Re: CoVid-19
Posted: Mon Mar 30, 2020 2:33 pm
given the fact that all the lockdowns and changes have not collapsed R0, and give the hospitals are one of the few if not the only that has increased its prevalence in our lives of those in lock down. You don't need more food than usual when sitting around, but when more people get sick they sure do hit the hospital.goldy313 wrote: ↑Sun Mar 29, 2020 11:12 pm Cigar....your second sentence after “here are the facts” is false.
While we do test those with symptoms we also test those in direct patient care and test those in the chain of infection, most in the second and third categories are not rich or famous. As I stated, I was called to come in for a test because a patient I had treated was positive.
While agree with much of your post, you can’t be just wrong in sentence number 2. There are some other points that are just wrong; being primarily spread in a medical environment? Maybe to health care workers but they are but a small portion. Just like any virus it is spread through contact. Cause of death is exactly that cause of death. Having a comorbidity doesn’t preclude you to death from something else, because a patient is immunosuppressed does not mean they can’t die from pneumonia.
It is a virus with no treatment thus far, we do not test everyone with flu like symptoms for influenza. We extrapolate the data and then we categorize influenza as sporadic, widespread, etc. We have no long term data on the Coronavirus and without school and work we have lost many data points meaning testing is the only way we have to get a picture of spread.
Testing has its limits.....false positives/negatives as you accurately mentioned, plus test results are only a snapshot in time. Ideally we would randomly test “X” amount of people, say every Monday we test everyone in Minnesota whose SSN ends in 233, then we would test 1 of every 1000 people and over time would have an accurate picture of what the actual infection rate is and how it is changing.
The science and statistical modeling is not very good and we are missing a chance to improve it. Your point about testing is accurate and we are not, as a county, state, or nation doing even a passable job of explaining this to the citizens.
Among the scariest things.....The city of Rochester has suspended public comments at city council meetings! You can submit them online but no longer have the right to speak them for the record. People were turned away and not allowed to speak on matters the council voted on. There is a lot being done at local, state, and national levels where it looks a heck of a lot more like a Communist state than a Republic. Edicts are coming from the Executive branch of government without approval from the other 2 branches of government and without a declaration of martial law.
Cause of death:
The CDC’s Full Document Explaining Coding For CoronaCold-19
COVID-19 Alert No. 2
March 24, 2020
New ICD code introduced for COVID-19 deaths
This email is to alert you that a newly-introduced ICD code has been implemented to accurately capture mortality data for Coronavirus Disease 2019 (COVID-19) on death certificates.
Please read carefully and forward this email to the state statistical staff in your office who are involved in the preparation of mortality data, as well as others who may receive questions when the data are released.
What is the new code?
The new ICD code for Coronavirus Disease 2019 (COVID-19) is U07.1, and below is how it will appear in formal tabular list format.
U07.1 COVID-19
Excludes: Coronavirus infection, unspecified site (B34.2)
Severe acute respiratory syndrome [SARS], unspecified (U04.9)
The WHO has provided a second code, U07.2, for clinical or epidemiological diagnosis of COVID-19 where a laboratory confirmation is inconclusive or not available. Because laboratory test results are not typically reported on death certificates in the U.S., NCHS is not planning to implement U07.2 for mortality statistics.
When will it be implemented? Immediately.
Will COVID-19 be the underlying cause?
The underlying cause depends upon what and where conditions are reported on the death certificate. However, the rules for coding and selection of the underlying cause of death are expected to result in COVID- 19 being the underlying cause more often than not.
What happens if certifiers report terms other than the suggested terms?
If a death certificate reports coronavirus without identifying a specific strain or explicitly specifying that it is not COVID-19, NCHS will ask the states to follow up to verify whether or not the coronavirus was COVID-19. As long as the phrase used indicates the 2019 coronavirus strain, NCHS expects to assign the new code. However, it is preferable and more straightforward for certifiers to use the standard terminology (COVID-19).
What happens if the terms reported on the death certificate indicate uncertainty?
If the death certificate reports terms such as “probable COVID-19” or “likely COVID-19,” these terms would be assigned the new ICD code. It Is not likely that NCHS will follow up on these cases.
If “pending COVID-19 testing” is reported on the death certificate, this would be considered a pending record. In this scenario, NCHS would expect to receive an updated record, since the code will likely result in R99. In this case, NCHS will ask the states to follow up to verify if test results confirmed that the decedent had COVID- 19.
Do I need to make any changes at the jurisdictional level to accommodate the new ICD code?
Not necessarily, but you will want to confirm that your systems and programs do not behave as if U07.1 is an unknown code.
Should “COVID-19” be reported on the death certificate only with a confirmed test?
COVID-19 should be reported on the death certificate for all decedents where the disease caused or is assumed to have caused or contributed to death. Certifiers should include as much detail as possible based on their knowledge of the case, medical records, laboratory testing, etc. If the decedent had other chronic conditions such as COPD or asthma that may have also contributed, these conditions can be reported in Part II. (See attached Guidance for Certifying COVID-19 Deaths)
Steven Schwartz, PhD
Director – Division of Vital Statistics
National Center for Health Statistics 3311 Toledo Rd | Hyattsville, MD 20782
“Probable” or “likely” or “assumed to have caused” are not exact terms. The big one, it seems, is that if coronavirus “contributed to death”, then it is apparently tallied as a “death from coronavirus.”
This is a big deal. Death “caused by coronavirus” is not the same as “coronavirus contributed to death.” But they are all apparently being lumped into the same category.
https://www.cdc.gov/nchs/data/nvss/coro ... deaths.pdf
Regardless, I also didn't interpret his initial post as being or suggesting an outward political perspective. To All,
