*Begin rant*

I just had a very frustrating convo with a co-worker.

She's convinced that ALL deaths are being reported as COVID19, regardless of what it is.

NO!

That's not how it works. AT ALL.

So, let's go through how death certificates work & how the CDC guidelines work.
1

First, a death certificate has multiple lines for primary cause of death (COD). Why? Because it's seldom straight forward and in the interest of accuracy, they're quite thorough.

And then there's a second section for underlying or contributing factors.
2

In one example I read, there were 3 primary causes of death & 1 underlying factor.

Thoroughness. Scientists of all stripes, including medical examiners/pathologists, are really into it. Which is why you should never ask them to explain something in their field to you. Really.
3

How about the CDC guidelines.

They will accept COVID19 as one of the CODs IF there is a confirming test to prove that the patient had COVID19. If there is not a test, it's "probable COVID19"and the CDC expects follow-ups to confirm that COVID19 is indeed a COD.
4

So, where does that leave us? Ah, yes, the everything is COVID19 lie.

A little scenario: say Uncle Morty has cancer. He's been receiving chemotherapy which has left him immunocompromised. He goes to your cousin's wedding and a week later, he's in the hospital with pneumonia.
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Unfortunately, Uncle Morty doesn't make it.

What is COD?

Bacterial pneumonia?
Cancer?

Well, if you ever got the chance to see it, you'd read on line 1 of his death certificate: pneumonia (and possibly the strain of bacteria that caused it). And depending on the state
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Where Uncle Morty died, the cancer (the SPECIFIC KIND) would be listed on line 2 of the first section or in section 2 as an underlying factor.

Still with me? Good.

So, say Uncle Morty got COVID19, not bacterial pneumonia.

Where would COVID19 be entered on the death certificate?

Well, that depends on the ME/pathologist. If they decide that pneumonia is the COD, they might list COVID19 on the 2nd line of section 1
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Or on line 1 since the pneumonia was caused by the virus.

But Uncle Morty's cancer is STILL listed on the certificate as a contributing/underlying factor.

Scientists are obsessed with accuracy and thoroughness.
8

Which is why COVID19 would only be entered on the death certificate if they'd confirmed its presence in Uncle Morty.

If they didn't have the test results back before Uncle Morty expired, it would list "Probable COVID19" as a COD.

And probables get followed up.
9

At the moment, the CDC is counting probable COVID19 as a separate category from the confirmed cases. The WHO is, as well.

So, no, the numbers aren't being overinflated. Not EVERY death is attributed to COVID19.

If you die of a heart attack, it's recorded as a heart attack.
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And, no, the CDC doesn't record you as a victim of the pandemic.

So...yeah.

*End rant*
11(fin)