Why the From or With Argument for Numbering COVID-19 Deaths is Flawed

Some people are suggesting that the numbers of deaths due to COVID-19 is inflated and not representative of the true number. They make the argument that these numbers don’t differentiate between those who died from versus with COVID. This argument is flawed because those making it demonstrate their ignorance on how deaths are certified in the US.

As a doctor who sometimes signs death certificates, let me explain how it is done. On the death certificate, an immediate cause of death is listed as well as those conditions that contributed to it. For example, it may be certified that a patient died from respiratory failure and COVID listed as a contributing factor. Respiratory failure is not a stand alone cause of death. There must be a certified cause for it. What this means is that the patient died from respiratory failure caused by COVID-19. There is no from or with on death certificates.

Why don’t we just list COVID-19 as the cause of death? Because it is important to know what COVID patients are dying from. COVID can cause pneumonia, strokes, pulmonary embolisms, respiratory failure, cardiac arrythmias and much more as we are learning. How would we know what is the way most patients with COVID are dying? We need to know so that we can prevent these results.

Some people suggest many of the people who died in the US died from other causes but were just coincidentally infected with this virus. So, what is causing the sudden spike in deaths we are seeing? Coincidence? No, experts: doctors, nurses, public health experts are all seeing the direct ravages of COVID. We are seeing people die because of it. Doctors don’t want our patients to die. However, we see directly how COVID is killing some of our patients.

As we watch, the numbers continue to rise. Perhaps, instead of making flawed arguments we should all be trying to help reduce the numbers by wearing masks, physically distancing ourselves from others, and frequently washing our hands.

Many patients have survived COVID. While this is a good thing, we need to know that there are those who have not. People all over the world are dying because of this pandemic. We can’t wish away their deaths or hide them under insignificant terms: from or with. You may make this argument but know that there is no such thing in the world of medicine, or reality.

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One thought on “Why the From or With Argument for Numbering COVID-19 Deaths is Flawed

  1. Counting things precisely has always been somewhat flawed, whether our Constitutionally mandated census or how much we really owe the IRS each year or the true prevalence of HIV in America. Some things are better done by sampling. What’s different about Covid-19, though, unlike the census though maybe not IRS liability, is that some secondary gain, usually political, exists for not having a correct count. Therefore whatever figures are proposed will be attacked. That’s probably OK, or would be if the skeptics of the data would be required to propose better data, which of course they aren’t.

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