Monday, April 27, 2020

Redefining COVID-19 Deaths the World Health Organization Way

While the number of new deaths apparently associated with COVID-19 seems to be skyrocketing in some jurisdictions, there is a single reason that could be pushing the death total higher.

Here is a recently released set of guidelines for classification (coding) of COVID-19 as a cause of death from the World Health Organization:

Here is the key page which defines the definition for deaths due to COVID-19:

Note this:

"A death due to COVID-19 may not be attributed to another disease (e.g. cancer) and should be counted independently of preexisting conditions that are suspected of triggering a severe course of COVID-19."

Here is how an International Form of Medical Certificate of Cause of Death is to be filled out where COVID-19 is listed as the "underlying cause of death" but comorbidities (i.e. pre-existing conditions including cancer, heart disease etcetera) are present:

Note that in the fourth case, the decedent had HIV for five years but yet, it is only considered to be a contributor to the death but COVID-19 is considered to be the underlying cause of death.

Here are examples of deaths not counted as having COVID-19 as an underlying cause:

As shown on this page, death coding of COVID-19 can be used in cases where there is no laboratory confirmation of the presence of the novel coronavirus, it merely has to be "probable" or "suspected":

Let's take a quick look at what Dr. John Lee had to say about the issue of recording deaths in The Spectator:

"If someone dies of a respiratory infection in the UK, the specific cause of the infection is not usually recorded, unless the illness is a rare ‘notifiable disease’. So the vast majority of respiratory deaths in the UK are recorded as bronchopneumonia, pneumonia, old age or a similar designation. We don’t really test for flu, or other seasonal infections. If the patient has, say, cancer, motor neurone disease or another serious disease, this will be recorded as the cause of death, even if the final illness was a respiratory infection. This means UK certifications normally under-record deaths due to respiratory infections.

Now look at what has happened since the emergence of Covid-19. The list of notifiable diseases has been updated. This list — as well as containing smallpox (which has been extinct for many years) and conditions such as anthrax, brucellosis, plague and rabies (which most UK doctors will never see in their entire careers) — has now been amended to include Covid-19. But not flu. That means every positive test for Covid-19 must be notified, in a way that it just would not be for flu or most other infections.

In the current climate, anyone with a positive test for Covid-19 will certainly be known to clinical staff looking after them: if any of these patients dies, staff will have to record the Covid-19 designation on the death certificate — contrary to usual practice for most infections of this kind. There is a big difference between Covid-19 causing death, and Covid-19 being found in someone who died of other causes. Making Covid-19 notifiable might give the appearance of it causing increasing numbers of deaths, whether this is true or not. It might appear far more of a killer than flu, simply because of the way deaths are recorded."

While all of this may seem rather academic to many of you, we must keep in mind that the number of reported deaths due to COVID-19 is being used by governments around the world to justify their "lockdown" procedures and imposition of "states of emergency", all of which reduce our civil freedoms.  With the WHO clearly demonstrating that it is willing to stretch the definition of a COVID-19-related death and the strong association of COVID-19 deaths and pre-existing conditions (Italy - 97.9 percent), we can be assured of one thing - don't believe everything you read when it comes to the number of COVID-19 deaths being reported.


  1. Maybe the WHO is just trying to to develop a standard so that Coronavirus deaths are reported in a consistent way across different Countries. Up to now it was kind of a Far West: every Country reporting deaths based on its own evaluation and criteria, making the data intrinsically non homogeneous.

    It will take years of statistical analysis to finally get a better picture of the incidence of the Coronavirus epidemic on deaths in various Countries around the world.

  2. Are you familiar with the 'Z' score at Euromo- if so do you know how to interpret that.