#proper research

So many people are jumping at the chance to show they don’t know what a death certificate looks like or know how to read past a headline.

For anyone reading this and is confused as to what I mean, nobody dies “of one thing” except for murder cases or violent death (like falling face first off of a building).  When you “die of AIDS”, what you actually have are comorbidities.  AIDS lowers your immune system and the fever causes severe internal damage that causes a sudden heart failure.  Three comorbidities.

The Flu isn’t a cause of death; the flu creates a system that taxes your body that underlying weaknesses/factors can be exacerbated that can lead to a direct cause of death.  That’s why, like COVID, you’re especially advised to get a flu shot if you’re:

Old

Immuno-compromised

Young

Because all three of them operate within “my body might not be working right and may have long-term complications from getting the flu, including maybe “dying of the flu”.  This is why the flu, in slightly more medical terms than the 5 o’clock news, is called an underlying cause of death.  

This is from the official CDC guidelines on “how to complete a Cause of Death certificate”

Look at it closely.  There’s an immediate cause of death, up to three underlying causes of death, and other related factors.  This is what a heart attack looks like.  Do you note how “acute myocardial infarction” isn’t even the immediate cause of death, despite them dying “of a heart attack”?

Do you note their history of smoking and OPD (likely itself caused by smoking)? Do you see the heart disease, listed as a tertiary underlying cause of death? This person died of heart disease, via a heart attack.

It’s also a perfectly legitimate thing to say this person died from smoking.

And that’s what it looks like for COVID, for AIDS, for cancer, etc.

The conversation has always been “the old and the immuno-compromised are the most vulnerable.”  This is what that looks like.

And now people are seeing this, don’t know what death certificates, causes of death, or comorbidities means and they just spout things that make no sense in the full context.

Take this publication from July 17th, for example.

People of any age with certain underlying medical conditions are at increased risk for severe illness from COVID-19

Let’s look at this from April.

For patients with hypertension not taking an ACEi or ARB, taking an ACEi, or taking an ARB, the mortality rates were 26%, 32%, and 30%, respectively. “This study reported mortality rates only for patients with definite outcomes (discharge or death), and longer-term study may find different mortality rates as different segments of the population are infected,” investigators concluded. “The findings of high mortality rates among ventilated patients are similar to smaller case series reports of critically ill patients in the US.”

From February

Objective: To evaluate the spectrum of comorbidities and its impact on the clinical outcome in patients with coronavirus disease 2019 (COVID-19). Severe cases accounted for 16.0% of the study population. 131 (8.2%) patients reached [admission to the ICU, invasive ventilation, or death]. 399 (25.1%) reported having at least one comorbidity. 269 (16.9%), 59 (3.7%), 30 (1.9%), 130 (8.2%), 28 (1.8%), 24 (1.5%), 21 (1.3%), 18 (1.1%) and 3 (0.2%) patients reported having hypertension, cardiovascular diseases, cerebrovascular diseases, diabetes, hepatitis B infections, chronic obstructive pulmonary disease, chronic kidney diseases, malignancy and immunodeficiency, respectively.

I don’t expect people to know what a determination of cause of death literally looks like.  You’re not experts.  Neither am I, really; I just have an unfortunately long history with cancer in my family.