https://www.postoj.sk/65044/mnohe-ob...le-od-alkoholu
This pathologist is making a critical distinction between
SARS-CoV-2 ( the virus)
and
C19 (the clinical disease caused by the SARS-CoV-2 virus).
It is a bit muddled here when he talks about "SARS-Co-2 infection" not being C19 (by definition, SARS-CoV-2 infection = C19). I presume he is talking about a positive PCR test where the patient is "colonised" by SARS-CoV-2 but with no actual invasive infection. Google translate can miss nuances. But I think that is what he means. That makes sense - we often swab a skin ulcer on a foot and will usually grow some bacteria, but most often these bacteria are simply colonising the ulcer (i.e. they are living on the ulcer and can be isolated in a lab), but the bacteria are not actually causing an infection, and antibiotics won't help as the ulcer is really caused by vascular disease or diabetes or something else.
So I think he is saying they had 366 C19 deaths (later increased to 390). But a further 127 deaths where the person had a positive PCR but did not have C19 (as no infection) and hence could not have died from C19.
The guy is making a lot of sense. Mortui Vivos Docent, the dead teach the living.
However in systems where you don't do an autopsy (rates are very low in many countries, and rates have decreased further this year due to concerns about viral transmission), you will over-count C19 deaths. If someone dies, there is a positive PCR, there is no other obvious cause of death, then the death is considered as C19.
Lots of old people die without an apparent cause. Something other than "old age" has to be written on a death certificate. So it is often put down to "dementia" or "heart failure" or something vague. But if you have a positive PCR and there is no other obvious cause, then the death will be attributed to C19.
Yesterday, korona.gov.sk reported 366 victims of Covid-19. What would be this number if we also added those victims who were positive for the coronavirus but died of another cause?
As of November 9, we have 366 deaths with Covid-19 (on November 10, the number increased by 24, ed. Note). We also have 127 deaths with SARS-CoV-2 infection detected, but these patients did not have Covid-19 and we only report them as infected in the statistics. It can be seen from these numbers that this is a significant difference. So if we didn't do a detailed investigation, we would have had significantly more deaths in Covid-19.
Some may say that, from the point of view of great statistics, this is negligible, but if we want to know exactly what the impact of the epidemic is, then, in my opinion, it is very important to have the most accurate numbers possible and to do it this way.
https://www.postoj.sk/65044/mnohe-ob...le-od-alkoholu
It is in connection with a heart attack that the number of victims of the disease has been relativized in the past. So if someone had a coronavirus infested lung but also had a heart attack, what would we die for, according to our classification?
If we have a patient who has a myocardial infarction, is hospitalized and treated for this disease, and dies of the symptoms of heart failure, he is routinely tested for coronavirus in the hospital and in our country at autopsy.
If the patient was tested positive, then, of course, in this case we examine the morphological changes in the airways and lungs in great detail. If no changes are found to support the diagnosis of advanced Covid-19, then the patient will only be included in the statistics as a death with SARS-CoV-2 infection.
However, if it was a recent heart attack, say one to two days, and the development of changes in the lungs related to Covid-19 clearly show that it was a week-long process, then the patient will be closed with Covid-19 and died to its consequences. Here we can talk about myocardial infarction as the immediate cause of death, but the underlying disease, the primary cause of death was Covid-19, which contributed significantly to the failure of the body.
There have been 4 previous viral outbreaks in the PCR era - SARS, MERS, Zika, and Ebola.
With ALL 4 of these previous outbreaks, CDC and WHO agreed that a person with an initial positive PCR required 2 further things to be diagnosed as a case
i) a repeat confirmatory PCR test
AND
ii) clinical features of infection
That all changed with C19. A positive SARS-CoV-2 PCR test = C19. No repeat test. No clinical features (as a large asymptomatic % is accepted as being part of the disease).
China however still requires a person to have a positive test (not clear if repeated) AND clinical features to be considered a case. They will still isolate and track positive PCR, but they are not cases.
Regarding the need for a confirmatory PCR test:
One study of positive SARS-CoV-2 samples tested the same sample a further 2 times (so each sample was tested 3 times). Note they didn't get another sample from the patient - they simply re-processed the sample a further 2 times.
55% of the time, the 2nd and/or the 3rd test were positive, and so the initial positive was considered a true positive
45% of the time, both the 2nd and 3rd test were negative, and so the initial positive was considered a false positive.