Most of the downplaying I've seen has revolved around the idea that those who died would have, "died anyway" from some other ailment or that hospitals are finding any reason they can to attribute deaths to covid.
So, while you have a great argument, I doubt you'll change any minds because those who disagree flat out reject your premise.
Or to take me as an example: I have asthma. That probably counts as a comorbidity, so if I die of covid, should that count as a covid death or not? I'm 42, I can reasonably expect another 42 years of life. Most chronic illnesses don't kill you.
I've actually seen some people with Asthma may have possibly survived because of certain Asthma medications that may do something to block covid, I can't remember the study, but if you're on that specific med, maybe that helped?
I'm > 400 lbs (690 in 2012), I'm 41, I survived having it. Except for long-covid which was a bitch.
From the CDC:
> Table 3 shows the types of health conditions and contributing causes mentioned in conjunction with deaths involving coronavirus disease 2019 (COVID-19). The number of deaths that mention one or more of the conditions indicated is shown for all deaths involving COVID-19 and by age groups. For over 5% of these deaths, COVID-19 was the only cause mentioned on the death certificate. For deaths with conditions or causes in addition to COVID-19, on average, there were 4.0 additional conditions or causes per death...
e.g. per that table, out of 560K deaths coded as COVID-19, 257K were also coded as "influenza or pneumonia". That's because Covid causes pneumonia.
Is this a useful metric, though? If covid is the catalyst to cause death with preexisting conditions, is not covid the actual cause of death?
Covid in these cases is an acute condition that is the direct cause of death.
If the answer to the question of, "Would this person be alive were it not for COVID?" is "Yes", then COVID killed that person.
You should be able to be fragile and still survive, that isn't an excuse to let someone die.
Dying with COVID does not mean you would be alive today if you hadn't contracted COVID.
What I can guarantee is that of those 95% who died with COVID, some percentage of them would have died anyway, under almost identical circumstances, except without COVID.
However, it is also true that some of those people would have lived if they hadn't contracted COVID, even though COVID was not the "direct" cause of death. For how much longer, who knows. But certainly not when they did.
In other words: the people saying we should only be counting the 5% direct deaths are wrong, and the people that say we should be counting all 100% who had COVID as deaths from COVID are... also wrong.
I believe we can be much more precise than you're giving us credit for in determining if contracting COVID was the direct cause of someone's death, even with comorbidities.
To be totally honest, when I see someone say, "we can't ever be totally sure" I nearly wholly discount that opinion, because it's very cheap to proffer, almost always true, and of very little value.
Also one of us is confused, and I don't think it is me. From what I've gleaned from this article, the 900,000 figure is not (as you say) "determining if contracting COVID was the direct cause of someone's death", but rather trying to figure out how many people would have died if this had been a "normal" year, i.e. if we could go to a parallel universe and make COVID never exist. This is absolutely not the same thing, as such a scenario will also count deaths as a result of our response to the virus as a death "due to the virus". This is my impression as they seem to be including things like suicide (criteria "c") and people who died because people with actual COVID were taking up hospital beds (criteria "b").
I think this is the correct way to think about this problem, as it is likely to be an underestimate, rather than an overestimate.
In other words, counting suicides probably doesn't matter, as the number is very low. The paper says as much: "The main potential increases in excess mortality due to deferred care and increases in drug overdose and depression are hard to quantify at this point or are of a much smaller magnitude."
The paper overall goes into very great detail about what was and wasn't included and why, which is vastly more rigorous than what you seem to be presenting, which is effectively throwing up your hands and saying, "we'll never know!"
One is the OP's idea, "deaths due to COVID". This idea is "how many people would have died if COVID had never existed". However, what a lot of people hear when you say "deaths due to COVID" is "this is the number of people that died as either a direct or indirect result of having COVID in their system". But that is not the 900,000 number being cited.
It is made even worse by the HN headline, which is "death toll from COVID", which even more strongly implies the above.
And... that's exactly what the linked article is doing. And yeah, it turns out that all these people (on balance) would indeed still be alive had they not been sick with covid.
It is definitely not only looking at whether people would have died sans covid in their system.
As to whether a suicide due to pandemic-induced depression "counts" as being "caused by the pandemic" or not, isn't exactly the kind of confounding effect you railed against above? Isn't the solution, again, to not demand that we micro-classify every death and simply look at the external effects we can measure?
To answer your question though, no, they should not be lumped together because they are not the same thing and so the mitigations would've/could've/should've been different. In other words, lumping all these things together as "caused by COVID" is the opposite of useful. For example, you do better next time with deaths due to COVID in your system (category "a") by ramping up vaccination faster/better facemask policy/earlier lockdowns/etc. You can decrease category "b" by having more hospital beds / more healthcare capacity. You can reduce the deaths in category "c" (seemingly suicides) by having lockdowns that aren't up-and-down rollercoasters / better mental healthcare / etc. All of these, though being "due to COVID" should be handled very differently so it is counterproductive to lump them all together.
Again, I think you might be projecting a bit here, because the only reason I can think of that you would want to lump them together is to push a political agenda. Not for any utilitarian reason.
>"Would this person be alive were it not [for contracting] for COVID?"
Put another way, people in perfect health shouldn't be the only ones whose covid deaths are counted.
If an obese person is in a car accident and immediately dies, we say that they died due to the more immediate health event: the car accident. -- even though we know that obese people are more susceptible to death in car accidents.
This is like saying that 0% of people who have contracted HIV have ever died of HIV, they died of other diseases. Well, sure, but what allowed those other diseases to be contracted?
The top "other factors" are (in order): Pneumonia, "everything else", respiratory failure, high blood pressure, diabetes, cardiac arrest, heart disease, acute respiratory distress syndrome, etc.
It's pretty clear to say that far more than 5% died of Covid induced complications, not that they died of "natural" causes and also tested Covid positive. Saying the 5% number is almost certainly abuse of statistics, especially given the notable uptick in mortality in the US.
I'd consider it playing devil's advocate, depending on the scenario. The problem is, these days I often see a lot of bad faith arguments being passed off as "just playing devil's advocate".
You can be obese and diabetic and still live to be 80+ years old. My grandma is both, and will be turning 81 this year.
But if someone who is only 30, but obese and diabetic dies to COVID, it's a pretty damn bad faith argument to try to claim that COVID was not the cause of death.
Well, I don't even know where to find this kind of data, but your hypothesis could be tested by comparing the number of deaths in 2020 against the number of deaths in 2019, broken down by cause of death.
Not a lot of young people know a huge amount of people in the risk groups, it's easy to dismiss if it hasn't affected someone you know.
What if there was an epidemic virus, that, within a year +/- a few months of contraction, killed hosts over the age of X (20, 50, 70), regardless of underlying health conditions.
It raises some interesting questions! The three I’ve come up with so far:
(1) what does a society look like, without (mature, older, very old) people? What surprising positive and negative evolutions occur?
(2) how would our current societies react to the gradual onset and eventual global expansion of such a disease?
(3) if we found a cure for the disease a few (now, shorter than previously) generations later, who would take it?
It’s kind of similar Lord of the Flies, except instead of a shipwreck, it’s a disease and it happens gradually, to preexisting societies and cultures.
With Covid it was easy people to think it wasn't really a big deal, it reduced the appetite and compliance necessary to keep the pandemic contained.
That's practically inviting them to cite back the average life lost from the 1918 flu. If you're trying to counter someone who's downplaying Covid that is probably not something you should invite them to do.
I've found it is helpful to count by equivalent number of deaths to something that the person has actually experienced, as it is way too easy to brush away deaths that occurred in 1918.
For instance, it's as if you took the number of years of life lost in 9/11 and multiplied it by 120.
Good example of the asymmetry of bullshit here.
For COVID numbers, even with 1M deaths, that would be 1/330 (US population) losing on average ~15 years vs. everyone losing almost 2 years now. It's emotionally tough to pick a policy when you are condemning one group to statistical death, but you still have to try and be objective. My personal opinion is that we'll be writing books about the "the lost generation" in 10 years about children currently in school.
1. The current death toll is with the existing lockdowns. There are good reasons to think that without (especially the early) lockdowns the death toll could have been way higher.
2. Being dead for 1 year cannot be equivalently compared to being socially distant for 1 year (not 2). Is that not obvious?
3. This is before we get into life long disability, etc. due to covid. I know someone whose parent had a covid caused stroke, essentially ending their existence as the person they were before.
I'm not sure she is going to agree with you when she visits you toward the end of your life.
> For 3. it cuts both ways, how many new alcoholic parents and child abuse that ruins an entire lifetime?
It's far from obvious what the effects of COVID-19 are on child abuse. The data is hard to disaggregate because there are so many conflicting factors, but there isn't obvious reason to believe that child abuse is up during the pandemic given the data we have seen: https://www.ucsf.edu/news/2021/03/419961/child-abuse-surges-...
That sounds like it is not obvious.
> The data is hard to disaggregate because there are so many conflicting factors
Basically sums up COVID policies. The point remains, I have yet to see any clear objective policy making that even tries to estimate impact on life of all citizens. In absence of anything resembling a consideration of all age groups, I just ignore any opinion of lockdown both for and against.
So if you are going by this "differential quality of different years" argument, you have to account for the fact that most of these years actually aren't for really old people.
> It wasn't obvious that applying enough pressure wouldn't have prevented the uncontrolled explosion that we now have to deal with.
I'm not sure exactly what you're saying here, but I think we agree. Nothing about this pandemic has been obvious.
Very little of our COVID infections have been linked to either of the geographic borders in this country. While I understand there are greater risks with those borders, it doesn't make the situation incomparable.
> Also, Australia and New Zealand just broke their travel bubble, I don't know if that still constitutes as a "short lockdown" if you haven't been allowed to leave your country the entire time.
Bars and restaurants and sports have been available the whole time. Even if there wasn't a travel ban from the country, where would people even go? Most other countries aren't allowing visitors.
Except we didn't lose a year. A lot of us actually kind of liked the last year. Many got to work from home and discovered it was a lot less stressful than commuting into an office every day, for example. I have a feeling that some of us are going to recall the last year with a bit of nostalgia in the future.
Imagine trying to learn on an old phone, using a cellular internet connection in a bedroom you share with your sister.
So, while I'm glad you enjoyed your year at home -- the focus here was on the impact on students.
I keep seeing statements like this, and I must disagree. My mom's retired, nearly 80, and having an absolute blast living her life. At her prime, she was the primary wage-earner, had two kids, and never had a moment to herself. Her quality of life now is much better than when she was "in her prime". She's got a bunch of friends in the same boat.
https://www.cdc.gov/obesity/data/obesity-and-covid-19.html
And they also reduce life expectancy on their own even without COVID-19. Being obese cuts life expectancy by about 7 years.
https://pubmed.ncbi.nlm.nih.gov/12513041/
So the actual average YLL is probably a little less than 15.
I don't blame the researchers for this bias. The detailed data to correct for it generally isn't available so they're doing their best with what they have.
The authors of this are doing exactly the same thing, but from the other direction:
> Given that there is insufficient evidence to estimate these contributions to excess mortality, for now we assume that total COVID-19 deaths equal excess mortality. For the reasons presented in this section, we believe that this is likely an underestimate.
This is all simply noise. The way we'll find out the answer to this question is when someone pulls the death certificates for 2020, and actually tabulates the percentage directly caused by Covid.
It will happen, but this work isn't it.
Moreover, we know that there are examples of the opposite: deaths where Covid was on the certificate as a contributing factor, but not the primary cause. These aren't hard to find.
An 85 year-old with congestive heart failure and late-stage cancer and Covid reflects the modal situation here. It isn't some theoretical event -- it's incredibly common.
Right now, what we have is aggregate death counts (which we know are high), and people speculating that they're elevated because of Covid (or in this case, making models based on speculation).
As well, you get the over-the-top cases where someone that dies of a gunshot is included in the covid death count[0].
Some states have tried to do better by breaking it down a little finer. Like Colorado provides[1] a breakdown down by confirmed vs probable. But the data here is still not great.
[0] https://www.kmov.com/news/colorado-coroner-calling-out-how-s...
? It's incredibly clear by looking at Colorado's numbers, there was no misclassification at all. Definitely mistakes have been made, but this isn't even an example of one.
Your comment is bizarre. The same case you're criticizing is from the state you go on to praise in the next sentence. These, unequivocally, have never been included in "death by covid" counts.
> financial implications for a state saying they have covid deaths
Yes, but there are also immense legal, financial, and political implications for lying about covid deaths. There is no evidence of this happening on a widespread scale.
There are obvious signals in total excess death counts indicating the number of deaths due to covid, we can do retrospective random testing of early classified covid deaths.
There is no evidence of some systematic conspiracy or anything of the sort. I encourage you to consider that you might be engaging in motivated reasoning.
I'm fairly sure there is no tissue available to test from any of those bodies
The situation was ripe for fraud, and there is no way to prove it didn't happen en masse. Human nature suggests it did happen. The evidence of what caused those deaths is destroyed shortly after the paperwork is filled out. The whole thing is set up in such a manner that suggests inflation of the numbers, and to have no way to counter the claims as all evidence is gone
It’s simply incentives, it doesn’t take a top-down conspiracy to have independent actors try to game a system in order to profit financially.