In Illinois, it's pretty cut and dry:

""If you were in hospice and had already been given a few weeks to live, and then you also were found to have COVID, that would be counted as a COVID death. It means technically even if you died of a clear alternate cause, but you had COVID at the same time, it's still listed as a COVID death. So, everyone who's listed as a COVID death doesn't mean that that was the cause of the death, but they had COVID at the time of the death." Dr. Ezike outlined." -- Dr. Ngozi Ezike, Director of Illinois Department of Public Health

I'm sure the tens of deaths that happened like this really changed the statistics in a meaningful manner.

The point is that until it's well-defined, we don't actually know, so people will wiggle in doubt if they want to.

Poor definitions enable people to present the data differently depending on their biases and agendas. We should want to prevent that not by grounds of "you're crazy," but by making the definitions non-interpretable.

Does that come up a lot? How many people are currently in hospice in the state of Illinois with a few weeks to live?

There have been a lot of excess deaths in 2020. It seems reasonable to guess those people died of either COVID-19 or our response to COVID-19 (eg reluctance to seek medical treatment). None of these mortality statistics are perfect, but given the fairly short window of a mild COVID-19 infection, it seems pretty reasonable as a first approximation to assume that if they had it when they died, they died from it. There might be some cases where this is wrong (died of severe trauma during a car wreck in which they were a passenger rather than a driver) or questionable (the hospice case) but how much do those really affect the overall numbers?

Illinois averages 300 deaths per day from all causes, so if 3%-5% of all Illinoisians are COVID+, that error starts to add up.

Meh. The excess deaths are a lot more than 3%–5%. In a super quick search: "From Feb. 2 through July 25, Illinois had officially recorded 10,252 more deaths than typically would be expected" [1] => 59 per day. If 300 people died per day (your stat) and 5% of those were misattributed to COVID-19 because they were tested and happened to have a harmless COVID-19 infection (this is a silly upper bound), that's only 15 misattributed out of the 59, so at least 75% are correct. That's already good enough to use for setting policy IMHO. In reality, I doubt everyone who died was even tested, so I think more error lies in the other direction.

[1] https://www.chicagotribune.com/coronavirus/ct-dataviz-corona...

It's pretty hard for to decide how to interpret that, because it sounds like the guy is arguing that the statistics about Covid deaths are really bad and their way of registering a Covid death is completely stupid and therefore it is silly to think there is as bad a situation around the pandemic as you might otherwise suppose - on the other hand the guy who is telling me this is the "Director of Illinois Department of Public Health " and as such most likely responsible for the completely stupid way of registering the Covid deaths.

The average time people live in care homes for elderly with extra care needs ("särskilt boende") is between six and nine months[0]. That's where most of the deaths happened at least in the spring. So most of the people in those homes would be dead now anyway, and if they died from covid or from something else while they had covid is up for debate.

Edit: Maybe hospice is the best translation for särskilt boende.

According to one investigation [1] among people who died outside of hospitals 15% died directly from covid, 70% had other comorbidities, and 15% died from something else while they had covid.

[0] https://gupea.ub.gu.se/bitstream/2077/40037/1/gupea_2077_400...

[1] https://lakartidningen.se/aktuellt/nyheter/2020/08/covid-19-...

So, your not arguing that people didn't die from Covid19, just that you think those people weren't expected to live for much longer? The implication being we shouldn't care so much because someone died only a year earlier?

It seems reasonable to create a statistical analysis based on years of expected life lost -- but that still doesn't mean people aren't dying from Covid19.

Aside, slightly tangential: Back in Feb/March BMJ had some controversy about UK government hiding excess Winter deaths in flu statistics. The implication being that the gov were taking more deaths over Winter and saying it was flu when in fact the deaths were more related to poverty (no heating, little food). Next thing we know people are saying Covid19 want a problem because it wasn't even as bad as flu (though at the time is was killing far more people as a proportion of those infected). Lies and statistics, and all that.

I'm arguing that the comparison with AIDS that someone else made is an inaccurate one, since AIDS can shorten the life of someone that was healthy before they got it. Nobody in a hospice is healthy, and a large part of the ones that died with or by covid would have died within 30 days anyway.

If that were all there is to Covid, the excess mortality in Q2 should have been compensated by a reduction in Q3. While we do see such a reduction for Q3 in the numbers for Stockholm (which I cited in a sibling comment), it's too small to balance the tally.

It's not all there is to covid, but I think it's still worth observing. I mentioned in another comment that the total number of deaths in Sweden in 2020 up to November 1 is 3000 more than average the same period during 2015-2019. That's about half of the total number of official covid deaths.

> So, your not arguing that people didn't die from Covid19, just that you think those people weren't expected to live for much longer? The implication being we shouldn't care so much because someone died only a year earlier?

I don't think this is what they're saying. I think the point is that those people's actual times of death weren't far enough from their expected times of death given their preexisting conditions to be able to confidently say that they died of Covid, rather than just having died with it. In other words, that there's a good chance they would have died at the exact same time even without Covid.

That's not how "cause of death" works. Doctors/Coroners don't just pick a cause randomly they look at how you died and actually investigate it if it can't be readily determined.

Presumably you think doctors have always been lying about cause of death? What do you think their motivation for that is?

> 70% had other comorbidities

They still died of CoVID-19. A lot of people have heart disease, or diabetes, or are overweight, or have any number of other conditions. If they get CoVID-19 and die, you can't just write that off because they were overweight.

It wasn't just diabetes or being overweight, the article mentions heart disease, lung disease, and dementia. Half of them were 88 years or older. They died either in their homes or in hospice.

If you look at the official statistics for the whole country right now, 26% of all dead where 90 years or older, and 41% 80-89 years old. Most of them weren't just a bit out of shape, they were already sick.

I mentioned heart disease. Heart disease is very common, and nowadays, a lot of people live productive lives despite it. If someone is managing their heart disease and living their life, and CoVID-19 comes along and kills them, that's still a tragedy.

If they're managing their heart disease and living their life they're not living in a hospice, which the people in that particular study did.

And yet they're still at elevated risk of death if they get CoVID-19, which they probably will if a "herd immunity" strategy is followed. The frustrating thing is that many people will then downplay their death by saying they had a comorbidity.

In Stockholm County in Q2, there were approx. 2209 more deaths compared to the years 2015-2019. In Q3, there were approx. 310 fewer deaths compared to that timeframe. [1]

If I were a betting man, based on these numbers, I'd put my money on excess mortality once everything's been tallied, at least in that county.

[1] https://www.scb.se/en/About-us/news-and-press-releases/exces...

That's different from country to country. In Denmark hospitalizations are counted as covid hospitalizations for example, even if you arrive due to e.g. a broken leg, but you have covid. Not sure about deaths though.

Of course they are counted as Covid hospitalizations, because they requires the same special care as all other Covid cases - you can't just put a Covid-infected patient in the regular orthopedics ward, you need to quarantine them and all the staff that comes into contact with them.

Also, I doubt the amount of people suffering from broken legs are really skewing those Covid numbers. Most people sick enough to require hospitalization while also infected with Covid will have much higher risks of Covid-related symptoms as well.

Certainly it makes sense when talking about hospital capacity - but it does give a bit of a skewed impression when you're looking at the hospitalizations re: cases.

You'd be surprised. Around 1/7th of the covid hospitalizations in Denmark[0] are hospitalized for "other reasons" - where covid is not the primary factor - I'd say that is significant.

[0] - https://www.dr.dk/nyheder/indland/braekket-ben-fylder-i-cent... (link only in danish, sorry)

"Man who died in motorcycle crash counted as COVID-19 death in Florida: Report." I recall one similar in the UK. Meanwhile, in that area ... "Nearly one in 10 'virus deaths' was from other causes" according to the Telegraph.

We have multiple standards for each country (if not smaller governmental units) and the standards have changed, the testing has changed, etc. Statisticians will be decades puzzling it all out.

It's really only excess mortality we can count on right now.

The case you cite was from July 2020 and has been fixed [1]:

> It does appear to the case, however, that a motorcyclist who was killed in a traffic accident also tested positive for COVID-19, and was initially listed among Florida’s COVID-19-related deaths. But officials from the Florida Department of Health said that person has since been removed from the count.

I can't read the paywall'd Telegraph article but I think this [2] is the same:

> The ONS looked at nearly 4,000 deaths during March in England and Wales where coronavirus was mentioned on the death certificate. In 91% of cases the individuals had other health problems. The most common was heart disease, followed by dementia and respiratory illness. On average, people dying also had roughly three other health conditions.

So basically -- people's other health problems cause them to be more severely affected by a respiratory disease that has also been shown to affect the heart and brain [3]. That seems like an intuitive result, and the study backs it up.

> It's really only excess mortality we can count on right now.

The excess mortality will certainly show the bigger impact in the long term, but to imply COVID-19 death numbers are being artificially inflated or so grossly inaccurate that they're useless is irrational.

[1] https://www.snopes.com/fact-check/florida-motorcyclist-covid...

[2] https://www.bbc.com/news/health-52308783

[3] https://www.mayoclinic.org/diseases-conditions/coronavirus/i...

It's a good thing that I didn't imply they were being artificially inflated, then.

Someone stated that vehicular accidents are not being reported as COVID-19; I found a counterpoint. And I do not doubt that it is one of many. That is all.

It's science. Questioning the easy numbers is what you're supposed to do. You tear and kick at something that is "known" until you get sick of it and move on to something else. Similarly, we have just oodles of confounding factors for our statistics here and we should be acutely aware of it at every step. This is not a thing that rests.

Many many people die every day. If Covid is widespread, some are bound to have been infected with Covid.

Are you sure car accidents are not recorded as Covid, because I've read claims to the otherwise several times. It may not matter what the doctors think, if there are policies in place, or financial incentives (extra money for treatment of Covid patients).