Burying the dead during the pandemic in Hamadan, Iran (Photo: Farsnews.ir/Behzad Alipour Wikicommons)
Miles Elliott
21st Century Wire
It was front-page news this week that China has revised the coronavirus death toll for the city of Wuhan, the original epicentre of the outbreak. Three days earlier, New York City also revised its coronavirus death figures. Wuhan’s death toll jumped by 50%; New York’s jumped by 17%. In both cases, the change in the death toll reflected inclusion of “probable” or “suspected” cases of COVID-19 — patients who were not tested for the virus.
This is consistent with recent World Health Organization guidelines instructing certifiers to record COVID-19 on death certificates in the absence of testing, including where the disease is only “assumed to have caused, or contributed to death.”
Whether taking their cues from the WHO or not, many nations are recording deaths of suspected and probable COVID-19 cases as deaths due to COVID-19.
Source: World Health Organization
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For example, in the United States, Center for Disease Control (CDC) adopted the WHO stance on March 24, presumably along with other member states. Other countries, such as Britain and Ireland, had already designated COVID-19 as a “notifiable” disease, requiring it to be listed on death certificates wherever it is present. Therefore, the death toll figures being used to drive ‘lockdown’ policies and other coronavirus response measures include significant numbers of unconfirmed cases, as well as cases with serious complicating factors (long-term chronic medical and respiratory conditions), potentially exaggerating the danger or role played by COVID-19 in the actual cause of death.
An added complication is that COVID-19 has no unique symptoms of its own (the most common being fever and cough, which can have various causes). This undoubtedly adds a great degree of difficulty to the job of physicians trying to determine “probable” cases of the disease. Faced with the death of a patient, determining the cause of death may not be straightforward — especially where the patient has long-term health conditions (comorbidities) affecting a patient’s outcome.
For context, most of the coronavirus deaths in Italy (88%), UK (91%) and USA (99.1%) involve other health conditions. In light of this, these judgement calls by physicians, as well as the way in which they are being required to fill in death certificates, are vitally important to getting an accurate picture of COVID-19 mortality without including deaths from other causes.
On the situation in the UK, professor of pathology Dr John Lee wrote in The Spectator:
“If someone dies of a respiratory infection in the UK, the specific cause of the infection is not usually recorded, unless the illness is a rare ‘notifiable disease’. So the vast majority of respiratory deaths in the UK are recorded as bronchopneumonia, pneumonia, old age or a similar designation. We don’t really test for flu, or other seasonal infections. If the patient has, say, cancer, motor neurone disease or another serious disease, this will be recorded as the cause of death, even if the final illness was a respiratory infection. This means UK certifications normally under-record deaths due to respiratory infections.
Now look at what has happened since the emergence of Covid-19. The list of notifiable diseases has been updated. This list — as well as containing smallpox (which has been extinct for many years) and conditions such as anthrax, brucellosis, plague and rabies (which most UK doctors will never see in their entire careers) — has now been amended to include Covid-19. But not flu. That means every positive test for Covid-19 must be notified, in a way that it just would not be for flu or most other infections.
In the current climate, anyone with a positive test for Covid-19 will certainly be known to clinical staff looking after them: if any of these patients dies, staff will have to record the Covid-19 designation on the death certificate — contrary to usual practice for most infections of this kind. There is a big difference between Covid-19 causing death, and Covid-19 being found in someone who died of other causes. Making Covid-19 notifiable might give the appearance of it causing increasing numbers of deaths, whether this is true or not. It might appear far more of a killer than flu, simply because of the way deaths are recorded.”
The question needs to be asked, how many deaths being attributed to COVID-19 are “probable” cases, diagnosed with no test on the basis of non-unique symptoms, because the WHO as well as national health authorities have instructed physicians to record deaths this way? How many serious health conditions are being minimized so that all “COVID-19 deaths” can be captured? And what part is played by the World Health Organization’s guidelines in potentially skewing these figures?
In the wake of the change to Wuhan’s death toll, various media outlets are questioning the Chinese government’s honesty and transparency, with frequent mentions of a possible cover-up of the real numbers. While the Chinese have explained the discrepancy as a function of statistics catching up to reality, western media outlets are questioning the veracity of China’s statistics altogether. Amid such questions, nobody seems to be asking what part the World Health Organisation guidelines played in bringing about the revision.
When it comes to New York, it may be no surprise that no such questions about transparency are being floated by the MSM. However our question remains: what part is played by the WHO in affecting the way deaths are recorded, and therefore the way the COVID-19 death toll is calculated?
Ultimately, this is just more evidence that the various death tolls, projections, curves to be “flattened” and other statistics surrounding the pandemic are not necessarily incontrovertible “science” but in fact largely just estimates, based on various assumptions which may or may not be borne out by reality.
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