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Comment by cm2187 | Hacker News Reader

Without going into the debate about this paper, worth noting that the same assumption is made about covid deaths, ie it covers everyone who was diagnosed or was assumed to had covid before their death, even if the person died of terminal cancer. And since hospitals were a major place to catch the virus, I don’t think we can assume that the misattribution of the cause of death is immaterial.

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This is a common statement and I don't think this is true.

Foremost: If someone had cancer, that does not mean he would have died immediately. Heck, he could have "survived" it, or at least lived for several more years.

Second: This does not explain the huge numbers of deaths. You can easily compare how many people died of/with lung cancer from 2019 to 2020 and then for 2020 to 2021 and clearly see that COVID made a difference here (called Übersterblichkeit in German, and visible in all COVID-affected countries).

And AFAIK most countries do actually not report a death with COVID, e.g. a car accident, as being caused by COVID.

In other words, this is a common myth from the skeptics department and only serves in undermining COVID-related efforts, even if well intended.

There's also enough studies that debunk the myth at this point. https://www.nature.com/articles/s41598-021-82862-5 for example.

There might be more serious studies out there, but the abstract in your link says that they selected 26 patients with severe covid and verified that they died of covid. It is a bit circular and certainly not applicable to the countrywide covid stats.

Okay, clinical pathology in hospital settings aside, what country are you talking about? Here in Germany cause of death determination for COVID-19 deaths is part of the data we gather.

Random German state (Bavaria) for example [0]: Cause of death known for 98% of all COVID-19 deaths, 87% of these died from the disease, 13% from other causes. I just don't really see how it's misattribution when that data is available (which I assume it would be in any country not completely overwhelmed by the pandemic).

[0] https://www.lgl.bayern.de/gesundheit/infektionsschutz/infekt...

Well, in France for instance, this ICU specialist says that 3 patients out of 8 he saw going through the ICU are classified as covid patients because they tested positive but are not in ICU for Covid [1, around 18min into the video]. Now this is one ICU, and not all deaths occur in ICUs, so I wouldn't extrapolate it to national numbers. But it certainly makes me think that covid deaths are over-estimated.

[1] https://www.youtube.com/watch?v=r1hOyShXHak

Just because they're tested positive for Covid and later die in the hospital, doesn't mean that the death certificate will state Covid as cause of death.

That may be but it's not necessarily how the covid deaths stats are collected. I believe in the UK for instance, the definition of a covid death is a death that occurred within 28 days of a positive test, irrespective of the cause of death.

There's not one way to collect these stats, see the section "ONS and PHE COVID-19 deaths data are produced in different ways and have different purposes:" in [0] on what the UK gathers how. Neither of which changes the excess deaths resulting from the pandemic.

It's just a matter of timeliness in some cases and up to the consumer of such data to decide which is suitable for which analysis (and honestly a moot point, no country tests enough to warrant the assumption that the odd accidental death that is later corrected would be worse than the effects of undercounting).

[0] https://www.ons.gov.uk/aboutus/transparencyandgovernance/fre...

Excess death data clearly shows this is not a big factor: https://www.liberation.fr/checknews/2021/01/15/covid-19-en-f...

Dude is also a known antivax: https://www.vice.com/en/article/qjpxwx/how-france-became-the...

Not too surprising when you see where he works ;-).

Please have a look at your argumentation:

- "I don't think this is true" - "And AFAIK most countries do actually [...]" - "In other words, this is a common myth [...]"

You present your thoughts, a theoretical anecdote and things you might have read. And based on that you conclude that it is a "common myth"?

Thank you for your critique.

If now you have something to add to the points made after "Foremost:" and "Second:" your post could have added something to the discussion as well, instead of just attacking my form.

Again, your argumentation is problematic and therefore hard to argue with.

Your first point depicts a fictional anecdote that tries to prove that terminally-ill patients with a positive COVID-19 test could have lived longer. It's like saying "If someone has stage IV cancer and tests positive for COVID-19, that does not mean he died due to COVID-19. Heck, he could have even died due to multidrug-resistant bacteria"

What's your source? What's mine? What does it add to the discussion to bring up fictional scenarios?

Regarding your second point: Source? How closely does excess mortality correlate with COVID-19? Could there be other causes? We are talking about highly complex situations that need to be thoroughly analyzed.

The "argumentation is hard to argue" because you do not have arguments.

If you do not have anything to add about the subject, please don't waste anyone's time complaining about form.

Did you read my comment?

It does not appear that they did. You offered multiple good questions.

No, this is not true in general. There are several different ways to count the number of covid deaths, and "had covid, later died" was simply one that was often used at the start of the pandemic of efficiency reasons.

Good investigators have always been aware of the limitations inherent in the assumption, but initially other measures based on the official death certificates were simply not available (and in any case have their own complications when interpreting), so people used what was available and cautioned about the limitations the first four times they said anything.

There weren't enough terminal cancer patients dying with COVID-19 to significantly impact the death numbers. The most common comorbid conditions in COVID-19 deaths were high blood pressure, high cholesterol, and obesity.

http://dx.doi.org/10.5888/pcd18.210123

That's why you need a control. How many people in an unrelated similar sample also died during the period. Though I have no readily available evidence for this, I suspect that people vaccinated vs unvaccinated would be more similar than people diagnosed with COVID vs people undiagnosed.

Agree, if you segment your data by age (massive age difference between the two populations).

It's good that we can compare the deaths in 2020 to previous years [1].

[1] https://archpublichealth.biomedcentral.com/articles/10.1186/...

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