“With” versus “from”

One of the puzzling things about Covid-19 has been filtering through the reporting of various reports -economic, medical, political, etc.- trying to get a proper understanding of what the risks really are. But even evaluating the actual medical risks based on reported death rates has been nearly impossible to make sense of until I came across an article that reminded me of a common complicating factor in understanding gun/murder stats.

It’s been well-known in the gun-rights community for a long time that it is not always possible to directly compare different nation’s crime stats because they use different definitions even for seemingly “obvious” things like murder. If a bobby in the UK finds a bullet-riddled body in an alley, covered in gang tattoos under spray-painted graffiti that reads “die, snitch!” it’s doesn’t get recorded as a murder, merely a death, until they have a conviction of the perpetrator of the crime. In America the police would mark it down as a murder even if they never ID the body. The UK clears less than half their murders, so their murder rate by American statistical definitions is more than twice the officially poblished Home Office numbers. They record fatalities the way they do for domestic political purposes. As a second example: if a man kills his wife and two children, then himself, in Japan it would be recorded as four suicides, in the US it would be recorded as three murders and one suicide. That is part of the reason for their much higher suicide rate in official stats.

Similarly, in the medical community, the insurance company has “codes” for diagnoses and procedures, and how something gets recorded dictates who pays and how much. When a person has many complications, sorting out causation from mere coincidence can be difficult, and often leaves room for reasonable disagreement. If an elderly  person dies, and they have serious heart disease, normally uses an inhaler because they sufferer from seasonal allergies and mild asthma, are receiving treatment from emphysema, take a list of medications as long as your arm for various things, and died with Covid-19 in their system, symptoms of sepsis, viral pneumonia, bacterial pneumonia, and bronchitis, did they die BECAUSE of Covid-19, or merely WITH Covid-19 as a complicating but possibly very minor contributing factor?

Currently, in Italy, anyone who test positive for Covid19 and dies is said to have died FROM it. Other nations are not. In fact, in China, it appears if there exists any other complicating factor, then that other complicating factor is declared the cause of death; that’s how they can claim they have no new deaths from it. The “reality” for both is likely somewhere in between these two extremes.

Different nations and medical systems will have different incentives to do it different ways. If, for example, a US insurance company knows they’ll be compensated by the federal government for Covid-19 related expenses, they will be HIGHLY motivated to code it that way. If, on the other hand, there is no compensation and they pay out a lower rate based on some other diagnosis like “lung disease” (I’m not a medical insurance professional, so I do not know what specific sort of things might be use, but you get the idea), then they might be more motivated to code it that way in a complicated case such as the one given above. In China, because of a cigarette consumption about twice the per capita rate of America, horrendously polluted air and water, a government-run healthcare system designed around efficiency rather than care quality, and a political preference for narrative-building rather than truth, will almost always have a much higher death rate than the US from such a disease, regardless of what the official stats show.

Clearly, based on how the Chinese reacted, and on how many world leaders who have gotten it have die, when it turns into the more serious/complicated form it is a disease to be reckoned with. But considering how many people appear to be asymptomatic, any how many who have no underlying morbidity factors only have mild cases, I’m coming down more on the side of “be cautious, particularly if you have the underlying risk factors like age, being a smoker or having diabetes, but don’t freak out.”

So why the full-court press and shut-downs and hysterical over-reactions? Politics, of course. The Dems know that with a roaring economy and promises delivered they have no chance of beating Trump. Their only hope is to crash the economy and spin the FedGov response as a failure that they can hang on Trumps head. Note it’s mostly Democrat-run states that are going overboard with shutdowns and panic-talk. Meanwhile, the Media-Democrat complex will spin a narrative of the great Democrat governor response (looks like Cuomo for the brokered Dem convention this year, and WA state’s Jay Inslee is obviously angling for 2024), and all the BOLD steps they took because they’d been abandon by the incompetent Trump administration.

But Trump is the king of making lemonade from an unexpected delivery of lemons. I have a few ideas how he might use the Covid-19 panic to not just mitigate, but upend the Dem attacks completely. More on those thoughts, perhaps, later.

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