Coronavirus and elderly death rates

Amid this week’s dire predictions of a Chinese Flu bloodbath, Julie Kelly at American Greatness details her skepticism about the accuracy of reported deaths to date:  “[T]here is little information available as to what qualifies as a coronavirus fatality for official counts. And there is good reason to approach such tallies with skepticism since reporting from states like New York is suspiciously vague.”  She explains that deaths in patients with co-morbidities “are always attributed to coronavirus as the main cause of death instead of just noting it as a contributing factor.”

My father had a catastrophic fall when he was 86, as well as a cornucopia of additional medical conditions including dementia.  The fall most certainly precipitated his decline, but was it the fall or his body’s inability to deal with the fall that caused it to shut down?  Would he have died at that time but for the fall?  Did it simply hasten his inevitable demise from something else going amiss in his body?  Do people with an interest in dementia research throw his death into the tally of “elders dying from dementia” even though it is more likely the dementia did not cause his death and was probably only a contributing factor?    

That said, and in deference to doctors and medical examiners, the cause of death is not always crystal clear.  Moreover, except in limited cases, Jews generally do not perform autopsies and, frankly, I don’t believe autopsies are generally performed unless there is a reason for it or the family demands it. Thus,  how many autopsies are actually being performed on suspected COVID-19 victims that confirm it as the cause of death, let alone tests that confirm the infection?  Determining a cause of death with absolute certitude is not always the no-brainer we have come to expect from television shows, and could be further muddled by an absence of autopsies and inconsistencies in administering tests.

Accordingly, Kelly criticizes CDC Guidelines for not requiring testing for COVID-19 in cases where it is suspected “if the circumstances are compelling within a reasonable degree of certainty,” although testing is ideally recommended where a COVID-19 infection is presumed or probable.  This invites (and I love this so much that I just had to quote it) “bureaucratic guesswork [that] is unacceptable while the economy is in chaos, tens of millions are suddenly out of work, and power-hungry government tyrants arrest surfers and pastors for daring to violate ‘social distancing’ decrees handed down to their local authorities by Beltway lifers.”

While commenting on the confusion with reporting and tallies on the CDC website itself, as well as inconsistencies in that reporting with the New York Times and Worldometer, Kelly focuses her concerns on nebulous reporting from New York that does little to instill confidence given it is all subject to change pending further investigation. 

If the numbers are indeed bloated, this begs the question whether inflating the numbers serves a political purpose to, let’s say, demand more federal dollars get dumped into the budget of failing states and cities, like New York and New York City?  Or, does it merely stoke the flames for making the case for President Trump’s ineptitude in dealing with COVID that ultimately drove a booming economy into the abyss?  The more deaths, the longer the isolation, the longer the shutdown, the worse the economy, the more desperate the population… the more likely a Trump loss?  In either case, it’s crystal clear who benefits.

There is an additional factor here that belies the statistics we are being force fed and might account for a lower death rate or at least explain the high death rate among our seniors.  To date, I haven’t heard anyone address this.  It has been widely reported that some deaths among the elderly were attributed to the Chinese Flu whereas, in fact, their deaths were due to other co-morbidities.  Check.  But the elderly tend to have DNRs (Do Not Resuscitate orders), Advanced Directives, and other legal documents, especially when they are in a facility or admitted to a hospital, that limit the type of care they will receive.  Medical professionals are not allowed to treat a patient contrary to those instructions, even if (especially if) it is to save their lives, and they risk liability should they violate those directives.  

Thus, is it possible we are losing so many elderly patients not only because of the lethality of the virus and the vulnerabilities a multitude of co-morbidities might present, but also because they are not being treated as we might treat others who are not constrained by such legal documents, signed when they were of sound mind and body, that prevent medical professionals in hospitals or facilities from performing lifesaving or even curative procedures?  The elderly may have voluntarily waived the respiratory, cardiac, or off-label treatments that have been saving the lives of other COVID-19 victims—including other old-timers who had no such restrictions.  

This virus has ravaged through care facilities populated by the aging like a fire.  Such facilities almost always require these legal forms be filled out, although that is not to say everyone selects the “no treatment” option.  And, to be clear:  I’m not blaming the elderly for signing these documents -- these difficult and heart-wrenching decisions are often made by families, next-of-kin, guardians, health-care representatives, etc., and are supposed to be made on behalf of the patient, in accordance with either their expressed wishes or what is believed they would have wanted.  I’m also not blaming those who make these decisions on their behalf.

However, since a significant number of COVID-19 deaths among the elderly could be attributed, at least in part, to a denial of treatment, shouldn’t these cases should be highlighted in a separate category and not included in the overall number of deaths by COVID-19?