How Accurate Is the Coronavirus Death Toll?

shunyadragon said:

The above bold is patently false. The doctors determine the cause of death, and they get absolutely no financial incentive You are advocating that the hospitals commit fraud, which you need to document to make such an accusation. Hospitals do not recieve any incentive for diagnosing uninsured patients that die of COVID-19. Private hospitals get a tax break for all unisured patient bills regardless of whether they had COVID-19 0r not.

Any compensation large hospitals like I worked at Duke have such high budjits in the billions, that any compensation would not be meaningful in the millions they spent on COVID-19 over their basic operation costs.

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I'm not making any accusations, I'm just simply pointing out an obvious moral hazard.

Suave said:

I'm not making any accusations, I'm just simply pointing out an obvious moral hazard.

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No, you did not simply point out a 'moral hazard' that may exist, you said, "I can only state with certainty, there'd be a financial incentive for hospitals coding uninsured patients as being C.O.V.I.D.-19 patients as opposed to being non-C.O.V.I.D.-19 patients. This incentive would surely not exist in the presence of universal health care.

'With certainty?' That my friend is an accusation for which is false and there is no evidence. This is a 'moral hazard' for which there is no evidence that it even potentially exists.

shunyadragon said:

No, you did not simply point out a 'moral hazard' that may exist, you said, "I can only state with certainty, there'd be a financial incentive for hospitals coding uninsured patients as being C.O.V.I.D.-19 patients as opposed to being non-C.O.V.I.D.-19 patients. This incentive would surely not exist in the presence of universal health care.

'With certainty?' That my friend is an accusation for which is false and there is no evidence. This is a 'moral hazard' for which there is no evidence that it even potentially exists.

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I'm with @Suave on this one. If you have the option to get money (or more money) and the caveat is a fraud accusation if you lie, the "moral" capitalistic decision is to lie if the potential benefit outweighs the potential risk. And it is to be expected that some hospitals judge the risk to be less (independent from it really being low).

Heyo said:

I'm with @Suave on this one. If you have the option to get money (or more money) and the caveat is a fraud accusation if you lie, the "moral" capitalistic decision is to lie if the potential benefit outweighs the potential risk. And it is to be expected that some hospitals judge the risk to be less (independent from it really being low).

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It still remains to remotely effect the fatality count you would have to have national massive fraud. The hospitals have no control over the cause of death on death certificates it is the doctors that make the decision based on criteria used for over fifty years. The doctors receive no compensation for making the decision of COVID-19 as the cause of death. Also the hospitals actually do not recei, when compared to the costs of the COVID-19 pandemic significant benefit from designating fatalities as caused by COVID-19 as the cause of death.

No reliable source has reported any such massive fraud that could make this a remote possibility.

Accusations such as this require documentation and it does not exist.

shunyadragon said:

It still remains to remotely effect the fatality count you would have to have national massive fraud. The hospitals have no control over the cause of death on death certificates it is the doctors that make the decision based on criteria used for over fifty years. The doctors receive no compensation for making the decision of COVID-19 as the cause of death. Also the hospitals actually do not benefit from designating fatalities as caused by COVID-19 as the cause of death.

No reliable source has reported any such massive fraud that could make this a remote possibility.

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I agree, but that wasn't the point. The point was that Covid patient compensation would lead to some form of fraud, i.e. that patients are diagnosed with Covid when the diagnose fits remotely.
I simply don't know if a patient who was treated for Covid may automatically be assumed to have died of Covid.
The excess mortality rates say clearly that in sum the Covid death numbers are under reported not over.

Heyo said:

I agree, but that wasn't the point. The point was that Covid patient compensation would lead to some form of fraud, i.e. that patients are diagnosed with Covid when the diagnose fits remotely.
I simply don't know if a patient who was treated for Covid may automatically be assumed to have died of Covid.
The excess mortality rates say clearly that in sum the Covid death numbers are under reported not over.

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False, COVID-19 diagnosis IS NOT used when the diagnosis fits remotely. It is diagnosed based on a positive test for COVID-19 supported by the symptoms as the cause of death.

There is absolutely no compensation to the doctor making the determination that the death was primarily caused by COVID-19.

shunyadragon said:

False, COVID-19 diagnosis IS NOT used when the diagnosis fits remotely. It is diagnosed based on a positive test for COVID-19 supported by the symptoms as the cause of death.

There is absolutely no compensation to the doctor making the determination that the death was primarily caused by COVID-19.

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For an otherwise well educated and intelligent person your occasional lack of reading comprehension is especially unnerving. Is it because of a political agenda or simply just not paying attention?
Assuming the later, let's walk trough what I wrote:
1. Hospitals get paid better for Covid patients. (Living people who are treated. "Better" for them can even mean getting less through Medicare guaranteed than billing someone who is probably unable to pay.)
Agree?
2. This creates an incentive to diagnose the (living) patient with Covid even though s/he might have the flu. (This may include testing with a quick test and not counter checking.)
Agree?

shunyadragon said:

The above bold is patently false. The doctors determine the cause of death, and they get absolutely no financial incentive You are advocating that the hospitals commit massive national level fraud, which you need to document to make such an accusation. Hospitals do not receive any incentive for diagnosing uninsured patients that die of COVID-19. Private hospitals get a tax break for all unisured patient bills regardless of whether they had COVID-19 0r not.

Any compensation large hospitals like I worked at Duke have such high budgets in the billions, that any compensation would not be meaningful in the tens of millions at every major hospital at the minimum they spent on COVID-19 over their basic operation costs.

The same criteria for diagnosis of fatalities due to flu for many years including complications and preexisting conditions.

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I suppose physician owned hospitals might have physician administrators who are doctors with a financial stake in the hospital. Right?

Suave said:

I suppose physician owned hospitals might have physician administrators who are doctors with a financial stake in the hospital. Right?

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No

shunyadragon said:

No

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According to Health and Human Services, "Physician-owned specialty hospitals are hospitals that primarily perform cardiac, orthopedic, or surgical procedures and are partially or fully owned by physician investors."

Reference: https://oig.hhs.gov/oei/reports/oei-02-06-00310.pdf

Suave said:

According to Health and Human Services, "Physician-owned specialty hospitals are hospitals that primarily perform cardiac, orthopedic, or surgical procedures and are partially or fully owned by physician investors."

Reference: https://oig.hhs.gov/oei/reports/oei-02-06-00310.pdf

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So?!?!?

These are a distinct minority of the total patients compared to the literally huge corporate and non-profit hospitals like Dunk University Hospital, UNC, and other municipal hospitals.

It still remains that what you propose would require massive coordinated fraud at the national level to significantly impact the fatality totals for COVID-19.

The most reliable count comes from comparing the history of fatalities from all causes in the USA with the total fatalities during the COVID-19 pandemic Based on this simple reliable method there is no evidence o over counting of fatalities due to COVID-19. In fact the evidence demonstrates in many countries particularly third world countries that count of fatalities is grossly under counted.

How Accurate is the Coronavirus Death Toll?

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Over-reported some places. Under-reported others. I'm not convinced that international figures are always comparable.

Here in the United States and in Europe and Japan I suspect, a disproportionate number of fatalities are elderly people. Many of these people present other comorbidities such as COPD or heart disease. Many of them were already in shaky health with conditions that could have killed them even without covid. When such a person dies, it's often very difficult to assign a single cause of death.

Counting all of these as covid deaths may or may not be justifiable on the theory that they were surviving (if only barely) until covid came along. But it would definitely be enlightening to see covid fatalities in otherwise healthy people separated out from fatalities in people with preexisting conditions where there were multiple causes of death. The former number will inevitably be a much smaller number.

Elsewhere in the world in places where medical care is more limited, many covid deaths aren't happening under a physician's care and probably aren't being counted in the statistics. Most of Africa probably fits that description. It's hard to know what's happening out in the villages. Lots people people might be dying out there and are just receiving local rites and are being buried in local burial plots with nobody in the health ministry in the capital knowing anything about it.

And there are countries where official statistics are suspect. (That's you, China.) When it becomes apparent that lockdowns are significantly impacting the economy, it's no doubt tempting to the rulers to sweep the whole thing under the rug and put a happy face on it. It prevents panic. It's doubly attractive if most fatalities are unproductive but costly seniors, and when boasting of lower fatality numbers than rival nations can be spun into an argument for the superiority the system.

According to the CDC, about 1/4 of new cases are in children. Even though they are better able to defeat versus someone of my vintage, nevertheless this is certainly not good because certain maladies can linger.

metis said:

According to the CDC, about 1/4 of new cases are in children. Even though they are better able to defeat versus someone of my vintage, nevertheless this is certainly not good because certain maladies can linger.

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Are they somehow unable to spread it to the elders also?

Wandering Monk said:

Are they somehow unable to spread it to the elders also?

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Nope-- the virus couldn't care less how old or young one is.

Altfish said:

Also, do you count those who died of non-Covid diseases which were not diagnosed soon enough due to doctors/hospitals being otherwise engaged because of Covid

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I'ld say that such deaths absolutely are to be counted as deaths caused by covid.

It's like if a country is bombed and among the things bombed are important food production sites.
The casualties of this bombing aren't only those that get killed during the explosion. All the deaths from starvation that follows, due to food shortages as a result of those sites being bombed, are just as well casualties of the bombing imo.

So people not getting the care they otherwise would have had if it wasn't for covid, are certainly casualties of covid in my view.

Then there are also cases like my step uncle.
He contracted covid and it got bad. He ended up in the icu and held in a coma. Covid severely weakened him. In the end, he won from the virus. He was cured from covid, but his body, lungs off course, was wreck.
Within a day after being declared "cured" from covid, he contracted an infection with a bacteria. Weakened as his body was, it spread very fast and got to the severely weakened lungs. He died from this infection.

His death certificate mentions the bacteria. It doesn't mention covid.

If it wasn't for the covid infection, first he never would have contracted the bacterial infection since he wouldn't have been at the hospital where he contracted it...
Secondly, even if he had the bacterial infection, more then likely he would have never noticed it as a healthy body wouldn't have had problems eradicating it.



I look at reported numbers and such stories like my step-uncle and it makes me conclude that the real casualty numbers (all included) for covid are likely to be much much higher then reported.

Twilight Hue said:

Death tolls vary depending on information.

Does it include complications from other pre existing conditions?

Is it strictly due to covid itself?

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Imo, it should be "would this death have occurred if covid never happened?"

Covid need not be the direct cause of death in order for a death to be ultimately the result of covid raging about the world..

TagliatelliMonster said:

Imo, it should be "would this death have occurred if covid never happened?"

Covid need not be the direct cause of death in order for a death to be ultimately the result of covid raging about the world..

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It amazes me how ignorant people are about this simple truth. Death certificates have Immediate and Underlying Causes of Death.