Those in England dying 8 times as fast as most people?
August 23/24, 2020
This hasn't been observed anywhere else that I've seen, but that may be just because we've never had such a glimpse. If it's actually happening in England, it's probably happening widely in other places, if not quite everywhere. As we continue to understand this virus and who it kills vs. who survives, and how much infection we should tolerate or encourage, this detail might matter. The quality and durability of survival itself is in question. We'll need to learn more to say just who faces this danger to what degree, but we have another reason why avoiding SARS2/Covid-19 will continue to be the best option for quite a few of us.
Damage caused in survivors
An issue that's getting more attention lately is the bodily damage the virus does to survivors. Neurological damage is feared, besides injury to the kidney and liver, and the obvious lung damage. But perhaps the clearest and most relevant to the death toll is the cardiovascular complications. Some sources:
* Covid-19 Is Creating a Wave of Heart Disease: Emerging data show that some of the coronavirus’s most potent damage is inflicted on the heart. By Haider Warraich (a cardiologist.)
Recently I made some study of "excess deaths" in various nations that reveal the virus' true toll as much higher than accepted, almost certainly well over one million by now. Here again is my summary infographic, already a bit dated and with an Easter egg - I hid a copy of Nicaragua's observatory toll "on purpose" Can you find it?
A sort of confusingly-written article at MedicalNewsToday was one of few I found to explain how 35% of U.S. excess deaths were "not directly" caused by Covid 19, maybe meaning indirectly caused by it - A cited study "... also found that excess deaths not linked * to COVID-19 rose significantly in states that had the largest outbreaks of the disease during the virus’s peak in early April. These included Massachusetts, Michigan, New Jersey, New York, and Pennsylvania. For example, in these states, there were 96% more diabetes-related deaths than experts predicted. For heart disease, the figure was 89%; for Alzheimer’s disease, it was 64%; and for stroke, it was 35%."
* (does "not linked" mean not causally linked, or just that the cause went unnoted, "not linked" in peoples' minds?)
The study seems heavy on worries about lockdown and fear of hospitals causing many of the deaths, but this is dubious. There's little to no evidence I've seen for immediately life-saving procedures being cancelled, and I see little reason for most people to choose dying at home over risking infection at the hospital, no matter how overblown the danger might've been in their minds. What stands out for me is just what kills them. I'm not sure about how Alzheimer's kills, but the rest are cardio-vascular, just the kind of deaths SARS2/Covid-19 can cause with its attack on the circulatory system (which the article mentions). These types of death were all way above average, right where and when the virus was at its busiest.
And it seems Pennsylvania included some 6,400 of these deaths "not linked to COVID-19" as probable COVID-19 (but since de-listed them again.). See here how this tallied with excess deaths and the below-average baseline adjustment I employed to estimate even more than the near-13,578 they had been reporting:
Note at the end the purple boxes show a rise in overall fatalities well into the excess range, despite a slow decline in Covid-19 deaths. It's just speculation to suggest this reflects a lot of early deaths from damage among disease survivors (both known and unknown). What would help narrow it down is to see the cause-of-death breakdown, or seeing if these death occurred among those known to be infected - as we get to see in Engand.
England revision - cut at 28 days
Public Health England took an unusual track early on. Scotland, Wales, and Northern Ireland employed a standard where a death is counted as Covid19 if it follows within 28 days of confirmed infection. Anything later is just a regular death of a citizen who had once been infected. But in England, they kept counting deaths no matter how long after infection they occurred and - less clearly but as widely understood - no matter the cause. As a BBC report explains how the new method will provide "a more accurate picture of the epidemic," but stops short of calling the inclusions unwarranted, and even explains why they seemed relevant:
"Prof John Newton, director of health improvement at Public Health England (PHE), said: "The way we count deaths in people with Covid-19 in England was originally chosen to avoid underestimating deaths caused by the virus in the early stages of the pandemic." But he said the new methods of calculating deaths from the virus would give "crucial information about both recent trends and the overall mortality burden due to Covid-19".
The new method might exclude more crucial information than it reveals, but in the switchover, we get a chance to see a relevant trend regarding that slowly-swelling death toll.
Apparently deaths after recovery were noted in England as common enough to be connected. Maybe their larger populace and high infection rate made the issue more evident than in the other countries of the UK. However many follow-on deaths they noted, of whatever type, it was initially all in a small small time frame meant it was all relatively soon after, and perhaps most or all were vascular damage, something related.
As for when they decided this: not sure, but on the Bing tracker, I note a leap of some 4,000 deaths added on April 24, in the middle of the UK's long peak of deaths, where they lost around 800 a day or higher for nearly a month straight. However (add 8/24) I had heard this was when they added deaths in care homes to the count, previously just counting at NHS hospitals. I just did this comparison with ONS tallies broken down by locale. 4/24 is right where Bing's gray bars start covering the ONS's yellow ones, with gaps at weekends and catch-up spikes. The red and blue lines at the end show the revision in question (see below), and start at the 200-250 level as if including care homes, but maybe not private homes or "other."
So they were counting these delayed fatalities in England into the summer. But it seems they didn't sort by types of death, just listing all kinds, and it came to include some clearly not related - people who had the virus, then died in a car crash or fell out a window or anything. It's not clear that was the driving problem behind the change, however - the time frame alone seems most central. but such tainting of the data would seem to justify it. PHE removed some 5,377 listed deaths up to August 12 and promises to count less from here on out. The BBC report explains the changes:
"The new methodology for counting deaths means the total number of people in the UK who have died from Covid-19 comes down from 46,706 to 41,329 - a reduction of 12%. And figures for deaths in England for the most recent week of data - 18 to 24 July - will drop by 75%, from 442 to 111."
As this included some portion of unrelated deaths, this was taken by some as a clue to systematic overcounting the authorities admitted to, the tip of an iceberg. Peter Hitchens at the Daily Mail, for example, hailed the revision as revealing "an error of more than ten per cent, a huge admission" they were "forced into" by "the brilliant forensic work of Professor Carl Heneghan and his brave colleagues at Oxford’s Centre for Evidence-Based Medicine, which showed that the previous figures were so loose that they could have included car-crash victims who once tested positive for Covid." It could also include delayed deaths from covid's damage, but that kind of thing never troubles Hitchens, who took the lowered death toll (still likely "inflated"), and went on to suggest mitigation efforts including "lockdown" have killed 2 people for every 3 the virus has or, as the headline puts it "the wrecking of the economy and the state-sponsored panic of these times has killed more people than Covid ever did." (note using the past tense "ever did" for a virus that's still active shows the muddled thinking at work here). See also as needed: https://twitter.com/CL4Syr/status/1294885046990458882
But as the articles about the count change and about estimated lockdown deaths say:
* The official tally - even before the revision - was likely "a significant undercount of the true death toll," excluding deaths in care homes, private homes, and other places, and excluding likely-related "excess deaths." (The Guardian)
* The critical SAGE report affirms far more would have died "had restrictions not been put in place and the coronavirus outbreak allowed to run wild throughout the population." They say "lockdown" etc. took far less lives than it saved. (The Independent)
So this iceberg tip isn't even made primarily of ice (wrongly counted deaths that inflate the true toll). It probably included at least some bits of ice, but as I'll show below, the bulk of this almost has to be another reflection of how covid kills - a bit slower sometimes. And the credible sources agree the likely undercounting of deaths in other areas more than offsets any small inflation, even if none of the 5,377 removed deaths belonged. They were always undercounting the cost in lives, and just made it worse.
Scotland, Wales, and Northern Ireland already used a 28-day cut-off - so it could be they were undercounting and now the entire UK is. A lot of the world probably is. How many excess deaths are among confirmed covid patients who had their heart attack or such, soon after recovery, deemed a coincidence based it falling on or after day 29? I've been wondering about the unknown cases who pass away unexplained at home, with the illness or later on from its damage. What about the ones we KNOW were infected? It's an area worth exploring.
The BBC report includes this interesting graph showing daily tallies compared between the new count (28-day cut-off) and the one with no time limit since early June, when the discrepancy was widening
The red line for all covid patient deaths falls right along with the blue one for deaths within 28 days, but a bit more slowly. Visually, the average seems to be around 60/day, starting out closer to 75, but later falling below 50 and finally hovering around 30, with that 25 at the end too unclear to call a further downturn - they may have just cut the tracking on a slow day.
And here is the difference shown with the whole span, displayed in cumulative curves, as found at Sky News, and somewhere at Public Health England's website. It's live, with data points I'm looking at (not always easy to float over). This is a just a screen capture as it looked on Aug. 21.
Blue line = got covid, died within 28 days, maybe of any cause (?), but it looks like a disease-related curve, many ill people dying in vast numbers, mainly in the direct infection crisis, trailing about two weeks behind the widest and deadliest spread. Even if that includes a few unrelated deaths, on this scale probably 99.x% will be straight-up killed by the infection.
The dark red line marking 60 days looks just about as disease-related - just as less swiftly-fatal deaths are coming in (that curve flattens) so too do the additional deaths that happen another 32 days out. Why would that many "recovered" victims die within a month of 'recovery'? Are there assassins out there knocking them off?
The bright red line suggests not as many die more than 60 days out. But then, we're not that far out from 60 days to see, and it does appear that segment was growing more sharply than the others as it has time to play out. But that's all the time they gave it.
Death Rate Compared
I found some UK government documents showing the deaths per month over several years, including breakdown for just England. I checked England all-causes deaths for August over five years (2015-2019). They were all quite similar, with an average of 36,810 deaths over the month. That's 8,379/week, 1,197/day.
Out of about 55,287,000 people in England, that's 0.01515% people dying per week or 0.002165% per day in an average August.
The following Covid numbers will be out of the smaller population of known cases in England: 270,046 is the final number at August 12 - it would be lower for the prior weeks). As given and seen:
* 5,377 past-28-day survivors had died, over about 23 weeks of crisis = 234/week on average, 33/day = 0.0122% (5.635 x normal, including the slower first weeks)
* 331 covid patients/week of July 18-24 = 47.3/day = 0.0175% (8.083 x normal)
* 75-30/day visual from BBC chart = 0.0272% to 0.0109 = 12.56 times normal in early June down to 5.035 times normal in mid-August.
But that was just crudely estimated by a quick visual scan. Checking the last 3 weeks on the other graph (7/22-8/12) it winds up dipping only to 8x normal. For each week, the new deaths at "no time restriction" (ntr), at 60 days, and at 28 days, then the compared death rate:
date ntr 60d 28d
to 7/29 454 135 116
dead survivors (all past 28): 338
rate 0.1252% (8.248 x normal weekly deaths - in August)
to 8/5 389 135 57
dead survivors (all past 28): 332
rate 0.1229% (8.109 x norm)
to 8/12 392 179 70
dead survivors (all past 28): 322
rate 0.1192% (7.868 x norm)
Then looking at the whole span with monthly snapshots on the 22nd, ending at the start of those last 3 weeks (but using the same 270k for England cases, not the ever-changing proportion of cases at each time):
date ntr 60d 28d
* 4/22 19,218 ? 19,184 dead survivors: 34 (hardly any time past 28 days)
* 5/22 32411 32406 31355 dead survivors/mo (1,056-34=)1,022 (0.3785%) vs. May all-causes deaths, 5 year average 39,653 (0.0717%) = 5.28 x norm
* 6/22 38193 37911 35397 dead survivors/mo 1,774 (0.6569%) vs. June deaths, 5ya 38,301 (.0693%) = 9.479 x norm
* 7/22 40837 39849 36452 dead survivors/mo 2,611 (0.967%) vs. July 5ya 37,603 (0.068%) = 14.22 x normal
Compare to dead-within-28-day covid cases that last month: 1,055 (0.391%). Shortly before they changed the count it was getting to where 2.5 times as many survivors were dying.
Conclusion
Do we really think people who recovered from the virus went on to get shot or hit by busses or die of other unrelated causes at 14, 10, 8, or even 5 times the national average? The normal rate for that probably applies, so about 1x out of the 5-14x is explained, and the remaining 4-13-fold increase in death rate is obviously related to the effects of the illness they had just suffered.
Now consider this is an average rate among a huge number of known cases (tending to be the worst among a larger body of unknown cases). Even among the 228,000 or so known cases still alive, most will likely recover with little or no damage and live on to die at the usual rate. That means whatever other portion making this terrible average is faring far worse, dying at something more like 20 times the usual rate. ...Most likely this is happening to the same class of mostly aged people that's known to die so widely, but someone should check the specifics on just who winds up compromised, and add this to our list of dangers to avoid.
We could consider it now as another risk - of uncertain size - that we must consider as we decide what balance we want to strike with this virus.
In the United Kingdom context: this accelerated death rate for covid survivors in England comes on top of:
* an un-tallied version of the same problem in Scotland, Wales, Northern Ireland,
* the confirmed, 28-day covid deaths in all three places
* the 36,695 England (hospital) fatalities within 28 days,
* the significant number of confirmed deaths in care homes, private homes, and other places (a bit over 5,000 more just in England and Wales)
* and a likely 15,000 or so further deaths caused or precipitated by the virus and currently unknown, buried in the mountain of unexplained "excess deaths."
In total, this would come out close to 70,000 killed so far in the UK - 0.104% off the top already. And these damaged people will keep dying for a while, depending how bad the damage, how many have it, and how many more are made.
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