Per wrote: ↑Fri Sep 18, 2020 12:48 am
Did you read this part of the medpagetoday.com article you linked to?
Several groups with different agendas have been working to undermine public confidence in the credibility of the COVID-19 death count in the U.S. Their efforts will intensify as the numbers continue to rise.
The death count is a moving target, and news accounts often pit well-meaning doctors and scientists trying to gather the data in rigorous ways against politicians and activists who want to skew the numbers to support foregone conclusions. The death toll from COVID-19 isn't likely to be accurate until years from now when we will have the luxury of looking back at the deaths happening right now in this country and comparing those numbers with those of previous years.
The disparity is called excess mortality. We are starting to get the first reliable data examining excess mortality. In a recent report in JAMA Internal Medicine, the number of U.S. deaths due to any cause increased by approximately 122,000 from March 1 to May 30, 2020. That's 28% higher than the reported number of deaths over those same months in previous years and much higher than officially reported COVID-19 death rates for that period. We are certainly undercounting, not overcounting, the victims of this slow-motion disaster.
Just saying.
Per -- excess mortality is a very important statistic. We can't know how many death would have occured in a counterfactual world, but we can have an idea of the expected range. This article points to one year, and we don't have enough detail to know what the standard distribution is from that one year, but let's assume that this increase is statistically significant.
You know what "excess mortality" it doesn't tell you? Increased deaths caused by COVID vs. increased deaths caused by the response to COVID. If you ban or limit access to "voluntary procedures," as was done in many US states and many nations, then you are going to see some kind of adverse health impact from this. If people with heart attack symptoms are less likely to go to the hospital (which appears to be the case, see this NYTimes article from May
https://www.nytimes.com/2020/04/06/well ... troke.html), then they are more likely to die from heart attack. CDC survey data show that mental health problems are considerably on the rise (e.g.,
https://www.cdc.gov/mmwr/volumes/69/wr/mm6932a1.htm), and it stands to reason that when the numbers are unpacked, we will see an uptick in deaths from suicide and overdose. These are not due to COVID, but they are due to the response to COVID, both the limitations on access to health care and the unreasonable fear that people have had of the disease. (When I say unreasonable, I don't mean it can't be dangerous, I mean as compared to the risks presented by other health challenges).
More than that, there will be a long tail to these health-health tradeoffs. Many of the voluntary procedures are diagnostic or preventative. If someone doesn't get a stent, they are more likely to get a heartattack. That's why people get stents. If people don't get colonoscopies or mammograms or go to their regular doctor visits where blood screens or other tools identify a need for pharmaceutical treatment or specific diagnositc procedures, their cancers and other conditions will be diagnosed at a later time. And we know that with many diseases, early detection can be the difference between life and death. Point is, there are people who will die because they found out they had something 4 or 6 months after they would have otherwise found out, and that's going to be a death that will occur many months or years from now. We won't know for certain that particular deaths were related to the COVID response, but we will know there will be many. And in countries where there is a lack of supply of diagnostics -- every country by particularly those running single payer health systems where cost savings are achieved by efficiency -- they are going to queue up people, meaning *everyone* will suffer an unusual delay as the people who didn't get tests for months are eligible once again to get them. Put differently, even when COVID goes, so long as the queue isn't caught up, people will suffer adverse health consequences from the COVID response.
The health-health tradeoffs from the COVID response is one of the most underappreciated aspects of what's been going on the past 6 months. The inattention to health-health tradeoffs borders on scandalous. Politicians and public health have been primarily addressing the question "how do we reduce the spread and serious health consequences of COVID" instead of the question (from the public health perspective) "how do we set public policy to maximize health" or (from the politician's perspective) "how to we set public health policy to maximize the common good" (which considers quality of life as well as life itself).
Of course, when these late-diagnosed cancer patients die, people will probably say they were caused by COVID. The author of what you quote makes this elementary mistake. But the public policy response is a choice, not the contagion itself or an act of God or the Chinese Communist Party
. They are the product of people making difficult choices made all the more difficult by asking the wrong questions.
