Well, of course, he’s only a physician.
Sunday, May 31, 2020
In case you wondered …
… COVID deaths – how accurate are the statistics? | Dr. Malcolm Kendrick. (Hat tip, Dave Lull.)
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Kendrick is not a physician qualified to review the numbers.
ReplyDeleteThe report he links to, for his information is this one: Covid-19: “Staggering number” of extra deaths in community is not explained by covid-19.
Sir David Spiegelhalter, chair of the Winton Centre for Risk and Evidence Communication at the University of Cambridge, the one who is qualified to review statistics (indeed a statistician), said that "many" of the dead are those: “who may well have lived longer if they had managed to get to hospital.”
These deaths are not due to any imposed "lockdown." Anyone dying at home has always been free to get to the hospital and fast. No. These are deaths that would not have happened if there were no Covid-19 virus going around -- people who did not go to the hospital who were having heart attacks, for instance -- the ones who did not know they were dying. This may be what people who miss the point do not understand, that death is so often sneaky deadly. It takes us when we do not expect it.
Once the pandemic got going, there was nothing health care policy could have done one way or another to save them. We could have been better prepared for sure, then we could have been bettered organized absolutely, however, and saved some precentage of them, by making it safe to go to the hospital.
We don't say, "But unless we have accurate data, we won’t know which has killed more: the disease or the lockdown," as the misconstruing doctor does, who for crissakes should get back to treating people and stop trying to be an epidemiologist. What we say is that Covid-19, in addition to taking lives directly, by infecting people and killing them, has also killed many who thought it imprudent to go to the hospital, but would have been welcome if they had, and in the end should have.
As a fairly typical heart attack patient myself, who did not know he was having one, I flatlined dead in 2003, and otherwise would have died at home, if I had not gone to the hospital for what I thought was a pulled shoulder muscle. I only went to get something for the pain so that I could go to work the next day. Heart attacks kill by surpise. Death "surprises" diabetes and cancer victims as well. People right now, as I write, are staying home with all sorts of deadly diseases, glossing over symptoms -- because just to go to the hospital or doctor's office, is to interact with others.
It is the people who are weighing the risks, who always do. Put another risk in front of them, like a war, wild animals on the loose, or a deadly pandemic, and the Benjamin Franklin weighing of the positives versus negatives, tips to the side of staying home, or at least not going to the hospital.
Here is another quote from the BMJ source article: "David Leon, professor of epidemiology at the London School of Hygiene & Tropical Medicine, agreed. 'Some of these deaths may not have occurred if people had got to hospital,' he said. 'How many is unclear. This issue needs urgent attention, and steps taken to ensure that those who would benefit from hospital treatment and care for other conditions can get it.'"
That's the epidemiologist's question, what ought to be any informed physician's question -- and it has nothing to do with "lockdown". If people are staying away from hospitals because of a deadly pandemic, maybe "Zoom" doctor's appointments could be more prevalent, completely replacing telephonic appointments, and set up in doctor's offices where they are unavailable now, getting the skills needed to the physicians to take care of patients this way -- then advertised heavily to the public, to make it a new normal. It's got to be something more than that, though, surely, for health care to serve the ill in times like these, but that's one track to go down.
As a practicing physician, I should think he would understand the numbers better than a mere lay person. Experience and context do tend to count.
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