Reply To: SARS cov2 and Covid 19

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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!