COVID as cause of death when it really wasn't: what's the data?

I have seen people claiming that hospitals that were treating inpatients for something other than COVID (heart trouble, kidney failure, asthma, whatever), but then tested positive for COVID, and then died in their care, often/always listed the cause of death as COVID, even when it really wasn’t. This was supposedly done because of financial incentives.

Do statistics during the pandemic give any hint of this? If it happened a lot, then ISTM we should expect to see a drop in deaths from other diseases during the time when COVID was running rampant.

People claim this, but it’s pure conspiracy theory. There is no evidence any such thing ever happened, and there weren’t actually financial incentives to have a patient die from COVID.

If there were drops in deaths from other causes, that could be because a) People who might have died of something else died of COVID first b)People didn’t go to a hospital and died undiagnosed c)people avoided each other, and so didn’t catch other deadly diseases d) other reasons

Plus of course the politically motivated deliberate under-reporting of COVID infections and deaths during the height of the pandemic, and at a time when there was a lot of concern that liability might attach to wherever some dead person caught their COVID. Whole lotta reasons for e.g. an old fart’s home to minimize any suggestion that COID was killing off their customers.

Surely the people making this claim would have the data to support the claim, if the claim was… you know… true.

This is a popular Fox News/anti-vax/conspiranoia talking point but it is largely without basis. The supposed “financial incentives” are nonsense; NCU care is expensive and not especially lucrative for hospitals on a per-patient basis because of the amount of professional labor required for round-the-clock monitoring and care, and they don’t get paid any more for claiming a death from “COVID” than any other form of death. We can reasonably assume that the disproportionate impact of the COVID-19 pandemic upon people in economically lower class and elderly (often fixed income) with limited or no medical insurance coverage means that many expenses will not be recouped.

From an epidemiological standpoint, you would expect a drop in mortality from chronic diseases of age and poor health because we know that SARS-CoV-2 had significantly higher mortality in people over 65 and who were obese, diabetic, immunologically-compromised, or had pre-existing cardiopulmonary and kidney conditions. If they are killed first by infection of the virus, they’ll die from that rather than their existing ailments, and that is correctly registered as a death due to COVID-19. However, because mortality overall went up corresponding to and lagging a few weeks behind peak infectivity rates, there is a statistical likelihood approaching certainty that these deaths were the proximate result of SARS-CoV-2 infection and not just a normal progression of existing conditions.

When a physician fills out a death certificate they have to decide on a proximate cause of death even though there may be several potential contributors, so there is some subjectivity there; however, death from COVID-19 is generally easy to distinguish from other common ailments as a) from a PCR-confirmed SARS-CoV-2 infection, b) a recent history of rapid-onset respiratory distress, low blood oxygen concentration, blood clotting in kidnesy and other organs, and characteristic scarring of the lungs (the “ground glass opacity” in chest X-ray), and c) ineffectiveness of standard treatments for these other conditions in halting the progression of illness. For a patient who is already in the terminal phase of a chronic illness, or who is infected with multiple pathogens which cause respiratory distress and pneumonia-like conditions there might be some ambiguity but in the vast majority of cases the progression of the COVID-19 disease is quite distinct from other pre-existing conditions in terms of the particular signs and symptoms and how quickly the patient is not able to maintain sufficient blood oxygen levels for adequate perfusion.

In short, this claim is nonsense, and if there is any error it is in underreporting of non-diagnosed or intentionally ignored infections. I’m sure someone combing through medical records can cherry-pick specific cases where there is ambiguity whether a pre-existing condition or COVID-19 was the proximate cause, but from an epidemiological standpoint there is no question that the observed excess mortality rates in 2020-2021 were due to the SARS-CoV-2 pandemic.

Stranger

In opposition to the CT, there was actually a rise in deaths due to heart attacks and other Cardiovascular diseases.

Seems to me that any financial incentives would be tied to some piece of legislation or other- someone would have to get paid for that, and during COVID, that would most likely be the government doing the paying. And any financial incentives would likely have had some kind of paper trail as well- the government doesn’t just hand out money without it.

I bet what the tinfoil hat crowd is talking about is situations like my father’s death. He technically died of pneumonia about a month or so after catching COVID (and getting over the acute infection). But he was in poor health to begin with, and COVID did enough damage to his lungs that he almost immediately caught pneumonia, and that’s what got him. So the death certificate reads something like “hypoxia due to pneumonia” with COVID listed as a secondary reason.

I’m sure the conspiracy theorists would nitpick that as not being a COVID death, but it’s absurd. It’s the worst sort of sea lawyering IMO. It’s akin to arguing that it’s not the gunshot that killed someone, it was the blood loss.

Not just elder care facilities and other private organizations; a number of state governments put up barriers or essentially stopped collecting and reporting data on SARS-CoV-2 infections and deaths. Worldwide, estimates of undercount vary from around 50% less up to several times the official numbers because of a lack of testing, transparency, and in some cases intentional misreporting.

Technically, we all die from heart failure because that is how death is defined. SARS-CoV-2 can certainly exacerbate cardiovascular problems and create inflammation and arrhythmia in previously healthy patients. We are still getting new information on post-acute sequelae of SARS-CoV-2 also known as (‘long covid syndrome’) which may have long term impacts on cardiovascular and neurological health conditions.

Nobody ever died from a shooting due to lead poisoning.

Stranger

I seem to recall there might have been some extra funding for hospitals when patients who had COVID died because of extra precautions they needed to take in handling of the infected body. But that would attach whether the deceased had died of COVID or with COVID, so that doesn’t support the conspiracy theory either, but may have been a source of information used in creating the theory.

As everyone knows, the cause of death is always cardiac arrest.

Drowned? Cardiac arrest. Stroke? Did some damage to the brain but what actually killed was cardiac arrest. Beheaded? Believe it or not - Cardiac arrest (the heart stopped because it wasn’t connected to the brain stem anymore!).

Eta: I see that Stranger also made this point.

Are you sure about that?

By that argument, nobody ever died of AIDS. They just died of pneumonia or septicemia or assorted other infections…which wouldn’t have been fatal if the individuals had had a functioning immune system.

I have learned a couple things when it comes to the cause of death. My mother battled lymphoma and ovarian cancer the last 2 years she was alive. When she died, we all thought the cause of death would be cancer. Her death certificate listed renal failure as the cause. Her doctor said the cancer contributed to her death but when we brought her to the hospital, she was at the beginning stages of internal organ failure. When this happens the kidneys are the first to go.

The second was a cousin of my wife. He had been suffering with heart disease for quite a while. When it was announced that a Covid vaccine had been developed, he went into full anti-vaxer mode, he said the vaccine was a government plot to inject devices into Americans so the government could track us. Around Christmas of 2020, he was diagnosed with Covid, he died a few weeks later. His death certificate listed Covid as the cause of death. This was about the time the news media was reporting hospitals were inflating the number of deaths from Covid, the claim was people were dying from other causes besides Covid. Some of his family members raised a ruckus about this, a couple even threatened the doctor with a lawsuit. Through an attorney, the doctor sent an cease and desist to the family which also had the reason for listing Covid as the cause of death. Basically if he had not contacted Covid or had been vaccinated, there was a chance he would still be alive. But because of he weakened medical condition, Covid killed him. This whole issue has created a huge divide in the family, my wife hasn’t seen many of her relatives since, she doesn’t want to listen to their anti-vax and other political crap.

Denialists have seized on the fact that death certificates often list comorbid conditions in addition to Covid-19.

“The CDC considers the underlying cause of death as “the condition that began the chain of events that ultimately led to the person’s death,” Jeff Lancashire, acting associate director for communications at the NCHS told PolitiFact in August 2020. In 92% of death certificates that mention the virus, COVID-19 was the underlying cause of death.”

So you have people claiming there really hasn’t been a pandemic and Covid-19 is insignificant, at the same time that they’re railing at public health agencies and hospitals for supposedly causing mass death by discouraging the use of worthless (for Covid) drugs like ivermectin and hydroxychloroquine.

Logical consistency isn’t their strength.

This is pretty much it in a nutshell. The rising number of COVID-related deaths at the start of the pandemic made those in charge of our response look bad, so something had to be driving those numbers up (other than, ya know, people dying from COVID). Enter the CT crowd with little understanding of how a hospital works, how a doctor determines cause of death, and how a hospital manages it’s finances, and et voila, “COVID deaths are being over-reported (because hospitals make more money that way)”. And those inflated COVID death numbers hurt the denialists’ war on vaccines (“the government is just trying to scare people into getting vaccinated”). If Faux News says it, it must be true!

I have heard the same BS argument over the climate change issue - that the CO2 numbers are inflated so someone can make more money, so you can just ignore the whole climate change thing.

There’s a certain amount of projection involved - people who willingly distort data for their own agenda and/or profit assume everyone else must do the same.

“Every accusation is a confession.”

Not necessarily. The concept of “brain death” is well-established in both the medical and legal professions.

That’s why it is permissible in certain cases to cut a completely functional, beating, heart out of a human; because they have already died due to brain death.

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