Whilst many of us are well aware of the concept of COVID-19 deaths being a reflection of dying WITH COVID-19 as oppose to dying FROM COVID-19, I think a proper illustration of this might help with the general understanding, and the fact we really don't have a very good idea at all, of the true, direct impact of COVID-19. As in, how many people would still be alive today if they had never contracted the virus?
In Canada, official figures report the current death toll associated with COVID-19 at 9234. In the US, this figure is currently 205799. Also note, the US CDC has released that of all COVID-19 deaths in the US, 6% had no other medical conditions (and nearly 100% were over 80, presumably), whilst the remaining 94% had co-morbidities such as hearth disease, hypertension, diabetes and obesity. 100% of COVID-19 deaths fall into 1 of 3 categories:
1) No Co-morbidities - This is the 6% the CDC is referring to. These are people who clearly died from COVID-19 alone, and had no other known health issues.
2) Co-morbidities, compounded by COVID-19 - These deaths are part of the 94% of COVID-19 related deaths that have other health conditions. These people had conditions that were compounded by COVID-19, resulting in their death. In other words, had it not been for COVID-19, they would still be alive.
3) Co-morbidities, not impacted by COVID-19 - These deaths are part of the 94% of COVID-19 related deaths that have other health conditions. These people had serious health conditions that resulted in their death. Whilst they also were positive for COVID-19, it played no role in their death. In other words, had they not had COVID-19, they would still be dead.
The issue with how everything is being reported, is that it is essentially assumed that 100% of deaths are a combination of categories 1 (6%) and 2 (94%) with no consideration for category 3. In reality, the 94% of deaths that include co-morbidities are actually a combination of categories 2 and 3, at an unknown ratio. Using the US death data (205799 deaths), the 94% figure equates to 193451 deaths. This means 193451 people died and had a positive COVID-19 test as well as additional underlying health issues (I believe the average was 2.6 additional conditions). The way the media and Governments currently report and base policy on, is the assumption that all 193451 deaths are a category 2 death, and would still be alive today had it not been for COVID-19. We know this to be factually incorrect. It would seem pertinent to know what portion of that 94% is actually a category 3 death, and would have died regardless of COVID-19. If it's an incredibly small portion, then perhaps it makes no real difference to policy, but what if the actual figure is 20%? 50%? 90%? If a significant portion of those labelled as a COVID-19 death, would have died from their co-morbidities anyway, that would certainly change how we look at this virus, how we react, how policy is made and so on. Yet here we are, many months in, and in the face of endless data, pretending category 3 doesn't exist. It's not always an easy task to know precisely how or why someone died, especially if they did have several co-morbidities, but in most cases it should be relatively easy to determine.
This also, relates back to the information the New York Times recently released about PCR testing sensitivity and how, in some cases, up to 90% of positive tests are actually not infectious and have a viral load far too low to worry about, yet again, this data appears to have been completely ignored as I have heard nothing about any jurisdiction looking to re-calibrate the PCR test, which is easily done. It would be very good to know what the viral load was of those whose deaths have been attributed to COVID-19 and also had co-morbidities (94%). If someone died with COVID-19 and they tested positive with less than 25 PCR testing cycles, there is a much higher chance that was a contributing factor in their death vs someone who tested positive with greater than 30 PCR testing cycles. Yet the only information we are given is whether or not they died and whether or not they were positive, even though up to 90% of those that are positive have such little virus it would be of no consequence.
Some like to point to excess death data as some level of proof that, if anything, COVID-19 related deaths may actually be under counted. The CDC has robust death data, unlike Canada. Their current report states that in 2020, the excess death count is 11%. This means, 11% more people have died from all causes than they would have expected. This information, and the claims that this proves the official COVID-19 death toll is accurate has 2 fatal flaws:
1) What the CDC is using to calculate "excess deaths" is an average of the last 3 years deaths (2017-2019, week by week). The problem with averaging previous years rather than projecting, is that deaths tend to increase year on year as population also increases. If you look at the historical data, there are far more deaths in 2019 than in 2014, for example. As an illustration, if in 2017 there were 1M deaths, in 2018 there were 1.1M and in 2019 there were 1.2M, a reasonable projection would be that 2020 would see 1.3M deaths. Yet the average that they have used to base 2020 excess deaths on would only estimate 1.1M deaths for 2020 based on the average from 2017-2019. These numbers are just fictitious numbers to illustrate the point, but it's a significant and important distinction to understand how they arrived at their figure for excess deaths. If, in this example, 2020 saw 1.3M deaths, this would be classed as 200000 excess deaths, when in fact a proper projection would have determined this death toll was in line with expectations.
2) Excess deaths simply represent the number of deaths over and above what was expected. That doesn't mean they are all due to COVID-19 infection. It would also include the number of people killed due to the response itself, such as suicide (some claims that has increased as much as 6000%), inadequate healthcare, not seeking out healthcare in a timely manner, cancelled surgeries and so on.
Whilst I am not at all denying that more people have died in 2020 than would have, the numbers directly attributed to COVID-19 are without a doubt lower than the reported "official" figures, we simply have no idea to what extent, and that is probably the most important piece of information of all. Those who died as a result of the response itself will also be a significant number that no one seems to want to address.