Doctors and Nurses Say More People Are Dying of Covid-19 in the US Than We Know | Hacker News Reader

Doctors and Nurses Say More People Are Dying of Covid-19 in the US Than We Know

buzzfeednews.com

58 pointsaazaa20 comments

Article summary:

- No claims of intentional undercounting.

- Some undercounting likely because testing is reserved for living patients where test results could affect how that patient is treated.

- Some undercounting may be temporary because of lags in test-results / reporting / tallying.

Buzzfeed quality

Usual comment: BuzzFeed is not the same quality as BuzzFeed news. Bfn is a good source.

They should rebrand the real news wing.

I've seen buzzfeed news report on stories I'm familiar with. Its all clickbait and sensational.

Would this apply to pretty much all countries? Especially "testing is reserved for living patients"? A lot of countries are struggling to test enough living people.

Of course. If you're interested in detailed reporting, it gets fuzzy. False positives, false negatives, not testing, losing results.. Most stats aren't exact in many ways. This is NOT a US-specific phenomenon (healthcare is Excellent, when provided), and in some cases cause of death was NOT COVID-19 either, despite positive test. For deaths, it is a bit better, since most countries do keep tally in that area, but actual testing may vary wildly post mortem.

For the "waiting for evidence"-crowd (inaction), this is bad news. There's just no time when action is required NOW.

However, by buying time, we can ironically "wait for the evidence"!

At least here in the states I have a hard time believing that we could have a significant spike in deaths that are missed entirely. But maybe it's possible that a death would be noticed and reported and handled through the proper channels, but that the count of the death itself would just get missed. And that we wouldn't notice until we compared deaths to population counts or something.

Here's another interesting way it could be masked. Perhaps flu deaths are decreasing substantially, but unnoticed covid deaths are being recorded as flu deaths to make up the gap - we wouldn't notice the spike because it would just be an absence of a dip. Maybe that wouldn't get noticed until our flu seasons in future years are weirdly muted.

I think the signal to look for is an increase in flu mortality rate in February-May compared to October-January if that kind of data exists. Confirmed flu cases are almost never also tested for COVID-19 due to the sheer number of flu cases, but even a small percentage of those being doubled up might change the mortality rate. They would also cause community spread because people don't take the same precautions for "just the flu".

both flu and covid kill the same kind of people, very old and frail ones. So in a sense they should be competitors, and they'll both kill fewer than if either disease were the only one.

Covid kills people who would survive the flu, so if someone catches both, they would have a higher chance of dying than from the flu alone, which would affect the flu's stats because these would be recorded as flu deaths.

Flu kills children, covid-19 doesn't. Not sure if there is an 'expected' percentage of flu deaths in children, but if so, we might estimate the covid effect by looking at those numbers.

The corollary is also true: more people are not dying of Covid-19 than we know.

True. And there are probably many more of them.

So altogether, inadequate testing underestimates incidence of infection, and overestimates risk of death from infection.

I think it would be useful to compare the mortality rate of a region with the past years. Other than uncounted coronavirus death there are other emergencies that cannot be throated properly in some heavily affected areas and that increase the overall mortality rate.

That would surprise me greatly. The one example is an ER doc who says there was 3 instead of 1 in a county? What is the implication here, complicit participation of all healthcare workers in a political scheme to undersell deaths while screaming for more resources? Incompetent testing? Poor reporting? We report every death to the medical examiner regardless, this would come up and be strictly tracked, even after the fact if the test results later. Would be nice to have evidence of a discrepancy to go off, otherwise I worry this just spreads fear.

Some of the confusion is that cases are reported in the county of residence, not the county of the hospital where they are being treated. I've had to correct multiple people who felt the "official numbers are wrong because Foo Hospital in Bar County reported treating 'x' confirmed cases, but the state's website only shows 'y' for Bar County.

It's likely that the doctor that was quoted in the article fell victim to that misunderstanding.

On a related topic, it would be nice if the ER doctors, nurses, and hospitals were doing a better job of reporting the county-of-residence. Here in Georgia, we have 166 cases where the county is "unknown" (out of 1525) as of noon's report.

A lot of people say China undercounted but according to WHO report China when it was at peak infection had started counting as confirmed cases that showed lung damage using chest scans instead of doing a proper test as they needed a quick turnaround on test results. Which to me doesn't sound like they wanted to hide the number of infected. Over the years I have realised we have western propaganda and Chinese propaganda and the truth dies somewhere in between

This feels somewhat sensationalist given the lack of evidence (other than hearsay).

And a lot more will, which I find a bit odd given how important it will be for Future planning. I get that it is mostly a waste of time to test a dead person but it seems like they could at least be labeled presumed covid.

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