[gizmo]

But the excess death data will also be tainted because people, especially older people, avoid going to hospitals out of fear of catching covid19. Cancer screenings are way down, and fewer people go to the ER with heart attacks and the like. This will inevitably lead to excess mortality down the road --even among otherwise healthy people--, but it will be very hard to determine the magnitude of this second-order effect.

Of course it's also very hard to distinguish between people dying with covid19 and dying because of it. And we've never even made a serious effort to track the cause of death of the elderly.

Meaning we don't know how many people die each year from the flu, and we don't know how many people are dying of covid19. When you add it all up, it will be very difficult to learn the right lessons from this pandemic.

[DanBC]

That's not what excess mortality means. They don't say "this many extra people died, I guess it must be covid" -- they're not fucking idiots.

When cancer patients die because their cancer treatment was cancelled they die of a cancer related cause, and that's how their death will be recorded, and that's how their death will be reported.

> And we've never even made a serious effort to track the cause of death of the elderly.

It's hard to understand your "we" here. Which country doesn't try to track cause of death for elderly people?

> Meaning we don't know how many people die each year from the flu,

But we can count the deaths the same way. We can look at deaths of people confirmed to have the disease, we can look at death certificates, we can look at excess mortality combined with community surveillance. The errors for all three are going to be similar for flu and covid-19.

[gizmo]

> But we can count the deaths the same way.

When person in an elderly care facility dies we don't do a forensic investigation. We just shrug and say "I guess it was their time". So we don't have an accurate mortality baseline to do any comparison against. And that's assuming we are accurately distinguishing between those who died of covid19 and those who died with covid19, which we don't.

I'm not suggesting that people who draw conclusions from incomplete data are idiots, I'm pointing out that the data we have is completely insufficient to make an accurate assessment of covid19 mortality.

[alkonaut]

I think this is why excess all cause deaths will be the best evaluation. Lots of people who die from Covid in care homes are people who would have died from this years flu anyway. They aren't excess deaths, they are the baseline deaths.

[gizmo]

I agree that 'excess all cause deaths' is an important metric, but we still have to correct for clear biases in both directions. E.g. fewer traffic deaths because of a lockdown.

[DanBC]

> When person in an elderly care facility dies we don't do a forensic investigation. We just shrug and say "I guess it was their time".

This ("we just shrug and say "I guess it was their time"") is untrue. It's okay that you don't know, but you should stop spreading this misinformation.

[gizmo]

The first link I get when I google "accuracy of death certificates" is this one:

The accuracy of death certificates. Implications for health statistics. https://www.ncbi.nlm.nih.gov/pubmed/1871957

> Significant discrepancies between the two documents were observed in 50% of patients. In 25%, the immediate cause of death was incorrectly stated on the certificate, having been assigned to a different organ system in the majority of those cases. In 33%, there was disagreement on major disease other than the immediate cause of death.

Anecdotally, elderly people I've lost had completely wrong death certificates. When common sense, anecdotal evidence, and a cursory review of the scientific literature point in the same direction I'm going to assume that's the way it is.

Also, try to be kinder in the way you communicate.