Coronavirus

[Wheeze]

The method of counting that PHE is using is stark, staring bonkers! As Carl Heneghan points out, one, no one will ever be deemed to have recovered from Covid-19, and, two, it will screw up the ability to detect a true second wave. I despair, I really do. And, of course, the elephant in the room is that most death certificates are filled out by junior doctors and often based on a best-guess clinical judgement. So, if the unfortunate patient has a serious condition like kidney failure or heart failure, if they test positive for covid and sadly then pass away, its likely they will be counted as a corona death. Its more likely a straw that broke the camels back scenario.

[Muddy Retriever]

The method of counting that PHE is using is stark, staring bonkers! As Carl Heneghan points out, one, no one will ever be deemed to have recovered from Covid-19, and, two, it will screw up the ability to detect a true second wave. I despair, I really do. And, of course, the elephant in the room is that most death certificates are filled out by junior doctors and often based on a best-guess clinical judgement. So, if the unfortunate patient has a serious condition like kidney failure or heart failure, if they test positive for covid and sadly then pass away, its likely they will be counted as a corona death. Its more likely a straw that broke the camels back scenario.

I was just reading an article from the Spectator and one of the comments at the bottom made me chuckle. It said:

“This just in from Public Health England - a man killed by a Great White Shark has died from Covid”

[Dave_Mole]

from the news today:

Matt Hancock has ordered an urgent review of how Public Health England compiles its daily count of Covid-19 deaths amid concerns they are exaggerated. A study by Oxford University pointed out the PHE’s figures record deaths of anyone who has previously tested positive for coronavirus. But experts point out that PHE’s daily figures under estimate the true picture. They point out figures from the Office of National Statistics, which record deaths that mention Covid-19 on deaths certificate is more than PHE’s count.

[Wheeze]

Either counting method is fraught because of the basic situation of death certification. The ONS stats show that 95% of the covid deaths are over 80 years age. Imagine an 85 year old diabetic patient with heart failure, kidney failure and COPD being admitted to hospital with breathing difficulties. This is a drastically common scenario every day, up and down the land. Ask any junior doctor! Any or all of those conditions will lead to breathing difficulty. Unfortunately the patient does not make it but routine testing includes the covid test which is positive. The junior doctor filling out the death certificate will put covid-19 on the death certificate maybe not a primary cause but certainly contributory. This time last year, the same clinical scenario would have no mention of covid. But today, the sad event is added to the hand-wringing tally of deaths intoned on the daily news. But its a nonsense. The death certification process is often a best guess. I know...I've been there. We used to get £25 for filling out a certificate. Junior doctors perk (or 'Ash Cash' as we bluntly called it!).

[Llani Boy]

Is that because you used to spend it on pipe tobacco, cigars and cigarettes?

[Wheeze]

Only the finest cubans!

[anthonykay]

During the pandemic I have heard several interviews with researchers from the Centre for Evidence-Based Medicine at Oxford. Whenever I hear that title, it sets me wondering what other kind of medicine there is: do they have a Centre for Superstition-Based Medicine? ["Old Chattox used to cure coronavirus with Eye of Newt. It always worked, but after she was hanged, no-one else knew the recipe."]

[Graham Breeze]

During the pandemic I have heard several interviews with researchers from the Centre for Evidence-Based Medicine at Oxford. Whenever I hear that title, it sets me wondering what other kind of medicine there is: do they have a Centre for Superstition-Based Medicine? ["Old Chattox used to cure coronavirus with Eye of Newt. It always worked, but after she was hanged, no-one else knew the recipe."]

Since my brother and sister in law have Cambridge Doctorates, publish widely and are members of a University faculty (and I have worked with other Professors) I appreciate that "academics" (as a general term) are notoriously bitchy, jealous and the epitome of "not thought of by me first so therefore wrong" but I cannot recall any other issue in my (long) life before Covid 19 where they have been given such a high profile and where there have been such a myriad of different, if not opposing, opinions.

I appreciate this is partly because academics are rarely allowed out into the sunshine to have their moment when people listen to and care what they have to say, and I appreciate that glory and future honours and future funding & etc hang on their performance: but nevertheless it has all been very strange.

Obviously mathematicians, who are of purer stock, are above all the aforementioned petty rivalry.

[Mike T]

Either counting method is fraught because of the basic situation of death certification. The ONS stats show that 95% of the covid deaths are over 80 years age. Imagine an 85 year old diabetic patient with heart failure, kidney failure and COPD being admitted to hospital with breathing difficulties. This is a drastically common scenario every day, up and down the land. Ask any junior doctor! Any or all of those conditions will lead to breathing difficulty. Unfortunately the patient does not make it but routine testing includes the covid test which is positive. The junior doctor filling out the death certificate will put covid-19 on the death certificate maybe not a primary cause but certainly contributory. This time last year, the same clinical scenario would have no mention of covid. But today, the sad event is added to the hand-wringing tally of deaths intoned on the daily news. But its a nonsense. The death certification process is often a best guess. I know...I've been there. We used to get £25 for filling out a certificate. Junior doctors perk (or 'Ash Cash' as we bluntly called it!).

But .... the average 80 year old - with the average number of chronic conditions seen at 80 - has 9 years to live if a man, 10 if a woman. So the idea that Covid mainly kills those who are in the last few months of life needs careful appraisal. One estimate I saw was that to achieve herd immunity through infection rather than vaccination would mean a reduction in annual life expectancy of about 2 years - that is huge.

[Witton Park]

But .... the average 80 year old - with the average number of chronic conditions seen at 80 - has 9 years to live if a man, 10 if a woman. So the idea that Covid mainly kills those who are in the last few months of life needs careful appraisal. One estimate I saw was that to achieve herd immunity through infection rather than vaccination would mean a reduction in annual life expectancy of about 2 years - that is huge.

This stat seems odd to me.

It's hard to find anything specific to an 80 year old, but what there is out there suggests an average 80 year old male will last 9-10 years and an average 90 year old male will last 4-5 years.

So for those with a Chronic condition to last just as long as those without sets off alarm bells.

Having said that, isn't arthritis a chronic condition? So perhaps every 80 year old is classed as having a chronic condition.