At long last, Dr No has found a way of estimating official covid death inflation. By official covid death inflation, he means the extent to which the authorities have deliberately inflated the number of covid deaths to increase, in SPI-B’s infamous words, “the perceived level of personal threat…among those who are complacent”. Let us be absolutely clear: this is the government, and its agencies, deliberately massaging official statistics, to scare the population witless, into submission and compliance. In SPI-B’s own words, this needs “hard-hitting emotional messaging” to be effective, and what could be more hard-hitting and emotional than official accounts of tens of thousands of deaths from the novel coronavirus? It is classical propaganda, “information, especially of a biased or misleading nature, used to promote a political cause or point of view”, a shocking and lamentable abuse of power that has no place in a modern democracy. Yet, for the last eighteen months, this tissue of partial truths, lies and deceits has been relentlessly streamed day after day by the government, via a complicit mainstream media, to the British public. The vast majority of other countries have also fared no better.
First, we can dispose of PHE’s comedy numbers of covid deaths, based as they are on the 28 day rule, a nonsense on a par with saying that if you detect a whiff of tobacco smoke on a person, and the person dies within 28 days, they are automatically counted as a death caused by smoking. Yet this is exactly what death from covid within 28 days of a positive PCR test within 28 days does: it uses a test of exquisite sensitivity to detect a possible whiff of a bit of a virus, and uses that to define a covid death. It is patently absurd, and we can consign it to the bin, and move on. Next slide, please.
The next slide concerns ONS’s numbers for ‘deaths involving covid’. These are orders of magnitude better than PHE’s comedy numbers, but until recently there has been no way of determining how many of these deaths are true covid deaths, where the underlying cause of death as we would normally understand the phrase is covid — where ‘he died from covid’ really does mean ‘he died from covid’ — and how many are conveniently, but misleadingly, added to these numbers, the better to achieve the inflated numbers that will provide the necessary hard-hitting emotional messaging to increase the perceived level of threat.
At this point, we need to review some of ONS’s definitions. Deaths involving covid are simply a count all deaths where covid in any shape or form appears anywhere on the death certificate. This is the headline figure you will normally see or hear, and it is itself already inflated, because it includes both deaths deemed — we shall have a lot more to say about this deeming shortly — by ONS to have covid as the underlying cause of death, that is, the person died ‘from covid’, as well as deaths where the person died ‘with covid’, that is, there was another, non-covid, underlying cause of death. ONS define the underlying cause of death as “the disease or injury which initiated the train of morbid events leading directly to death, or the circumstances of the accident or violence which produced the fatal injury”. In practice, this is a little bit more sophisticated than the man on the Clapham omnibus’s account of his father’s cause of death. The man on the bus might say his father died of a heart attack, but ONS are more likely to code the underlying cause of death as ischaemic heart disease.
ONS do sometimes say what percentage of the deaths involving covid (deaths both from and with covid) had covid as the underlying cause of death (death from covid). Typically this percentage is high, especially during peaks in the death rate. In mid January, for example, of all deaths involving covid, around 90% had covid coded as the underlying cause of death. By mid March, when the total number of deaths had declined greatly, this percentage fell to around 80%. This means that, in the headline figures that we read and hear for covid deaths, somewhere between 10 and 20% are not covid deaths; they are instead, by ONS’s own definitions, deaths with covid. The headline figures for covid deaths, based as they are on ‘deaths involving covid’ are thereby automatically inflated by around 10 to 20%, by simply including the deaths where covid was not the underlying cause.
It gets far trickier when we try to tease out how many of the deaths deemed by ONS to have covid as the underlying cause are in fact true covid deaths, where the patient really did die from covid. We know there must be some inflation, because of the WHO/ONS requirements for coding deaths due to covid, which boil down to a rule that says if covid appears anywhere on Part I of the MCCD (medical certificate of cause of death), then covid trumps any other potential underlying cause of death, even when the other cause makes better medical sense. More details on this nefarious coviddery can be found in Dr No’s earlier post, Ode to the Death Certificate.
The problem until now has been how to get a handle on the extent of this nefarious coviddery. We know that almost all patients who are deemed to have died from covid will have had ‘pre-existing conditions’, any or all of which are eminently capable of causing the patient’s death. The key question is: how often does covid improperly snatch death from the jaws of the other equally or even more capable underlying causes of death? In other words, how often do the WHO/ONS coding rules wrongly assign covid as the underlying cause, when by all normal common sense, and indeed medical sense, the other equally or even more plausible cause was indeed the true underlying cause of death.
The answer, it turns out, lies in taking a closer look at those ‘pre-existing conditions’ and considering what would happen under normal, non-covid conditions, and what actually happens, given the current covid conditions. We can do this using ONS’s own data, and get an estimate, if not a precise number, of the extent to which conditions which would, under normal circumstances, become the underlying cause of death, now get trumped by covid as the underlying cause, under the current rules.
The data comes from last year, but they appear to be the most recent data that include sufficient detail on those elusive pre-existing conditions, and there is no reason to suppose that what is happening now differs in any substantial way from what happened in the early months of last year. The crucial table is Table 5 in the underlying dataset. This details the “Most common main pre-existing conditions in deaths involving COVID-19, all ages and sexes, England and Wales, deaths occurring between March and June 2020”, and the key thing is the definition of main pre-existing condition. It is the “the one pre-existing condition [on the death certificate] that is, on average, most likely to be the underlying cause of death for a person of that age and sex had they not died from COVID-19”. In other words, it is the condition that would most likely have been the underlying cause of death, had covid not trumped it.
What do we find? At the time of the report, there had been a total of 50,335 deaths involving covid, that is, deaths where covid was mentioned anywhere on the death certificate. Of these, 4,476, less than ten percent, had no pre-existing condition, so we can allow those as likely true covid deaths. But what of the other deaths? Over a quarter, 12,869, had ‘Dementia and Alzheimer’s disease’ as the main pre-existing condition – the disease that would have been the underlying cause of death, had covid not reared its ugly head. Let’s now consider first what would have happened pre-covid, and then what appears to happen now, after the arrival of covid, and the new covid death coding rules.
Pre-covid, the MCCD may have just had one entry, Alzheimer’s disease, and that would be coded as the underlying cause of death (UCOD). But often there might be another entry, let’s say bronchopneumonia on the first line of Part I on the MCCD, with Alzheimer’s disease underneath, on the second row. In this case, the MCCD shows a sequence, Alzheimer’s (leading to frailty) leading to bronchopneumonia, and in keeping with the normal definition of the UCOD, Alzheimer’s disease is the “disease or injury which initiated the train of morbid events leading directly to death”, and so becomes the UCOD.
Now let’s replace bronchopneumonia on the first line with covid. Under normal rules, and by all standards of common and medical sense, exactly the same thing would happen: the sequence is Alzheimer’s (leading to frailty) leading to covid, and in keeping with the normal definition of the UCOD, Alzheimer’s disease is the “disease or injury which initiated the train of morbid events leading directly to death”, and so it becomes the UCOD. But under the covid rules this does not happen. The medically sensible UCOD gets trumped by covid, and covid is recorded as the UCOD, despite the presence of a pre-existing condition that is, on average, most likely to be the underlying cause of death, had they not died from COVID-19. Occam’s razor hasn’t just been blunted, it’s been twisted back on itself until it snapped in two.
Dementia and Alzheimer’s disease aren’t trivial, they are serious killers in their own right. Yet the covid death trumping rule expunges them from the official record, and replaces them with its own cuckoo, the covid death. A death that would normally, and correctly, have Alzheimer’s as the UCOD now has covid as the UCOD. Let’s be brutal and say that all the 12,869 deaths that had ‘Dementia and Alzheimer’s disease’ as the main (ie it’s present on Part I of the MCCD, and would most likely have killed the person were it not for covid) pre-existing condition were in truth dementia and Alzheimer’s disease deaths, but got hijacked by covid. If so, that means around a quarter of the alleged covid deaths have been wrongly given covid as the UCOD. Or, to put it in inflationary terms, say 32,466 true covid deaths (50,335 less say 5000 ‘deaths with’ that we already know about less 12,869 dementia and Alzheimer’s) have been inflated by around 55% to get 50,335 covid deaths. Cripes. That’s quite some inflation.
And that’s just for dementia and Alzheimer’s disease. The next most common main pre-existing condition (so it was on Part I of the MCCD, and a likely candidate for underlying cause of death) is ischaemic heart disease, with 5,002 entries. We don’t know what was on those 5,002 MCCDs, but what we do know is that even if there was a medically sensible cardiac cause of death, we no longer know about it, because covid trumped it as the UCOD. Let’s be brutal again, and say that all those true cardiac deaths got misleadingly poached by covid, and do the inflation calculation again. Covid death inflation now runs at a staggering 83%. Cripes, and cripes again. Much more of this, and there will be hardly any true covid deaths left.
The third row for main pre-existing condition is Influenza and Pneumonia, with 4,582 entries. This opens up yet another can of worms, or rather chickens and eggs, as in which came first. Did the patient with covid develop pneumonia? That probably is a true covid death. But what about the patient admitted with pneumonia who them succumbed to hospital acquired covid? That is almost certainly not a true covid as UCOD death. Or perhaps it is. Who knows? Dr No’s brain is beginning to hurt, so let’s not go there…
Clearly, and explicitly, Dr No has made some brutal assumptions. But equally clearly, it is impossible to avoid the conclusion that there has been significant and substantial inflation of the official counts of deaths involving covid, courtesy of the covid death coding rules, leading to a gross exaggeration of the perceived threat from covid. We will never know the true extent of the inflation, because the evidence has been buried and gone up in smoke, and so the necessary post-mortems and viral cultures can never be done. But the inflation, based on the above assessment, is so rampant that even if it is only half that suggested by the assessment, the official account of covid deaths is still wildly in excess of the true account. The government may have achieved its aim of increasing the perceived level of threat by using hard-hitting emotional messaging, but it is a shocking disgrace that it left truth at the front door, when it came inside to do its nefarious coviddery.
* (added 08:48 18th Aug 2021): The title for this post should really be (and was in the draft) Nefarious Coviddery and Covid Death Inflation. But Dr No is rather fastidious, perhaps too fastidious, about keeping post titles to a certain length, so they don’t word-wrap onto a second line. So he removed what he thought was the least important word. This may have led some readers to conclude, perfectly reasonably, that Dr No was talking about overall death inflation (an inflated number of overall deaths from covvidery). This is not the case: the effect described in this post increases the proportion of covid deaths, but the overall number remains the same. (added 09:15 18th Aug 2021): On further reflection, the title for this post should have been Coviddery and Covid Death Inflation. Not only does it have coviddery, which rhymes conveniently with a certain other wittery, it also has better alliteration. But Dr No was foolishly glued to nefarious, so he dumped the wrong word to get the title within length; and the title will stay as it is, because Dr No is also fastidious about never doing post-hoc editing (apart from the correction of minor typos). As the saying has it, Publish and Be Damned…