Don't assume you response you illicit in people is the same as others will illicit.
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Current Affairs Coronavirus Thread - Serious stuff !!!
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tsubaki
Player Valuation: £90m
I could understand that if they were going to replace it with a properly controlled testing regime (as the UK has been ramping up test numbers by gateway testing / workplace or school testing), but to get rid of that whilst not having anything in place to cope with the waves that are very likely to come again is criminal.
Purely from a pragmatic stance, if we accept we "just live with the virus", living with it in its current numbers means those beds and numbers of staff needed to support patients in hospitals/homes/social care settings will need to be maintained.
We live with a reduction of a regular -50-100 beds across each region.
Thats not at all correct no doctor would ever list Covid a cause of death if it wasn’t clinically indicative, there is absolutely zero incentive or motivation to do so and why would you. In fact it’s the opposite, if a cause of death is called into question or inconclusive your called to the corners court, not at all fun.
Someone might die from Covid, someone with multiple co-morbidities may die with Covid as a contributory factor and someone could die of something completely separately naturally and have Covid.
The death certificate documentation allows for all and for a doctor to give their clinical opinion. As below:
Certification of Death (UK) - OSCE guide | Geeky Medics
A guide to completing a death certificate, including step-by-step instructions and and cased based scenarios to allow you to practice.
geekymedics.com
There aren’t any rules and if there were, they would just be ignored, because medical ethics or rather the risk of ethical breach and being struck off by your regulatory body, due to a breach of code of professional ethics is far more serious then breaching NHS and service policy/advice - and I guarantee you that “rule” for determining Covid as the cause of death mandatorily doesn’t exist.
I can tell you any question marks in regard to the cause of death is very serious and you can be brought before the coroners court (I’m not aware of a sharp rise of cases being referred to the coroners court) and rightly so as it’s only right an undetermined or inconclusive causes of death is investigated fully - especially for those grieving - thus there is zero motivation or incentive for a doctor not to be accurate in regard to clinical evidence and determination in cause of death, absolutely zero.
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ARDS caused by Pneumonia caused by COVID.Thats not at all correct no doctor would ever list Covid a cause of death if it wasn’t clinically indicative, there is absolutely zero incentive or motivation to do so and why would you. In fact it’s the opposite, if a cause of death is called into question or inconclusive your called to the corners court, not at all fun.
Someone might die from Covid, someone with multiple co-morbidities may die with Covid as a contributory factor and someone could die of something completely separately naturally and have Covid.
The death certificate documentation allows for all and for a doctor to give their clinical opinion. As below:
Certification of Death (UK) - OSCE guide | Geeky Medics
A guide to completing a death certificate, including step-by-step instructions and and cased based scenarios to allow you to practice.
There aren’t any rules and if there were, they would just be ignored, because medical ethics or rather the risk of ethical breach and being struck off by your regulatory body, due to a breach of code of professional ethics is far more serious then breaching NHS and service policy/advice - and I guarantee you that “rule” for determining Covid as the cause of death mandatorily doesn’t exist.
I can tell you any question marks in regard to the cause of death is very serious and you can be brought before the coroners court (I’m not aware of a sharp rise of cases being referred to the coroners court) and rightly so as it’s only right an undetermined or inconclusive causes of death is investigated fully - especially for those grieving - thus there is zero motivation or incentive for a doctor not to be accurate in regard to clinical evidence and determination in cause of death, absolutely zero.
"ItZ nOT CoViD"
roydo
in memoriam - 1965-2024
I got the distinct impression when Nik passed that there was a political struggle between the various NHS dept's as to "who caused it". Cos tons of issues all contributed.
Went to the coroner, (speed dial), then an inquest, (again, speed dial) and after all that, the hospital reasons were accepted. Pretty sure stuff goes on behind the scenes to protect backsides. And deflect later legal challenges.
Cant blame them really, in this ambulance chasing world we live in.
It’s not an easy or pleasant process at all for families mate, after going through so much anyway in regard to loss and grief, being in court is surreal.
Not to go into Niks situation at all, it’s really important the details of clinical case, are weighed, as I think all involved deserve the best oversight, clarity and justice toward what may have happened. The court can be very procedural and it can move very quickly, i don’t know if you found this
but it can be hard to absorb and process any new or emerging information and it’s impact before things move on again - I know I found that. It can often be cold and clinical, though I think the coroner‘s are becoming more skilled.
They can deal with a range of cases, be it self harm, misadventure, negligence or inconclusive, sudden death and more.
Sorry to hear that was your expierence with Nik, it’s hard enough going it through it, without having the feel that there was some collusion or politics amongst teams, not nice.
roydo
in memoriam - 1965-2024
Was utterly fast tracked, very compassionate, but clearly an NHS proceedural thing. IMO. No issues with it at all, but as we are in Covid thread, I am not sure that once Covid is on a cause of death, the same rigour has been applied.
I don’t know mate, there is just zero motivation as I said, makes no difference to a doctor the cause so it doesn’t pay not to be as accurate as clinically indicative, the only decision you have to make is whether Covid was the cause of death, a contributing factor, or present but unlikely a factor. It’s not just the death certificate, there is a clinical narrative (record) also kept throughout the clinical care trajectory, it will be updated daily at least, a diagnosis and clinical reasoning won’t be just worked out when the time comes to fill out a Cert.
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Strange isn't it that the rate of hospitalisation and death decrease when larger numbers of the population are vaccinated.
Assuming "Covid deaths" arent really from Covid, vaccines would have no impact...but the data shows high vaccination rates and covid deaths decreasing. Consistently.
Also COVID does seem to be creating some long term issues that could well mean it is a significant contributing factor to deaths that are on the surface due to another cause.
After Covid, risks of heart problems remain elevated for up to a year
Among the unvaccinated, long-term heart risks attributed to Covid-19 were "everywhere," researchers found.
www.nbcnews.com
The study's lead author, Dr. Ziyad Al-Aly, a clinical epidemiologist at Washington University in St. Louis, said he and his colleagues expected to see some elevation in heart problems following Covid, but assumed it would be limited largely to people whose health wasn’t robust previously.
The elevated risk remained when researchers accounted for age and race, he said.
If we applied the same logic to cancer that people do with Covid, we've no need to "open up to treat cancer"..Also COVID does seem to be creating some long term issues that could well mean it is a significant contributing factor to deaths that are on the surface due to another cause.
Covid also increased the risk for heart failure by 72 percent, heart attack by 63 percent and stroke by 52 percent — even among those, like Wilson, whose original illnesses were mildAfter Covid, risks of heart problems remain elevated for up to a year
Among the unvaccinated, long-term heart risks attributed to Covid-19 were "everywhere," researchers found.
The study's lead author, Dr. Ziyad Al-Aly, a clinical epidemiologist at Washington University in St. Louis, said he and his colleagues expected to see some elevation in heart problems following Covid, but assumed it would be limited largely to people whose health wasn’t robust previously.
The elevated risk remained when researchers accounted for age and race, he said.
Anyway, some good Covid news.. The North West region had the lowest case numbers of Covid in the country, which hasn't been something we've been able to say often.
Hospitalisation is lowering and the trends show a reducing curve (not quite sure where it will plateau).
We'll have to see what the policy changes will mean over the next few weeks and months.
Hospitalisation is lowering and the trends show a reducing curve (not quite sure where it will plateau).
We'll have to see what the policy changes will mean over the next few weeks and months.
The same principal often applies, someone with cancer can often die of an acute infection (or other complications) as opposed to cancer. But they are more vulnerable to that infection due to being frail from cancer. The cause of death in that case, could be the cancer diagnosis or probably more like complications as a result of the cancer diagnosis, but if your being technical, it would be the infection, but putting that down in isolation isn’t clinically indicative.
Then someone may die from an infection, gotten due to frailty from cancer but also have dementia, high blood pressure, Afib, etc. A lot of older people will have multiple co-morbidities. You can see that determining the cause of the death isn’t always straight forward, nor singular and can be due to multiple factors adding up to an overall frailty. Even a singular “infection” even if it is the direct cause of death isn’t always clinically indicative of the overall clinical trajectory.
The other thing with death certs , is that they are given to those closest to the person who died, they need to be as accurate and reflective as possible but also being conscious of a grieving family who will be in receipt of it, while wanting to represent it as best as can be within the scope of duty and responsibility.
* Not to be glib or insensitive about the above topics as I realise illness and death touches everyone and don’t mean any of the above to be triggering for anyone.
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