[thu2111]

The UK made SARS-CoV-2 a "notifiable disease" which means by law any death from it must be reported to central government and it must be allocated to that death when present.

https://www.spectator.co.uk/article/The-evidence-on-Covid-19...

But there’s another, potentially even more serious problem: the way that deaths are recorded. If someone dies of a respiratory infection in the UK, the specific cause of the infection is not usually recorded, unless the illness is a rare ‘notifiable disease’. So the vast majority of respiratory deaths in the UK are recorded as bronchopneumonia, pneumonia, old age or a similar designation. We don’t really test for flu, or other seasonal infections. If the patient has, say, cancer, motor neurone disease or another serious disease, this will be recorded as the cause of death, even if the final illness was a respiratory infection. This means UK certifications normally under-record deaths due to respiratory infections.

Now look at what has happened since the emergence of Covid-19. The list of notifiable diseases has been updated. This list — as well as containing smallpox (which has been extinct for many years) and conditions such as anthrax, brucellosis, plague and rabies (which most UK doctors will never see in their entire careers) — has now been amended to include Covid-19. But not flu. That means every positive test for Covid-19 must be notified, in a way that it just would not be for flu or most other infections.

[DanBC]

The Spectator gets almost all of that wrong.

1) Death certificates rely on doctors using their best knowledge and experience to say what the patient died of, and what the patient died with. Flu and other respiratory illness is mentioned on many death certificates. See 5.4 here: https://assets.publishing.service.gov.uk/government/uploads/...

2) A notifiable illness has no meaning for death certificates.

3) We don't routinely test for flu. That's why all cause mortality is the preferred statistic for flu deaths, and also for covid-19 deaths.

[thu2111]

Huh. That's not the response I expected.

You're not arguing with the Spectator, they're just acting as a publisher. You're arguing with in his words, "a recently-retired Professor of Pathology and NHS consultant pathologist". So you're claiming a professional British pathologist doesn't understand how British death certificates work, and you know better. Bold move.

Especially so because you seem to actually be agreeing with what he wrote, which is weird. For instance your claim (3) exactly matches his claim that:

"the vast majority of respiratory deaths in the UK are recorded as bronchopneumonia, pneumonia, old age or a similar designation. We don’t really test for flu, or other seasonal infections."

You say flu appears on many death certificates. Yes and he never argued otherwise. He said despite that it's sometimes mentioned it's actually under-reported because testing isn't really done much for it - as you agreed with!

That leaves the question of notifiability. The rules say that COVID-19 must be mentioned on a death certificate if testing was done at all, even if negative (which is new to me, I wonder what that does to the widely cited stat of "number of certificates that mention COVID"). But the point is that relative to flu, testing deaths for COVID is enormous, practically blanket at this point. If you test a lot and you insist that every case is reported to central government it will cause a flood of reports to arrive on the desks of decision makers, who will then feel it's much worse than flu. But it's not, it's just a reporting artifact.