Coronavirus Taiwan Open - April-June 2022

I get the impression that a positive COVID test is all that is required. As Andrew pointed out, there seems to be no requirement that the person died of something obviously COVID-related. There was an article from a while back in the local rag regarding an apparent COVID death of a 30-year-old. Such things are of course very ambiguous because reporters aren’t clinicians, but it appears she presented originally with septicemia.

The lack of clarity here doesn’t inspire one with confidence.

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So one may be completely asymptomatic, with Covid possibly contributing zero percent to the death, but since they tested positive to Covid (at some indeterminate date in the past) it is labelled as a “Covid death”?

The descriptions in the news articles following “COVID deaths” imply that’s the case. What seems to happen is that the corpse gets swabbed and … OMG, it’s positive, he died of COVID. Not dissimilar to what happened elsewhere of course, and as @slawa said in a different context, it’s the way the WHO wanted it done.

I’ve no doubt a few people are dying with the classic COVID progression to death. But there seems to be an awful lot of noise in the reports.

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I guess they make sure it’s not a suicide or drowning (as of recently), then it’s a COVID death with 調查中 in the symptoms column?

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Wouldn’t it be then be more accurate to label these, as say, “Cancer (lung) death” with accompanying Covid positive swab at time of death? Something like:

Chronic heart disease death (Covid pos. at T.O.D.)

Chronic diabetes death (Covid pos. at T.O.D)

Terminal lung cancer death (Covid pos. at T.O.D.)

Since, there’s simply no detail on whether Covid contributed anything at all to the actual death?

It seems that to label these as “Covid deaths” is inaccurate and quite unscientific. I mean, if they are not sure what actually caused the death, or what percent Covid even contributed to it, then how can they boldly declare it ‘a death by Covid?’

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The obvious solution would be, like, you know, just duplicate the normal format for death certificates, which in most countries follows logic like this (UK guidelines) and which is designed to facilitate statistical accuracy, transparency, and a red-flag system for suspicious deaths:

The MCCD is set out in two parts, in accordance with World Health Organisation (WHO)
recommendations in the International Statistical Classification of Diseases and Related
Health Problems (ICD). You are asked to start with the immediate, direct cause of
death on line Ia, then to go back through the sequence of events or conditions that led
to death on subsequent lines, until you reach the one that started the fatal sequence. If
the certificate has been completed properly, the condition on the lowest completed line
of part I will have caused all of the conditions on the lines above it. This initiating
condition, on the lowest line of part I will usually be selected as the underlying cause
of death, following the ICD coding rules. WHO defines the underlying cause of death
as “a) the disease or injury which initiated the train of morbid events leading
directly to death, or b) the circumstances of the accident or violence which
produced the fatal injury”. From a public health point of view, preventing this first
disease or injury will result in the greatest health gain. Most routine mortality
statistics are based on the underlying cause. Underlying cause statistics are widely
used to determine priorities for health service and public health programmes and for
resource allocation. Remember that the underlying cause may be a longstanding,
chronic disease or disorder that predisposed the patient to later fatal complications.

You should also enter any other diseases, injuries, conditions, or events that contributed
to the death, but were not part of the direct sequence, in part two of the MCCD. The
conditions mentioned in part two must be known or suspected to have contributed to the
death, not merely be other conditions which were present at the time.

I don’t know for sure, but I would imagine Taiwan’s death certificates are (or were, back in times of sanity) filled out in more-or-less the same way. Replacing this with some ad-hoc alternative looks - at best - like incompetence. Of course, if a country has spent an eye-watering amount of money on doing X and it turns out that the statistics indicate that they probably should have done Y (and that X was largely unimportant) you wouldn’t want the statistics to flag that up, particularly if you were the person responsible for spending said money (in part upon your own salary).

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Suspicious, this is based on a comparison between May 2021 and May 2022. Might just mean than Taiwaneses have more babies when they are partially locked indoor. (edit: or another reason, cannot interpolate on just one month)

A lot of assumptions being made again about how covid death are counted.
It was clarified by CECC and I posted it several times already.

Chou Jih-haw (周志浩), head of Taiwan’s Centers for Disease Control, said at the briefing that the CECC is now using new criteria for defining COVID-19 deaths.

Up to the end of 2021, anyone who had tested positive for COVID-19 and died was listed as a COVID-19 death, he said.

This year, however, COVID-19 deaths are being listed only as those that can be directly attributed to the disease.

https://focustaiwan.tw/society/202206090024

What does, “Directly attributed to the disease” even mean? Are you saying that means that all these 80-100 year olds with stage 4 lung cancer, chronic kidney disease, chronic hepatitis, cardiovascular disease, etc. died wholly and solely “of Covid”? Like, absolutely zero contribution from any other comorbidity that they had?

It seems like the CECC are asking the public to swallow a whole lot of something to accept their own “assumptions.”

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That statement is quite obviously bollocks, though, isn’t it? At best, it’s impossible to really know from the half-assed descriptions of the conditions that led to death exactly what did … well, lead to death. Whereas the death-certificate format is explicitly designed to remove such ambiguity. So why did they throw away a perfectly workable system for recording cause-of-death and replace it with something completely uninformative?

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It is remarkable, that practically overnight they turfed out the old system, which seemed quite fine, and replaced it with something that simply muddies the waters. It all became less scientific, not more.

They did something similar in the UK. The excuse was that the number of deaths was “overwhelming the system” and corners had to be cut … despite the fact that deaths never actually increased much beyond a normal flu season, and then only in transient peaks. The obvious solution would have been to recruit some more manpower instead of (as was actually done) shutting everything down.

And here in Taiwan, I’m sure some people will suggest that the authorities are doing the best they can under difficult circumstances. Well: here we’ve got a bunch of people who have set themselves up as Generalissimos for Life (or for the foreseeable future), have unilaterally suspended the Constitution, and commandeered the entire resources of the country to “fight COVID” … and yet they’re unable to get some clear information about the deaths of a few dozen people into a daily Excel spreadsheet. Even though some faceless bureaucrat already figured it out years ago. If these are difficult circumstances, and they’re doing the best they can, I wouldn’t want to entrust them with anything more complex than doing the laundry.

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Chou Jih-haw (周志浩), head of Taiwan’s Centers for Disease Control, said this. Your questions should be directed to him.
But “directly attributed to the disease” is pretty clear.

You know it much better than the head of Taiwan’s Centers for Disease Control.

As with VAERS or covid deaths, medical professionals, who are allowed to access detailed private medical information of those people, make the decisions how their deaths are categorized.
Public has not access to such private medical data. It is abbreviated and anonymized in the reports.
Asking for death-certificates that only family members receive to be made public is ridiculous.

Yes, I know that’s the excuse generally given, but since it’s obvious to any casual observer that several of these deaths (perhaps a majority) cannot possibly be “directly attributed to the disease”, serious questions should be asked, and they need serious answers. And the CECC really strike me as very unserious people.

I’m quite amazed at the willingness of people here to make excuses for unprofessional behaviour (or possibly worse). A great deal of public policy (and the validity of some emergency legislation) hinges upon whether the CECC are being honest. It is in their best interests - if they are being honest - not to obfuscate the facts. As @FairComment said, if the precise details of the death certificates cannot be divulged, then other methods of conveying the same information are possible, and it doesn’t take a genius to figure out how.

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If it is “so clear” then I ask you to please explain it in plain English. What does that mean to you? Does it mean to you that nothing else apart from Covid caused that death? I’m asking you specifically.

If you take “directly attributed” to mean “Covid alone caused this death” then to a lot of people, that seems quite a lot to swallow, especially when these deaths pretty much all have severe comorbidiites such as heart and lung diseases, cancers and so on.

If we take their explanation as it is, then the way the CECC are labelling these deaths make it appear that none of these comorbidities played any part whatsoever in these deaths.

Personally, I find that very hard to believe, and possibly the way they are labelling these deaths is wrong. They’ve confessed they’ve previously labelled other so-called “Covid deaths” wrong in the past, so they have a history here in that regard. They are clearly not above making serious errors in death labelling.

One also wonders what the point of becoming a doctor is, if, after years and years of training, observation and clinical practice, one is simply told to “follow the WHO” in rubber-stamping suicides and drownings (among other things) as “Covid deaths,” or whatever other instructions they hand out which may be similarly clinically unsound.

I would think it would be highly embarrassing.

Well, it’s this sort of thing that led to mass protests among NHS staff in the UK. As I mentioned before, the onslaught of COVID horseshit was the last straw for one particular family member; she went off to work in a comfortable office doing research instead of helping sick people, because the gubmint was sending a clear message to highly-qualified, hardworking doctors that their services were not valued.

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The doctors I’ve met had a fairly robust professional ego. I suspect a few would have bristled at having to hand their nuts in a jar over to the WHO.

Most appeared to cave, though, lest they lost their jobs :frowning:

I’d rather blame it on the economic stress -from people in service industry who lost their jobs-, plus being cooped at home with granny, grampa and the kids all day and night is not conductive to passionate evenings.

In my experience, irregular menstrual cycles lead to more children, as people think they are safe, nah, it’s just a normal delay, not an 18 year headache one. Surprise!

Finally, most people here have trouble conceiving because they get married in their 30s, and start child making almost by 40s, with already lower sperm/less eggs to work with. Fortunately, IVF is affordable and there are no ideological/religious constraints…unless you use a Catholic hospital. Even the government has subsidies for IVF.

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Those reasons wouldn’t account for a 23 percent drop in one year.

Are those numbers definitely correct?