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POI for the Coroners Society of Ireland, Nphet’s figures for deaths may be innacurate

  • 18-04-2021 6:31pm
    #1
    Registered Users Posts: 27,467 ✭✭✭✭ drunkmonkey


    Death figures reported by Nphet “do not have a scientific basis”, according to the Mayo coroner Patrick O’Connor.

    He claims that many of those recorded as having died from Covid-19 were already suffering with other underlying illnesses that may have caused their deaths.

    O’Connor, who acts as a public information officer for the Coroners Society of Ireland, said that recording Covid-19 as the principal cause of death when a person was already terminally ill raised questions about the accuracy of the figures.

    Mayo coroner questions Nphet’s figures for Covid deaths
    https://www.independent.ie/irish-news/mayo-coroner-questions-nphets-figures-for-covid-deaths-40326117.html

    It does appear like he's correct, surprised he's the first to speak out we're a long way into this, why would the NPHET try and make the situation look worse than it is.


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Comments

  • Registered Users Posts: 3,948 ✭✭✭ Wolf359f


    Death figures reported by Nphet “do not have a scientific basis”, according to the Mayo coroner Patrick O’Connor.

    He claims that many of those recorded as having died from Covid-19 were already suffering with other underlying illnesses that may have caused their deaths.

    O’Connor, who acts as a public information officer for the Coroners Society of Ireland, said that recording Covid-19 as the principal cause of death when a person was already terminally ill raised questions about the accuracy of the figures.

    Mayo coroner questions Nphet’s figures for Covid deaths
    https://www.independent.ie/irish-news/mayo-coroner-questions-nphets-figures-for-covid-deaths-40326117.html

    It does appear like he's correct, surprised he's the first to speak out we're a long way into this, why would the NPHET try and make the situation look worse than it is.

    NPHET just report the figured they recieve from HPSC, so the coroner should be questioning them and not NPHET. Not once in that article is the HPSC mentioned.


  • Registered Users Posts: 1,226 ✭✭✭ Valhallapt


    Death figures reported by Nphet “do not have a scientific basis”, according to the Mayo coroner Patrick O’Connor.

    He claims that many of those recorded as having died from Covid-19 were already suffering with other underlying illnesses that may have caused their deaths.

    O’Connor, who acts as a public information officer for the Coroners Society of Ireland, said that recording Covid-19 as the principal cause of death when a person was already terminally ill raised questions about the accuracy of the figures.

    Mayo coroner questions Nphet’s figures for Covid deaths
    https://www.independent.ie/irish-news/mayo-coroner-questions-nphets-figures-for-covid-deaths-40326117.html

    It does appear like he's correct, surprised he's the first to speak out we're a long way into this, why would the NPHET try and make the situation look worse than it is.

    Yes about time this point was raised. The daily death figures are not close to accurate. The difference is died FROM covid vs died WITH covid. I know personally two such cases, one was a 45 year old relative who had terminal cancer, he was given weeks to live and must have got covid in the hospital or when he came home to die from a visitor, covid did not kill him cancer did. Another case is an elderly lady who got covid and seemed to make a good recovery, but had a fall after and died in hospital a few days later. Covid didn’t kill her the fall did.


  • Registered Users Posts: 14,289 ✭✭✭✭ banie01


    Don't get too swept up in a Coroner taking a stance behind the science here.

    Coroner's in Ireland are an appointed quasi-judicial position usually filled by Solicitors or Barristers.
    This isn't a "gotcha" this is a solicitor greatly exceeding his professional competence.

    He is neither a Doctor, Pathologist nor Medical Scientist.
    I'll be far more appreciative of the input of both Pathologists and epidemiologists than I will be of a solicitor in matters of causation of death and it's mitigation.


  • Registered Users Posts: 1,365 ✭✭✭ crossman47


    We'll know more about this when CSO publish final figures for the year. The excess deaths (over the average for recent years) will be a good indication of mortality due to Covid only. It will also have accelerated other deaths i.e. happened in Q1 rather than later in year.


  • Registered Users Posts: 15,493 ✭✭✭✭ odyssey06


    Valhallapt wrote: »
    Yes about time this point was raised. The daily death figures are not close to accurate. The difference is died FROM covid vs died WITH covid. I know personally two such cases, one was a 45 year old relative who had terminal cancer, he was given weeks to live and must have got covid in the hospital or when he came home to die from a visitor, covid did not kill him cancer did. Another case is an elderly lady who got covid and seemed to make a good recovery, but had a fall after and died in hospital a few days later. Covid didn’t kill her the fall did.

    Strange to just have a fall after being in hospital for a serious infection.

    How do you know they were even included in the covid death figures?

    At the end of the day, died with v from covid is a red herring to the impact covid is having on hospitals and infection control etc


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  • Registered Users Posts: 3,948 ✭✭✭ Wolf359f


    Valhallapt wrote: »
    Yes about time this point was raised. The daily death figures are not close to accurate. The difference is died FROM covid vs died WITH covid. I know personally two such cases, one was a 45 year old relative who had terminal cancer, he was given weeks to live and must have got covid in the hospital or when he came home to die from a visitor, covid did not kill him cancer did. Another case is an elderly lady who got covid and seemed to make a good recovery, but had a fall after and died in hospital a few days later. Covid didn’t kill her the fall did.

    It's like dejavu all over again. Like all notified diseases, they get mentioned on a death cert for obvious reasons.
    Your second example that lady would have what ever the cause of death was, as a result of a fall. And then covid would be listed under a separate section. It's not a cause of death or even a contributing factor.

    Now they need to clarify the wording they use when they announce deaths. It should be worded as deaths due to covid.


  • Registered Users Posts: 1,226 ✭✭✭ Valhallapt


    odyssey06 wrote: »
    Strange to just have a fall after being in hospital for a serious infection.

    How do you know they were even included in the covid death figures?

    At the end of the day, died with v from covid is a red herring to the impact covid is having on hospitals and infection control etc

    Yea maybe covid left her a bit weak when she had the fall so it’s hard to know.

    Covid was mentioned on both death certs- that’s then classified as died from covid.

    I’m not down plying the serious nature of covid, but NEPHET should be much more transparent on how the numbers are calculated


  • Registered Users Posts: 1,226 ✭✭✭ Valhallapt


    Wolf359f wrote: »
    It's like dejavu all over again. Like all notified diseases, they get mentioned on a death cert for obvious reasons.
    Your second example that lady would have what ever the cause of death was, as a result of a fall. And then covid would be listed under a separate section. It's not a cause of death or even a contributing factor.

    Now they need to clarify the wording they use when they announce deaths. It should be worded as deaths due to covid.

    Yes that’s my point the NEPHET numbers include every death certificate that mentions covid, regardless of it being the cause or not


  • Registered Users Posts: 7,641 ✭✭✭ BrianD3


    The proof (yes or no) will be when the CSO issues its report on principal causes of death for 2020. I'm open to correction but think that each death is attributed to ONE cause. And crucially, the number of deaths from cancer and diseases of the circulatory system doesn't vary much from one year to the next.

    Some 2020 deaths are going to be correctly attributed to Covid - but if, at the same time, there is a considerable decrease in deaths from cancer compared to 2019, that would show that cancer deaths have been attributed to Covid.

    The from/with debate has been done extensively on this forum and when poster bring up that figures may be overstated, other posters rebut this by appealing to the authority of the coroner i.e. if deaths are initially overstated they will be "denotified". And yet, now we have a coroner questioning the figures.


  • Registered Users Posts: 1,882 ✭✭✭ Smee_Again


    What’s the coroner’s background that he can make such a claim?


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  • Registered Users Posts: 3,948 ✭✭✭ Wolf359f


    Valhallapt wrote: »
    Yes that’s my point the NEPHET numbers include every death certificate that mentions covid, regardless of it being the cause or not
    A death due to COVID-19 is defined for surveillance purposes as a death resulting from a clinically compatible illness, in a probable or confirmed COVID-19 case, unless there is a clear alternative cause of death that cannot be related to COVID disease (e.g. trauma)
    That's how a covid death is defined in Ireland.
    Covid being listed on the death cert is irrelevant unless it's listed as a cause of death/contributing factor. It's a notified disease, so even murders and drownings, motor vehicle accidents involving people who are covid positive would have covid listed on the death cert, but not as a cause of death.

    If they had syphilis, Gonorrhoea or herpes, they would also be listed on the death cert as again they are notified diseases. But not as the cause of death.


  • Registered Users Posts: 15,493 ✭✭✭✭ odyssey06


    Valhallapt wrote: »
    Yea maybe covid left her a bit weak when she had the fall so it’s hard to know.
    Covid was mentioned on both death certs- that’s then classified as died from covid.
    I’m not down plying the serious nature of covid, but NEPHET should be much more transparent on how the numbers are calculated

    In the first case, for example, terminal cancer, who is responsible for putting covid on the death cert?


  • Registered Users Posts: 13,583 ✭✭✭✭ Zebra3


    Wolf359f wrote: »
    NPHET just report the figured they recieve from HPSC, so the coroner should be questioning them and not NPHET. Not once in that article is the HPSC mentioned.

    And I would hope that if the professionals in NPHET thought there was something odd about figures they were being provided they'd call it out.


    They would do that, wouldn't they?


  • Registered Users Posts: 6,371 ✭✭✭ Jim_Hodge


    Zebra3 wrote: »
    And I would hope that if the professionals in NPHET thought there was something odd about figures they were being provided they'd call it out.


    They would do that, wouldn't they?

    They do. It's why deaths are declassified.


  • Registered Users Posts: 1,226 ✭✭✭ Valhallapt


    Zebra3 wrote: »
    And I would hope that if the professionals in NPHET thought there was something odd about figures they were being provided they'd call it out.


    They would do that, wouldn't they?

    it’s a grey area, and not always obvious. In the uk they are very transparent about it. The death rate is anyone who died within 28 days of a positive covid test. They openly admit that it includes deaths from things like car crashes, but likewise it may miss some covid deaths due to an elderly person not having had a covid test. So it balances out in the end. But at least they are transparent about it.


    NEPHET often make statements like 18 deaths, 11 prior to April, that is someone manually reading death certs to see if covid is mentioned.

    Equally some will have died from covid but had it left off the death certificate or missclassified as the flu or something else.


  • Registered Users Posts: 9,149 ✭✭✭ normanoffside


    odyssey06 wrote: »
    In the first case, for example, terminal cancer, who is responsible for putting covid on the death cert?

    If they had Covid at the time of death it is down as a covid death without question.

    This is not actually news, Even Leo Varadkar said as much last a year ago and NPHET when questioned have said they are just following ECDC guidelines.

    At the same stage I am glad it is being reported again as it highlights that not all reported deaths were because of Covid.

    https://twitter.com/leovaradkar/status/1278995351169613824?lang=en


  • Registered Users Posts: 8,951 ✭✭✭ Ficheall


    ~10% increase in parts for the 65+ last spring, ~10% increase at Christmas, ~5% decrease around nowish.
    550628.png


    Things would probably have been worse without restrictions or most people taking precautions. Here's the Europe graph:

    550629.png


  • Registered Users Posts: 906 ✭✭✭ Stormyteacup


    Wolf359f wrote: »
    That's how a covid death is defined in Ireland.
    Covid being listed on the death cert is irrelevant unless it's listed as a cause of death/contributing factor. It's a notified disease, so even murders and drownings, motor vehicle accidents involving people who are covid positive would have covid listed on the death cert, but not as a cause of death.

    If they had syphilis, Gonorrhoea or herpes, they would also be listed on the death cert as again they are notified diseases. But not as the cause of death.

    I realise the WHO guidelines for reporting Covid deaths would indicate you are correct, however it seems we are not following those guidelines as you’ve interpreted.

    From HSPC website;
    https://www.hpsc.ie/a-z/respiratory/coronavirus/novelcoronavirus/surveillance/epidemiologyfrequentlyaskedquestions/

    ‘Q. Can you describe what death in confirmed/probable/possible case of COVID-19 means?
    The case definition for COVID-19 in Ireland has been updated routinely during the pandemic in accordance with the European Centre for Disease Prevention and Control (ECDC) guidance and updates.

    Deaths in confirmed COVID-19 case: A death in a person with laboratory confirmation of COVID-19 infection, irrespective of clinical signs and symptoms (including post mortem).

    Deaths in probable COVID-19 case: A death in a person with probable COVID-19 infection as described in the COVID-19 case definition below

    Deaths in possible/suspect COVID-19 case: See below scenarios for possible/suspect cases which should be reported as COVID-19 deaths.

    All deaths in patients suspected of having COVID-19 i.e. patients with symptoms clinically compatible with COVID-19 illness. These suspect cases may or may not have been tested for COVID-19 prior to death. These possible COVID-19 deaths include patients with pending COVID-19 laboratory results.
    All unexplained deaths/sudden deaths in residential facilities with a confirmed/suspected COVID-19 cluster/outbreak of illness unless there is a clear alternative cause of death that cannot be related to COVID-19 disease (e.g. trauma)
    A person can be classified as a probable or possible COVID-19 death without laboratory confirmation of COVID-19 based on the criteria for probable and possible cases of COVID-19 as outlined in the case definition.’


    From The Journal ‘Factcheck’;

    ‘When asked how Covid-19 deaths are recorded, a spokesperson for the HSE told TheJournal.ie: “In cases where an individual who has had a positive Covid-19 test before or after death, this will be notified to the national surveillance system and reported by HPSC as a death in a confirmed Covid-19 case.”

    They added that where the treating doctor has “a strong clinical suspicion” the patient had Covid-19 “due to the circumstances” and “the nature of the illness” but where the person has tested negative for the virus, or not been tested at all, these deaths will be notified to the national surveillance system and reported by the HPSC as a death in a “probable/possible Covid-19 case”.

    If it is later confirmed that the patient in question did not have the virus, their death is removed from the official figures.‘

    https://www.google.ie/amp/s/www.thejournal.ie/how-are-covid-19-probable-deaths-counted-5102540-Jul2020/%3famp=1


  • Registered Users Posts: 3,948 ✭✭✭ Wolf359f


    I realise the WHO guidelines for reporting Covid deaths would indicate you are correct, however it seems we are not following those guidelines as you’ve interpreted.

    From HSPC website;
    https://www.hpsc.ie/a-z/respiratory/coronavirus/novelcoronavirus/surveillance/epidemiologyfrequentlyaskedquestions/

    ‘Q. Can you describe what death in confirmed/probable/possible case of COVID-19 means?
    The case definition for COVID-19 in Ireland has been updated routinely during the pandemic in accordance with the European Centre for Disease Prevention and Control (ECDC) guidance and updates.

    Deaths in confirmed COVID-19 case: A death in a person with laboratory confirmation of COVID-19 infection, irrespective of clinical signs and symptoms (including post mortem).

    Deaths in probable COVID-19 case: A death in a person with probable COVID-19 infection as described in the COVID-19 case definition below

    Deaths in possible/suspect COVID-19 case: See below scenarios for possible/suspect cases which should be reported as COVID-19 deaths.

    All deaths in patients suspected of having COVID-19 i.e. patients with symptoms clinically compatible with COVID-19 illness. These suspect cases may or may not have been tested for COVID-19 prior to death. These possible COVID-19 deaths include patients with pending COVID-19 laboratory results.
    All unexplained deaths/sudden deaths in residential facilities with a confirmed/suspected COVID-19 cluster/outbreak of illness unless there is a clear alternative cause of death that cannot be related to COVID-19 disease (e.g. trauma)
    A person can be classified as a probable or possible COVID-19 death without laboratory confirmation of COVID-19 based on the criteria for probable and possible cases of COVID-19 as outlined in the case definition.’


    From The Journal ‘Factcheck’;

    ‘When asked how Covid-19 deaths are recorded, a spokesperson for the HSE told TheJournal.ie: “In cases where an individual who has had a positive Covid-19 test before or after death, this will be notified to the national surveillance system and reported by HPSC as a death in a confirmed Covid-19 case.”

    They added that where the treating doctor has “a strong clinical suspicion” the patient had Covid-19 “due to the circumstances” and “the nature of the illness” but where the person has tested negative for the virus, or not been tested at all, these deaths will be notified to the national surveillance system and reported by the HPSC as a death in a “probable/possible Covid-19 case”.

    If it is later confirmed that the patient in question did not have the virus, their death is removed from the official figures.‘

    https://www.google.ie/amp/s/www.thejournal.ie/how-are-covid-19-probable-deaths-counted-5102540-Jul2020/%3famp=1

    I'm a little confused now, that's like a Q&A explanation. (i.e. a layman's term)
    Going by that and assuming that's the exact definition and will not change, the ~250k people infected so far will over time, when they die from various other causes, will be counted as a Covid death. That doesn't make sense.
    Also vaccinated people who are infected and have no symptoms etc... if they test positive within their lifetime, and then die 50 years later from natural causes would, under that definition be classed as a covid death.

    Something tell's me that HSPC link is over simplifying it.


  • Registered Users Posts: 906 ✭✭✭ Stormyteacup


    Wolf359f wrote: »
    I'm a little confused now, that's like a Q&A explanation. (i.e. a layman's term)
    Going by that and assuming that's the exact definition and will not change, the ~250k people infected so far will over time, when they die from various other causes, will be counted as a Covid death. That doesn't make sense.
    Also vaccinated people who are infected and have no symptoms etc... if they test positive within their lifetime, and then die 50 years later from natural causes would, under that definition be classed as a covid death.

    Something tell's me that HSPC link is over simplifying it.

    It’s certainly confusing. However the fact that they quote WHO guidelines when explaining how a probable or possible death is to be recorded weakens the idea of oversimplification.

    A full period of recovery from Covid precludes a death from being recorded as a Covid death.

    It seems that Ireland decided on a method of recording Covid deaths from the outset, and when WHO guidelines were issued last April we implemented some of them - as we began including probable/possible cases - but understandably perhaps, from a scientific or data-collection point of view, we continued the method of initial reporting of recording deaths with a confirmed positive lab result as a basic.

    This document also sheds some light on coroners part in reporting deaths;

    https://hse.drsteevenslibrary.ie/ld.php?content_id=32848220


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  • Registered Users Posts: 3,501 ✭✭✭ political analyst


    NPHET's failure to consider the context of Covid death statistics (i.e. terminal illness, obesity etc) means that the most draconian of restrictions (limit on travel in the country, ban on click-and-collect) recommended by NPHET are not necessary because the recommendation for people who have underlying health problems that they take especially strong precautions (i.e. cocooning or at least wearing surgical masks and also using visors to prevent viral particles from getting into the eyes) would have been enough to protect those people.


  • Registered Users Posts: 1,130 ✭✭✭ Del Griffith


    Jim_Hodge wrote: »
    They do. It's why deaths are declassified.

    Quietly, months later, after NPHET and RTE have used the original 'suspicious' number in all headlines to full effect.


  • Registered Users Posts: 9,799 ✭✭✭ raind


    Quietly, months later, after NPHET and RTE have used the original 'suspicious' number in all headlines to full effect.

    330px-Manwithtinfoilhat.jpg


  • Registered Users Posts: 15,493 ✭✭✭✭ odyssey06


    NPHET's failure to consider the context of Covid death statistics (i.e. terminal illness, obesity etc) means that the most draconian of restrictions (limit on travel in the country, ban on click-and-collect) recommended by NPHET are not necessary because the recommendation for people who have underlying health problems that they take especially strong precautions (i.e. cocooning or at least wearing surgical masks and also using visors to prevent viral particles from getting into the eyes) would have been enough to protect those people.

    You're failing to consider the context of our ICU numbers and hospital capacity.
    And the number of people considered 'vulnerable', and the number of people they live with... and their essential access to services.
    Deaths are really secondary to hospital capacity.
    Nothing would have changed in NPHET's advice based on how deaths were classified.

    Also, there's a huge gap between 'draconian restrictions' and 'cocooning' in terms of levels through which you can drive a bus.


  • Registered Users Posts: 27,467 ✭✭✭✭ drunkmonkey


    draconian
    adjective
    (of laws or their application) excessively harsh and severe.
    "the Nazis destroyed the independence of the press by a series of draconian laws"

    In fairness the laws are draconian, the only bus you'll fit between them and cocooning is a hot wheels one.

    Everything is stifled, the press, basic human interaction, religion, you name it the party has taken control of it based on ill reporting of the relevant facts.


  • Registered Users Posts: 156 ✭✭ Iguarantee


    BrianD3 wrote: »
    ...Some 2020 deaths are going to be correctly attributed to Covid - but if, at the same time, there is a considerable decrease in deaths from cancer compared to 2019, that would show that cancer deaths have been attributed to Covid...

    Would cancer deaths only be attributed to Covid if the total deaths was the same or higher?


  • Registered Users Posts: 1,226 ✭✭✭ Valhallapt


    Iguarantee wrote: »
    Would cancer deaths only be attributed to Covid if the total deaths was the same or higher?

    It comes down the the doctor writing the cause of death. The cso measure “excess mortality” which is the number of people who have died above a typical year.

    https://www.cso.ie/en/csolatestnews/pressreleases/2020pressreleases/pressstatementmeasuringmortalityusingpublicdatasourcesoct2019-sep2020/

    So we can clearly see covid causes a huge spike in excess mortality. However we are also seeing fewer deaths from other causes.

    It’s the gap between NEPHET figures and the cso which is hard to be accurate on. The cso figures do suggest that NEPHET figures have overstated covid deaths.

    I am not down playing the deadly nature of covid, but there are question marks over NEPHET numbers which should be challenged. The coroner is correct to question it.


  • Registered Users Posts: 11,609 ✭✭✭✭ MadYaker


    The surges in COVID caused other types of healthcare to be ignored. I’d guess cancer deaths next year will be higher due to late or missed diagnoses. These deaths are not directly attributable to COVID but are sort of caused by it.

    When will the CSO release figures for 2020?


  • Registered Users Posts: 27,467 ✭✭✭✭ drunkmonkey


    Ok prime time is about to answer the question, how many people would be still alive if the pandemic didn't happen.

    This should be good as we didn't have any excess deaths in 2020. Let's see what RTE says, place your bets...


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  • Registered Users Posts: 1,226 ✭✭✭ Valhallapt


    Ok prime time is about to answer the question, how many people would be still alive if the pandemic didn't happen.

    This should be good as we didn't have any excess deaths in 2020. Let's see what RTE says, place your bets...

    So prime time study attributes 3,200 deaths due to covid disease. NEPHET attributed 4,800 deaths to covid.


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