Sivad wrote:Montana Physician Dr. Annie Bukacek Discusses How COVID-19 Death Certificates Are Being Manipulated
April 6, 2020
Figures Don't Lie, But Liars Figure
Dr. Bukacek is a longtime Montana physician with over 30 years' experience practicing medicine. Signing death certificates is a routine part of her job.
In this brief video, Dr. Bukacek blows the whistle on the way the CDC is instructing physicians to exaggerate COVID-19 deaths on death certificates.
I wonder, she just happens to be wearing the lab coat and a stethoscope when she wandered into the conference/theater room for the lecture
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That's funny. Anyhow she is making a strawman of the situation. First, the cases of people that came to the hospital for unrelated reasons, died for unrelated reasons and for some reason was tested and positive for COVID19 are few and very sporadic. The truth of the matter that since this COVID-19 issue started here in the US, tests have been very short in supply and the vast majority of doctors wouldn't even think of ordering such test unless they truly think the patient might have it (and contributing to the presentation). In fact, just 3 weeks ago I had some ED colleagues of mine complaining of how hard it is to order such tests and to actually get them. This has improved and last week my hospital for the first time started testing some people without symptoms/risks factors because they were being discharged to facilities and these facilities would not accept patients without a negative test. But this is a very recent development, nothing that could significantly alter the statistics that we have been collecting for weeks. So this idea that somehow someone came into the hospital with a gunshot wound and was tested for COVID 19 and tested positive even though the person had no symptoms and later went to die from GSW complications and was reported as COVID 19 death is mostly a strawman. Could it happen for a minority of cases? probably but the cases are so few and sporadic that it will balance out by those that die at home/facilities and are never tested (or reported for that matter).
Finally, all of this non-sense of co-morbidities and death certificates. The vast majority of Americans have at least 1 comorbidity. Obesity, smoking, Hypertension, Asthma, Diabetes, with only those few you can readily see why it is actually hard to find a "healthy" 30 years old.
Of course, a mildly hypertensive person on therapy, well-controlled is probably at a similar risk as someone that doesn't have hypertension at all (this is admittedly speculative from my part but based on an understanding of pathophysiology) but it makes a difference in reporting and carries into the statistics. Also, not all institutions collect the data with the same reliability especially in times like this. How do we know if you have co-morbidity if you have never been in my hospital? We ask you. What happens if you can hardly breathe and get intubated immediately? We don't get much information. We might go by the pills that you take if you presented to the hospital with a bag full of pills (often it is not the case) and sometimes if you ever got prescriptions electronically some EMRs might show SOME of the prescriptions that have been filled for you in the past, but if you weren't taking anything because you were not seeing a doctor for your chronic conditions... well we won't know and it won't get reported.
Finally "cause of death" is easier said than done. It is true what she says that we get a lot of flexibility to what to list in a death certificate and that we often don't know the cause. But it is far more subtle than she lets on. The problem is that there is a "proximal cause of death" and usually, an underlying disease/problem that lead to that proximal cause of death. For instance for COVID - 19 the patient might die from Cardiopulmonary arrest, or they could have a Brain death due to a prolonged period of hypoxia, or it could be a refractory shock (Blood pressure tanks), or severe progressive multi-organ dysfunction. COVID19 itself doesn't cause the death but rather causes stress of the different organ systems until one or more of them fail and that causes the death. It is analogous to saying that a bullet does not cause a death, the whole in the heart caused the death... Sure, this might be technically accurate but misses the point.