Season Officially Suspended -- COVID-19/Coronavirus Talk

[Stupendous Yappi]

This is a BS talking point that just isn't backed by any actual data. In the US alone there are more than 300k more deaths than the average year at this point. This is like arguing that AIDS has never killed anyone. If they would have lived had they not gotten the virus, then they died due to the virus.

My states medical association just released a survey that showed 1/3 of the population have put off needed medical care for other conditions during the pandemic/isolations. When you cite total deaths (the 300,000 number) it’s not easy to be sure where to assign them by cause. Cardiac deaths and cancer deaths are up, for example, including those which were preventable or at least postponable with routine care, independent of having a Covid infection.

I haven’t come across anything reliable that teases apart the causes of death. Add me to the group who think the statistics here are hopelessly mired in partisan politics. I’ve actually read studies that basically contradict the 300,000 number completely and show that total deaths are only slightly higher than usual..suggesting the majority of Covid deaths were in people who were likely to die of other causes soon. I don’t really believe that, any more than I believe the high estimates. There are far too many people who have a vested interest in one extreme or the other.

 

[bleedblue1223]

I wish I could like this more than once. Trying to steer the impact of the virus into so-called co-morbidities and away from COVID is akin to saying that you can't attribute a traffic death to drunk driving if the guy the drunk driver killed had terminal cancer and would have died in a few months anyway. As you point out, most of the people who have died from AIDS have died from pneumonia and other ailments, but AIDS actually caused the pneumonia.

This line of thinking is simply trying to understate the impact of how badly our national response has been mishandled and carries only political favor - there is no value to aiding the preservation of the human toll to making such an argument.

To this point, there have been cases where someone died with COVID, and it was considered a COVID death, when they didn't die from COVID. And to the point that @Thallis made about more deaths than average, maybe the COVID environment has resulted in that, but why would we associate increased homicides with COVID.

Personally, I look at the death numbers as more of a range, even if they are 25% higher or lower, it's still a high enough number that we should care about.

 

[67Blues]

To this point, there have been cases where someone died with COVID, and it was considered a COVID death, when they didn't die from COVID. And to the point that @Thallis made about more deaths than average, maybe the COVID environment has resulted in that, but why would we associate increased homicides with COVID.

Personally, I look at the death numbers as more of a range, even if they are 25% higher or lower, it's still a high enough number that we should care about.

A relative of mine from a small rural IL area had advanced Alzheimer's disease, liver disease, kidney disease, COPD from smoking, and a couple flavors of cancer. Kept at home as long as possible, but at one point had to transfer to a nursing home for end of life care (given a month to live). Passed away within a couple of weeks there. Tested for COVID which of course tested as positive. Death certificate listed COVID complications.

 

[EastonBlues22]

A relative of mine from a small rural IL area had advanced Alzheimer's disease, liver disease, kidney disease, COPD from smoking, and a couple flavors of cancer. Kept at home as long as possible, but at one point had to transfer to a nursing home for end of life care (given a month to live). Passed away within a couple of weeks there. Tested for COVID which of course tested as positive. Death certificate listed COVID complications.

I'm sorry for your loss.

 

[EastonBlues22]

With regards to the mortality rate discussion:

There's research that the mortality rate, at least in the US, is actually underestimated as opposed to overestimated. There are a number of other studies as well, like THIS one. Here's another article discussing the matter (again, for the US). The CDC has its own excess death data for public consumption HERE.

I think it's difficult to pin down an exact number, but I do think the evidence generally supports that the mortality data isn't being dramatically overstated, as has been proposed in some circles.

It bothers me that healthcare has become such a partisan issue in this country. It also bothers me that there are so many who would exploit those who need trustworthy guidance/information (to make informed choices on these important topics) simply so they might further their own agendas and ambitions.

 

[Ranksu]

It take only 4 days Trump be 'cured' from covid-19.

 

[Ranksu]

Worldwide:
Total Cases: 44,738,099 (+500,796 today)
Active Cases: 10,858,527
Critical Cases: 81,140
Deaths: 1,178,513 (+7,090 today)
Recoveries: 32,701,059

 

[Ranksu]

@Stupendous Yappi How would look USA covid-19 cases if they would go Sweden model?

 

[Stlblue50]

To this point, there have been cases where someone died with COVID, and it was considered a COVID death, when they didn't die from COVID. And to the point that @Thallis made about more deaths than average, maybe the COVID environment has resulted in that, but why would we associate increased homicides with COVID.

Personally, I look at the death numbers as more of a range, even if they are 25% higher or lower, it's still a high enough number that we should care about.

Exactly, the CDC recently released a statistic that show only 6% of covid deaths had covid as the only cause for death.

Around 50% were in nursing homes and many states allowed positive covid patients into homes with patients who were negative.

With hospitals getting paid for covid deaths/use of ventilators and 94% of these deaths could have easily come from another condition or most likely preventable medical errors.

 

[bleedblue1223]

Exactly, the CDC recently released a statistic that show only 6% of covid deaths had covid as the only cause for death.

Around 50% were in nursing homes and many states allowed positive covid patients into homes with patients who were negative.

With hospitals getting paid for covid deaths/use of ventilators and 94% of these deaths could have easily come from another condition or most likely preventable medical errors.

There was always going to be multiple factors in the deaths though, so that's not out of the ordinary. When my grandma passed before COVID started, it was really just old age, but as one thing shuts down, another shuts down, and another shuts down. In cases like that pneumonia becomes pretty common. I'm sure COVID played a significant factor in the vast majority of the deaths, but that doesn't mean there are plenty of examples out there where someone simply died with COVID. Inconsistent standards has been one of my issues throughout all of this. Seems a lot of us still don't really know what to do in certain situations or groups/organizations/schools/etc. don't know exactly what to do. Way too much winging it.

 

[EastonBlues22]

Exactly, the CDC recently released a statistic that show only 6% of covid deaths had covid as the only cause for death.

Around 50% were in nursing homes and many states allowed positive covid patients into homes with patients who were negative.

With hospitals getting paid for covid deaths/use of ventilators and 94% of these deaths could have easily come from another condition or most likely preventable medical errors.

That 6% statement doesn't mean the other 94% of the deaths weren't caused by Covid. That's a misunderstanding that has taken root because of misleading information, and a general lack of knowledge among the public about how Covid's pathology works and how causes of death are determined.

 

[Stupendous Yappi]

That 6% statement doesn't mean the other 94% of the deaths weren't caused by Covid. That's a misunderstanding that has taken root because of misleading information, and a general lack of knowledge among the public about how Covid's pathology works and how causes of death are determined.

But there are incentives baked into the system for the person who declared cause of death, for their institutions etc, to benefit by listing Covid. Federal monies are involved, for example. There are enough shameful anecdotes of ludicrous reports to realize there is bias occurring. On what scale? I think the truth is obscured beyond hope of ferreting it out now.

I don’t have an argument, just making the observation. Ultimately people can pull the statistics that support their deeply held opinions and cast doubt on the others. That practice is almost the exact antithesis of science, the scientific method.

 

[Ted Hoffman]

But there are incentives baked into the system for the person who declared cause of death, for their institutions etc, to benefit by listing Covid. Federal monies are involved, for example.

Then why aren't huge numbers of deaths - I'm talking at least half of all deaths, probably upwards of 90% or more - mentioning COVID in the cause of death section of every death certificate? Health care providers don't pass up any chance to squeeze money out of anyone who will pay up; they sure as hell won't pass it up from the federal government when they feel like they've getting their balls squeezed for years on Medicare reimbursements.

There is a 20% premium for Medicare payments if COVID is diagnosed, passed in the pandemic relief package - but again, if this were being abused, vast numbers of people on Medicare who showed up for treatment would "magically" have COVID so providers could cash in. There's no evidence of that.

 

[EastonBlues22]

But there are incentives baked into the system for the person who declared cause of death, for their institutions etc, to benefit by listing Covid. Federal monies are involved, for example. There are enough shameful anecdotes of ludicrous reports to realize there is bias occurring. On what scale? I think the truth is obscured beyond hope of ferreting it out now.

I don’t have an argument, just making the observation. Ultimately people can pull the statistics that support their deeply held opinions and cast doubt on the others. That practice is almost the exact antithesis of science, the scientific method.

Indirect (excess death analysis) and direct (reporting) measures largely agree on the general scope of the mortality impact of Covid-19, so that fairly strongly suggests the "anecdotal" evidence (which is easily the least scientific of all evidence, and which is literally the antithesis of the scientific method) of abuse isn't significantly skewing the reported data.

Just because there are people who would muddy the waters doesn't mean the truth is hopelessly obscured. It just means that you have to dig a little harder to get to the facts (as best we know them). There might be disagreements about what those facts mean and what should be done in light of them, but there is good underlying information out there that we can work with.

 

[Stupendous Yappi]

Indirect (excess death analysis) and direct (reporting) measures largely agree on the general scope of the mortality impact of Covid-19, so that fairly strongly suggests the "anecdotal" evidence (which is easily the least scientific of all evidence, and which is literally the antithesis of the scientific method) of abuse isn't significantly skewing the reported data.

Just because there are people who would muddy the waters doesn't mean the truth is hopelessly obscured. It just means that you have to dig a little harder to get to the facts (as best we know them). There might be disagreements about what those facts mean and what should be done in light of them, but there is good underlying information out there that we can work with.

I am also going by direct observation of what I’ve witnessed in my own local institutions and the behavior of some peers. I know first hand this is happening. I do not know how prevalent it is. Maybe it’s extremely rare and I’ve had unusual experiences. I can easily understand the incentives for fraud. I’ve read reports of similar behavior elsewhere.

I don’t have much energy for arguing any point here. I was more just sharing my experience and my opinion about the (lack of) quality of the data.

 

[Ted Hoffman]

I am also going by direct observation of what I’ve witnessed in my own local institutions and the behavior of some peers. I know first hand this is happening. I do not know how prevalent it is. Maybe it’s extremely rare and I’ve had unusual experiences. I can easily understand the incentives for fraud. I’ve read reports of similar behavior elsewhere.

I don’t have much energy for arguing any point here. I was more just sharing my experience and my opinion about the (lack of) quality of the data.

Not aiming this at you. There's a saying along the lines of everyone thinks they're honest, it's everyone else who's scamming the system. Are there incentives for fraud? Of course, especially right now. But if it were even semi-widespread, logically one would expect someone to be stepping forward to say hey, I know we're screwing the government over by coding everything under the sun as COVID - here's the receipts to prove it.

This is aimed at you, though. If you know first hand this is happening, don't you have a responsibility to your fellow taxpayers to blow the whistle and say something?

 

[Blueston]

I am also going by direct observation of what I’ve witnessed in my own local institutions and the behavior of some peers. I know first hand this is happening. I do not know how prevalent it is. Maybe it’s extremely rare and I’ve had unusual experiences. I can easily understand the incentives for fraud. I’ve read reports of similar behavior elsewhere.

I don’t have much energy for arguing any point here. I was more just sharing my experience and my opinion about the (lack of) quality of the data.

As the adage goes, the plural of anecdote is not data.

 

[Stupendous Yappi]

Not aiming this at you. There's a saying along the lines of everyone thinks they're honest, it's everyone else who's scamming the system. Are there incentives for fraud? Of course, especially right now. But if it were even semi-widespread, logically one would expect someone to be stepping forward to say hey, I know we're screwing the government over by coding everything under the sun as COVID - here's the receipts to prove it.

This is aimed at you, though. If you know first hand this is happening, don't you have a responsibility to your fellow taxpayers to blow the whistle and say something?

Why do you assume I haven’t spoken up? But the first step is trying to correct the person’s behavior. Contacting federal authorities isn’t really the place to start.

And I’m not submitting my experience as “data” (to respond to other posts). That’s why I didn’t even mention it in my initial comment. But the notion fraud was occurring at all was challenged, and I think that’s naive based on what I’ve seen with my own eyes.

What many probably don’t understand is that these small community hospitals are under tremendous financial pressure and have been damaged greatly by measures to respond to Covid. This particular hospital was virtually shut down, no real urgent care, no procedures, multiple units converted to Covid units that were partially utilized at best. People furloughed and laid off. It’s easy to see how someone would rationalize fudging things to try to eke out a little more revenue. I’m not excusing misconduct, but I’m sympathetic to the stresses.

My own clinic laid off two physicians among other cuts, the two newest (including me), due to disastrous finances through the pandemic. I’m fortunate my specialty is in high demand, so I was able to find other options, but these types of moves by health systems were unheard of prior to Covid.

 

[Stlblue50]

Throw in the health care system as a whole in the US being run on the theme of money, money, money. It tries to suck as much money out of a patient or insurance company that comes in as possible.

With less people going into hospitals for non covid conditions......

 

[bleedblue1223]

How hospitals received funding from COVID was really just political maneuvering to try and keep as many hospitals to stay afloat as possible. My last job implemented ERP systems at hospitals, I happened to be on a lot of rural ones, and every single one of them had major cash flow issues, more than a handful were going through a takeover from a holding company. A level of questionable reporting to keep hospitals open was always going to be inevitable. I don't think people that aren't close to the situations realize just how bad the financial situation is for many hospitals.

 

[Celtic Note]

How hospitals received funding from COVID was really just political maneuvering to try and keep as many hospitals to stay afloat as possible. My last job implemented ERP systems at hospitals, I happened to be on a lot of rural ones, and every single one of them had major cash flow issues, more than a handful were going through a takeover from a holding company. A level of questionable reporting to keep hospitals open was always going to be inevitable. I don't think people that aren't close to the situations realize just how bad the financial situation is for many hospitals.

Are you talking about for profit hospitals? The big non for profits didn’t seem to have those problems pre Covid.

 

[bleedblue1223]

Are you talking about for profit hospitals? The big non for profits didn’t seem to have those problems pre Covid.

Smaller rural hospitals, I'd have to go back and look if they were for or non profit. I just view how hospitals received funding from COVID as a necessary issue for issues on reporting because of how inept our government ended up being on providing funding to ensure that hospitals wouldn't have to worry about the financial side of things. If bad reporting ended up happening, it was necessary to ensure financial viability through the pandemic.

 

[Stupendous Yappi]

Are you talking about for profit hospitals? The big non for profits didn’t seem to have those problems pre Covid.

I read it as he’s talking about smaller regional hospitals, like the ones I’ve been discussing. It’s a disaster for the local community if they shut their doors. One of the consequences of the Affordable Care Act was that the economics of scale are much stronger, and the pressures to consolidate into large healthcare entities are stronger. Unfortunately, small hospitals absorbed by national for-profit entities does not correlate with a higher standard of care. Decisions are made in the interest of a national shareholders. Not much incentive to sacrifice profit for better (but less profitable) services. Local communities have to be grateful for what they can get.

 

[bleedblue1223]

And those hospitals tend to have to pay a premium for doctors.

 

[Celtic Note]

Throw in the health care system as a whole in the US being run on the theme of money, money, money. It tries to suck as much money out of a patient or insurance company that comes in as possible.

With less people going into hospitals for non covid conditions......

Outcome based healthcare has taken the backseat to throughput. It’s still important, but not the priority for the health systems (the doctors and nurses don’t tend to share that line of thinking). Even the more renowned institutions have moved to that turnstyle model and the doctors are being hamstrung by the administration frequently.