalang33/status/1266780455812112387

The reason is that for an explanation of covid, one needs either a pcr teat (none available) or clearly defined clinical symptoms (e.g., fever, cough, myalgia, hypoxia …). The disease is still in it’s infancy, hence it is harder to diagnose precisely at the individual level in a normally diseased population 85+. But at the population level, the aggregation of thousands of independent events provides the clear signal.

In fact, at the peak, if EVERY 85+ death was ascribed to COVID19, one would have been correct at least 67% of the time. Probably better odds than just guessing (as is current practice). Expecting to sum from bottom up is nonsense, there is no expectation that all cases will have been found.

The bmj is really the doctor’s Union magazine. It’s not a serious journal. And anecdote is not data.

Maybe jjprestidge thinks that all these tens of thousands of people have just dropped dead of…what, fright?

Away with your silly trivial nonsense. Yes there will be a handful who don’t go to A&E when they are dying of a (treatable) heart attack. It will be far far less than the number who die of C19 but are not correctly attributed.

Around 60,000 excess deaths now. (64k according to Chris Giles who has been doing the best up to date analysis IMO). Vast majority would have been easily prevented by locking down earlier, and we’d also be in a much better shape for TTI on a smaller daily number of cases.

Who was it that thought it was a good idea to have a bunch of clowns running the country?

My Googlefu is failing me in finding the claim by the BMJ

I’m a scientist too and I’d like to understand the data at a fully granular level but that’s nigh impossible. We have to make reasonable assumption based on the evidence, but with accuracy of tests, not running tests on the deceased and so on those assumptions will have to be broad.

I’m going to also suggest there’s a third category. There’s those that clearly die of Covid-19. There’s those that die with Covid-19 (but it might be something else that actually kills them). And then there’s also those that die BECAUSE OF Covid-19.

By this, I mean those without Covid-19 but who maybe didn’t get the help they needed for fear of going into hospital, or left it too late to get a good outcome – heart attacks, strokes, etc. Those that have missed early cancer diagnoses, and may not be a stat yet but have a far worse prognosis as a result of waiting. Those that maybe lost a job, can’t pay their rent, and can’t face it any longer. How many of these are attributable to Covid-19?

Could they all have been saved / are they all to be added to the account – IDK. But in the absence of another killer among us what else is there to explain the excess deaths?  Sure, there’s always variability but that’s where folk like TiRed and his analyses and standard deviation/confidence levels comes in.  If it isn’t Covid-19, and it’s not because of Covid-19 – once you get beyond natural variability what else explains the excess?

My next-door neighbour has been exercising his common sense with a BBQ and party all day with about 8 guests :/

There will be a lot of “because of C19” deaths in the future, but most of them won’t have happened yet. Think of all the delayed cancer testing and treatment, and lots else besides. Most of them aren’t instant/acute but rather the result of poorer outcomes due to delayed diagnosis and treatment. They will play out over the coming months and even years.

As for current deaths, there just aren’t that many people having fatal incidents, that would have been saved by medical attention, but who don’t attend due to fear of C19.

Similarly for the “died with C19 but not of C19” category. There may be a few but with the typical incidence around 1% at any one time, they are unlikely to make up more than a handful of deaths.

once you get beyond natural variability what else explains the excess?

A lot of the non-attributed excess is due to Covid19, but with misdiagnosis, as we have been learning that the range for symptoms caused by illness due to the virus is wider than at first thought. Yes, there are additional deaths due to the health service not functioning as normal, but it’s hard to add up all the possible causes and get to the current figure. There are also many additional lives being saved during the lock down… people who would have died from non-Covid19 related ways normally but did not. In some age groups the death rate is down compared to other years. This virus is hitting the elderly hard… and the government should have done more to protect those in care homes, and control the virus in the community better/earlier to reduce deaths at home as well.

My mum made it through. Not everyone is lucky enough to be able to say the same.

.

<edit> never seen same link above 🧐

https://www.theguardian.com/world/2020/may/30/could-nearly-half-of-those-with-covid-19-have-no-idea-they-are-infected

when not throwing Maitlis under the bus, Newsnight is one of TVs finest programes

last night they had a short doccumentary from the first hospital in europe to diagnose covid

ist from about 16 minutes in and its utterly compelling

https://www.bbc.co.uk/iplayer/episode/m000jjpm/newsnight-29052020

^ That Newsnight feature was excellent as was Clive Myrie’s feature all week from Royal London

In a big surprise to us all, new Sage member comes out saying Government not led by Science
https://twitter.com/michaelsavage/status­/1266820479773532168

If your of a nervous disposition, don’t look at this mornings news.   House party’s, raves, packed beaches…

I suspect most people don’t need to check the media. The bottle clear up started for my neighbours at 7am. Still going… ‘twas a big night for them and their guests.

People definitely enjoying their new found freedom, unsurprisingly. And, of course, with those freedoms actually starting Monday, the government can hold their hands up and say that if behaviour this weekend results in the virus hanging around at current levels for longer than you might think desirable, it’s not on them.

Greentricky’s tweet:

NEW: SAGE member tells @ObserverUK that the government is *not* being led by science in easing lockdown. It is exercising its authority.

Graham Medley, prof of infectious disease modelling at @LSHTM, in his own words below (I've added the bold):

More in tomorrow's @ObserverUK pic.twitter.com/qTBq3Zsj3c

— Michael Savage (@michaelsavage) May 30, 2020

Thanks for posting as it looks like it has been removed. Quite a damning report.