As reported previously, and increasingly confirmed by physicians around the world, the pattern of mortality is the same this year compared to previous history. For example, in Italy, the median age of those dying with the virus is 84, and more often males than females, with deaths rarely in younger age groups.
The virus is there along with one or more of the usual comorbidities: cancer, heart disease, arteries, chronic lung disease, and so on. Some Italian doctors have lamented that some patients who normally would have gone into palliative care in their nursing homes have instead died on ventilators in an ICU.
Andrew McCarthy writes at National Review The Problem with New York City’s COVID-19 Death-Rate Estimates
Still, quantifying fatalities and the mortality rate remains elusive. Case in point: New York City. As the New York Times reported yesterday, Gotham’s Health Department abruptly added 3,700 victims to the COVID-19 death toll even though these decedents were not tested.
Despite the lack of coronavirus diagnoses in these cases, the inference that it was a factor in death (or, as the city insists, the proximate cause) is not irrational. The Health Department says that 3,000 more people died in the last month than would ordinarily have been expected in the City this time of year. The City has been vexed by the sparse availability of testing. By counting only people who had tested positive, it was surely undercounting COVID-19 deaths to some degree.
But to what degree? We really don’t know. In truth, we will never know beyond educated supposition.
City health officials deduce that some of the spike in “excess deaths” is only indirectly attributable to the coronavirus. On this theory, COVID-19 infections so overwhelmed the health-care system that some non-infected people are assumed to have died of conditions that would otherwise have been treatable.
Meantime, health officials have been tracking deaths they’ve hypothesized could have been related to the virus, based on symptoms and medical history. But what does that mean? Was the coronavirus present in the decedents (unconfirmable because they weren’t tested)? Are health officials saying COVID-19 was actually the proximate cause of death? That it may have exacerbated underlying health problems? That such comorbidities would not have killed the decedents but for the (unconfirmed) presence of COVID-19?
New York City is dysfunctional, but this is not a New York issue. The guesstimating is being done at the express invitation of the federal Centers for Disease Control.
The CDC instructs officials to report deaths as COVID-19 deaths whenever the patient has either tested positive or, despite the absence of a test, presents circumstances from which presence of the infection can be inferred “within a reasonable degree of certainty” — such that its contribution to death is “probable” or may be “presumed.” This is drawn from CDC guidance, which directs that COVID-19 be specified in death certificates whenever “COVID-19 played a role in the death.”
Who knows? The fact is, they are just making estimates. But, as the Times computes it, this estimate has suddenly increased the overall U.S. death count from COVID-19 by a whopping 17 percent. And if the Big Apple is going to cook the books this way, what is to stop Newark, New Orleans, Philadelphia, Boston, Chicago, Detroit, Los Angeles, and the rest?