“Just when I thought I was out, they pull me back in!”
Al Pacino—Godfather Part III
08/30/2020 COVID-19 update
I am sure many of you have seen posts regarding preexisting conditions and risk factors for Covid. Either 94% had a risk factor or only 6% had no other risk factors for COVID 19 death.
First things first—THIS IS COMPLETELY FALSE.
I will explain.
The confusion arose from an article from the CDC titled “Weekly Updates by Select Demographic and Geographic Characteristics
Provisional Death Counts for Coronavirus Disease 2019 (COVID-19).”
It is actually a very informative article. It goes through the various causes of death mentioned in the death certificate.
Table 3 Conditions contributing to deaths involving coronavirus disease 2019 (COVID-19), by age group, United States. Week ending 2/1/2020 to 8/22/2020.
The above referenced table classifies all the deaths according to what is on the death certificate. Eg: out of 161,392 covid deaths 35,272 death certificates also had hypertension on the death certificate. 20,210 had cardiac arrest. 25,936 had diabetes and so on and so forth.
6% of the deaths had only COVID 19 on the death certificate. The media reported it as only 6% of the patients affected had no risk factors or to say it another way 94% had at least one comorbidity. This is not what that table says at all.
To illustrate this let me give you an example.
52 yr old with no medical problems comes to the hospital with pneumonia and tests positive for covid 19. In hospital he has respiratory failure and is placed on a ventilator. While on the ventilator he develops a clot in his lungs and dies. The death certificate will be filled or should be filled like this.
First diagnosis: Pulmonary embolism (blood clot in lungs). Second diagnosis: pneumonia. Third Diagnosis: COVID 19.
This patient in Table 3 will be classified under respiratory diseases and other diseases of the circulatory system. So, even though he really did not have any risk factors coming in his death certificates reflects more than COVID 19 as a diagnosis and this is how it should be.
Some physicians in the above case may just put COVID 19 as a diagnosis without any qualifiers. These are the ones that were recorded as the death certificates with only COVID 19 as the diagnosis and part of the so called 6%. As I explained for the above patient, the 6% could be patients with no comorbities or with comorbities.
If you are 80 yrs old with Alzheimer’s and came to the hospital with pneumonia due to COVID and died with it then you died of COVID. On your death certificate the top line will be
Underlying conditions contributing to death is Alzheimer’s.
If you are 50 yrs old with no underlying medical problem and came to hospital with pneumonia due to covid and died. Then
Both will have the same damn death certificate.
Again to reiterate the table is not wrong, the way the media and politicians spun it is wrong. This table only shows the comorbidities mentioned in the death certificate. It does not mean these comorbidities were present before COVID and it does not discriminate whether the comorbidities happened with the COVID.
20,210 patients had cardiac arrest as a comorbidity. Come on guys, that by itself should tell you something. It’s not possible.
In short please, do not believe the posts that say only 6% of the deaths are patients with no comorbidities. The simple fact is we do not know.
Pradeep Arumugham is a Greenville, N.C., cardiologist and faculty member at East Carolina University. Used with permission.