At what point did you / will you take the coronavirus epidemic seriously?

[Omaha 680]

I would think they'll be able to figure the effective totals by comparing death totals from years past. After a few years, I would think they could even estimate how many years people lost at the end of their lives because of COVID-19.

Not really. Overall deaths are way down for march in the usa (probably everywhere in the west). Turns out when you never leave your house your chance of dying goes way down.

[Uncle Ted]

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[Northwestcoug]

I would think they'll be able to figure the effective totals by comparing death totals from years past. After a few years, I would think they could even estimate how many years people lost at the end of their lives because of COVID-19.

My point is that this argument of ultimate causes of death in COVID patients is pointless. What difference does it make if some patients are predisposed to COVID morbidity? They contracted the virus, and they died. That is the ultimate cause of death. We are not ‘vastly overestimating’ COVID deaths.

When an elderly patient breaks a hip, gets hospitalized, and develops pneumonia and dies of it, the cause of death is pneumonia. We are not vastly overestimating the deaths of hospital acquired pneumonia because we fail to recognize the broken hip comorbidity.

[Jeff Lebowski]

ugh

[SeattleUte]

My point is that this argument of ultimate causes of death in COVID patients is pointless. What difference does it make if some patients are predisposed to COVID morbidity? They contracted the virus, and they died. That is the ultimate cause of death. We are not ‘vastly overestimating’ COVID deaths.

When an elderly patient breaks a hip, gets hospitalized, and develops pneumonia and dies of it, the cause of death is pneumonia. We are not vastly overestimating the deaths of hospital acquired pneumonia because we fail to recognize the broken hip comorbidity.

But in that situation the cause of death is rarely if ever identified as pneumonia or broaden him. It’s typically identified as “natural causes.” Here, if the same individual, in the same condition, caught the flu, and then died of pneumonia, it would also typically be “natural causes.” How often do you see that someone in their 80s died of the flu or pneumonia or a broken hip? Rarely if ever. But now if they have Covid-19 and die after the same course of illness, it’s they died of Covid-19. If the reporting were consistent, no problem. But it’s not.

[SeattleUte]

My point is that this argument of ultimate causes of death in COVID patients is pointless. What difference does it make if some patients are predisposed to COVID morbidity? They contracted the virus, and they died. That is the ultimate cause of death. We are not ‘vastly overestimating’ COVID deaths.

When an elderly patient breaks a hip, gets hospitalized, and develops pneumonia and dies of it, the cause of death is pneumonia. We are not vastly overestimating the deaths of hospital acquired pneumonia because we fail to recognize the broken hip comorbidity.

It is complicated and it isn’t pointless. Public policy always used to consider trade-offs, and this ought to be a consideration.

https://fivethirtyeight.com/features/what-does-it-mean-to-die-of-natural-causes/

[Omaha 680]

Italy and Spain have flattened.

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We are close, likely already past peak infection as well.

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[Northwestcoug]

But in that situation the cause of death is rarely if ever identified as pneumonia or broaden him. It’s typically identified as “natural causes.” Here, if the same individual, in the same condition, caught the flu, and then died of pneumonia, it would also typically be “natural causes.” How often do you see that someone in their 80s died of the flu or pneumonia or a broken hip? Rarely if ever. But now if they have Covid-19 and die after the same course of illness, it’s they died of Covid-19. If the reporting were consistent, no problem. But it’s not.

No. No.

I can assure you, if a hospitalized patient gets pneumonia and dies from it, the listed cause is 'pneumonia'. It doesn't matter at all if the patient was healthy before getting hospitalized, or even if the patient had comorbidities that worsened the effects of pneumonia.

When I issue an autopsy report, I list all the diseases the patient has, in descending order of 'acuteness'. These might or might not be proximate causes of death. When I'm confident of the ultimate cause, I list that as cause of death. In our broken hip patient, this would be pneumonia. If I were ever to do an autopsy on an obese diabetic patient with hypertension and history of a heart attack, who contracted COVID and died of respiratory failure, I would list the cause of death as COVID. The comorbidities are essentially footnotes. They undoubtedly made it worse, but they are not the immediate cause of death.

[BigPiney]

No. No.

I can assure you, if a hospitalized patient gets pneumonia and dies from it, the listed cause is 'pneumonia'. It doesn't matter at all if the patient was healthy before getting hospitalized, or even if the patient had comorbidities that worsened the effects of pneumonia.

When I issue an autopsy report, I list all the diseases the patient has, in descending order of 'acuteness'. These might or might not be proximate causes of death. When I'm confident of the ultimate cause, I list that as cause of death. In our broken hip patient, this would be pneumonia. If I were ever to do an autopsy on an obese diabetic patient with hypertension and history of a heart attack, who contracted COVID and died of respiratory failure, I would list the cause of death as COVID. The comorbidities are essentially footnotes. They undoubtedly made it worse, but they are not the immediate cause of death.

Wait, you do autopsies? I did not know that.

[Northwestcoug]

Wait, you do autopsies? I did not know that.

I do. Well, they're pretty rare in my practice now. But I had plenty in residency. And I don't do forensics.

[Mormon Red Death]

https://twitter.com/benshapiro/status/1247722747972571136?s=19

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[BigPiney]

I do. Well, they're pretty rare in my practice now. But I had plenty in residency. And I don't do forensics.

Cool, I did not know that. There isn't anyone in my county that does them, at least there wasn't a number of years ago, and I don't think that has changed. We have to export then to elsewhere in the rare occasion that one is needed.

[Northwestcoug]

Cool, I did not know that. There isn't anyone in my county that does them, at least there wasn't a number of years ago, and I don't think that has changed. We have to export then to elsewhere in the rare occasion that one is needed.

Yeah, many rural counties don't have close access to autopsy services. Part of that is due to medical science advancement. In the generation before me, autopsies changed the clinical impression of death in a significant percentage of hospitalized patients. Now with better radiology and laboratory science, an autopsy is only rarely needed to determine the cause of death. Forensics is a different story.

I hate autopsies. I'm glad I only rarely have to do them.

[Pelado]

Yeah, many rural counties don't have close access to autopsy services. Part of that is due to medical science advancement. In the generation before me, autopsies changed the clinical impression of death in a significant percentage of hospitalized patients. Now with better radiology and laboratory science, an autopsy is only rarely needed to determine the cause of death. Forensics is a different story.

I hate autopsies. I'm glad I only rarely have to do them.

It's tough to save an autopsy patient, even for some of the best physicians.

[Northwestcoug]

I missed this. The journal that published the French study of hydroxychloroquine has issued a 'statement of concern':

Hydroxychloroquine-COVID-19 study did not meet publishing society’s “expected standard”

https://retractionwatch.com/2020/04/06/hydroxychlorine-covid-19-study-did-not-meet-publishing-societys-expected-standard/

It would be great if we had capable scientific journalism and a president who trusts experts rather than sycophants. But here we are.

Again, it may help in a select few of patients. But it's becoming clear that the potential group of those who benefit from it is shrinking rapidly.