As this phase of the pandemic evolves, many of the divisions it has exposed remain and yet more surface. In a diverse population some of these are to be expected, but many are based on mis-interpretation of data resulting in misinformation, or what can be called “alternative facts”
This latest one is based on, to a degree at least, a misunderstanding which I feel well placed to clear up. It is the oft repeated notion that only a small fraction of deaths involving COVID are actually caused by it. For me, this shows how easy it is to be duped.
Whats it about?
A recent response to a Freedom of Information (FOI) request to the Office of National Statistics (ONS) has been hitting the web, proclaiming loudly that “only” 6,000 people have died of COVID19 in England and Wales. For those who want to jump on this bandwagon, the data is interpreted as showing how the pandemic is one big hoax and the 155,000 deaths an “extraordinary lie”. This then is amplified by social media with the usual hyperbole:
“The of the lies and propaganda over the past two years is unprecedented, and it looks like it’s all about to come out in the wash”. Er…not quite………..
This was also picked up from the ONS data by John Campbell, the You Tube sensation whose avuncular style had created a huge on line following, but who also gets this horribly wrong. He describes the findings a “quite profound”. For me, they are hardly surprising. Let me explain why.
The reality….
The FOI request asked the question “Please supply deaths caused solely by covid 19, where covid is the only cause of death..” The answer came back that indeed, about 6,000 people have died with only COVID19 written on their death certificate, that is, people who were otherwise perfectly fit before falling ill. In itself I find this rather sad, 6,000 deaths in people at no risk whatsoever is in itself really tragic.
But what about the other 149,000 deaths – are they just a hoax? Indeed not. They are simply people who had another condition contributing to their demise, as this graph from ONS shows.
The vast majority of people who succumb to COVID also have something else contributing to their demise; diabetes, hypertension, obesity and a whole host of other diagnoses we pick up as we go through life.
For example, while considering myself fit, if I were to die of COVID19 then it would be likely I would have MS included on my death certificate. I would not be one of the 6,000, however directly COVID would have caused my death.
Death Certificates
The image below shows a death certificate used in the UK. While their completion can at times be a little haphazard, they are designed to capture information on any disease the deceased person might have suffered. In my experience of having filled in hundreds of them, it is an uncommon experience indeed to have only one cause of death on the form.
This is because they include the direct cause of death, diseases which led to but didn’t directly cause the death and other contributing conditions.
So the majority of deaths caused by COVID will also feature a host of other associated diagnoses as shown in the bar chart above. The 6000 with no other conditions at all being a small percentage of the total is thus completely expected.
In other words, this latest hoax about a non-hoax is at best due to a simple lack of understanding of death certification, more likely due to enthusiasm to bolster fringe ideas, and of course, occasional mendacity.
Deaths due to or involving COVID19.
Of course there will be people in whom a positive test result is associated with death and not its cause. The ONS have tried to quantify this with the following results:
The majority of deaths with COVID on the death cert were actually caused by COVID.
Indeed, contrary to all this, when looking at total mortality data, the global figures for COVID deaths are likely to be a significant underestimate with up to twice the official death toll being caused by COVID19. Thats another story.
In Short.
The Pandemic is a sad business, it has caused so much direct and indirect misery in an already dysfunctional society. For me it is also a sad matter that there are those out there who genuinely think that it has only killed a relatively small number of people and that the death toll is nothing but a hoax. For me, the fantasy this belief creates is another pandemic pathology.
I completely understand that government as we experience it hardly engenders a sense of trust, far from it. But applying that sense of suspicion to real data has to be done with some discretion to avoid spreading damaging misinformation – this matters. I hope this post will have explained the reality behind this latest myth.
If you have managed to get this far, thanks for reading the post. If you have any comments or questions, then feel free to leave them in the box below and I will respond as soon as I can.
Till next time, I wish you the best of health.
Thanks for the clear explainer, Colin. The ONS gave an accurate reply to a specific question. Too bad the questioner hadn’t understood the precise nature of their own question!
Thanks Jackie. I do agree. The answer did not surprise me at all, indeed, the loss of 17,000 perfectly fit people to COVID is terribly sad and a burden for their families and friends. Shows how publications can go wrong without the help of an editor to say, ‘hang on, have you got this right?’
https://www.who.int/classifications/icd/Guidelines_Cause_of_Death_COVID-19.pdf
“2. DEFINITION FOR DEATHS DUE TO COVID-19 A death due to COVID-19 is defined for surveillance purposes as a death resulting from a clinically compatible illness, in a probable or confirmed COVID-19 case, unless there is a clear alternative cause of death that cannot be related to COVID disease (e.g. trauma). There should be no period of complete recovery from COVID-19 between illness and death. A death due to COVID-19 may not be attributed to another disease (e.g. cancer) and should be counted independently of preexisting conditions that are suspected of triggering a severe course of COVID-19.”
Is this not followed in the UK?
If it is, is this the same reasoning that is used with other illnesses?
Am I to infer from that paragraph that everything, baring blunt force trauma and cancer, should be recorded as COVID-19? Or is it just my suspicious mind?
No, the WHO guidelines which do not apply here. They are guidelines. The Coronavirus Act 2020 defines how death certification had changed to allow less direct contact with the certifying doctor, but not much has changed really. HMG’s dashboard make the distinction between deaths following a positive test and those where COVID caused or contributed to death according to the death certificate which is filled in to the best of the doctors ability. I trust the latter more.
So is there some kind of table comparing both underlying v contributing causes of death with covid, against the other most prevalent causes of death?
Some of the ISARIC data is good at looking at the risk of death after admission according to other health parameters. Have a look here:
https://isaric4c.net/risk/v1/
Outcomes in terms of death and other causes of death can be found in the ONS.
Nicely explained, I watched that video and thought it was too shocking to be without a caveat or two, especially the low death rate part, but also the average age of death, which was 82 (wouldn’t that mean there were probably some people over 100 years old to get the average so high?).
Can you do an explainer article on why Pfizer requested that it’s vaccine trails be kept secret by the FDA for 75 years?
Pretty bad. Thats corporations for you! I do think they should release the raw data, but unlike the Tamiflu fiasco, there has been an avalanche of subsequent real world data which is far more important and encouraging.
I’m totally convinced by your article, and the wording used when talking about Covid deaths, as X people with Covid on their death certificate ie not the only cause written on the certificate. Sadly I don’t think that this will change opinions of the conspiracy theorists. However it does give me better information with which to counter the argument!
Thanks Sue. I agree and do think its a bit harsh to minimise the hardship of those who have been hit by COVID