FISH ON
I keep seeing this “6%” figure, and it’s used constantly by people who don’t understand how a US Certificate of Death is filled out.
The 6% isn’t what you think it is. If COVID-19 is listed as the Underlying Cause of Death in Section 32 Part I of the US Standard Certificate of Death, then COVID-19 initiated the chain of morbid events leading directly to death, regardless of what other conditions might be present. Further, COVID-19 should never be the only condition listed in Section 32 Part I because COVID-19 is not an immediate cause of death. A natural progression is required for Part I. For example: hypoxemia (immediate cause of death) due to ARDS due to COVID-19. That is a complete chain of events. Add the onset intervals and you have a correctly completed Section 32 Part I.
The items in Part II contribute to the patient’s inability to survive, but are not part of the chain of events that led to that patient’s death. For example, a patient who has lived with COPD for the past 10 years. That patient contracts COVID-19 and dies. COPD doesn’t cause COVID-19 and COVID-19 didn’t cause the COPD. Having COPD limited that patient’s ability to survive the COVID-19 infection that killed them, so COPD goes in Part II. But COVID-19 is still the UCoD in Part I and it’s a COVID-19 death.
Every time the “6%” bit gets tossed around, it’s evidence that the person tossing it doesn’t understand any of this. There’s still about 600,000 US Standard Certificates of Death in the United States where COVID-19 is listed as the Underlying Cause of Death, and that’s the only line that matters for statistics tracking. There is only one underlying cause. There is only one immediate cause of death. There may be events in between. There may be many conditions contributing to death.
Here’s how silly that “only 6%” really is: consider a 58 year old patient with hemophilia. He’s lived with the condition for his entire life. One day he walks in on a robbery at a convenience store and is stabbed several times. Based on the extent of the injuries and the response time of medical personnel, it’s likely a patient without hemophilia would survive the injuries, but this man does not.
What you are suggesting with this “6%” stuff is that he didn’t die from being stabbed. Nonsense. He absolutely died from being stabbed. He was just fine for 58 years, then he got stabbed, then he died. It’s ridiculous to assert that anything other than stabbing should be listed as his cause of death. But that’s exactly what you’re suggesting when you say “only 6%” died from only COVID-19. “Only 6%” died from being stabbed because 94% had hemophilia or hypertension or diabetes or heart disease? No, they died because they got stabbed. They lived for years or decades with those other conditions.