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The most important part of this CoatesvilleTimes article is at the bottom. I added the bold:
“It’s wonderful to see the number of COVID-19 deaths in nursing homes going down,” Chester County Coroner Dr. Christina VandePol said. “But our involvement in these deaths has brought to my attention that most deaths in long-term-care facilities are not required to be reported to us. State law should be amended to require all deaths in congregate care settings be reported to the Coroner or Medical Examiner. Most nursing homes are closed loop systems, with the same people who supervise patient care issuing the death certificates. Death certificates are sometimes issued based on information given over the phone to an on-call physician. There is a lot of room for miscommunication and conflict of interest. Our elderly, their families, and our community deserve to have access to an independent and objective review whenever a death occurs in these circumstances.”
"To quote Dr. Ed Donoghue, a forensic pathology colleague at the Georgia Bureau of Investigation, "No matter how these deaths are currently being attributed, after this pandemic terminates, an excellent approximation of the true fatality rate of COVID-19 deaths can be made by the calculation of the excess mortality for the period. This calculation was very helpful during the 1995 Chicago heat wave. Almost certainly, because of the scarcity of testing and other reasons, we will find that the number of COVID-19 deaths has been grossly underestimated." The final death toll is going to depend on multiple factors: the density of the population; availability of testing; genetic factors (both host and virus); the public health response; and the robustness of the healthcare system.
A soldier in the heat of battle can't think strategically about the outcome of the wider war. The death toll of COVID-19 is not going to be accurate until epidemiologists and statisticians have time to crunch the numbers. But the excess stresses on our healthcare system are clearly evident in countless firsthand reports from emergency rooms and ICUs in our hardest-hit regions. The challenges of formulating a real-time body count must not be offered as an excuse to abandon or dial back the mitigation measures that we know are working to keep whole populations alive and safe. We are slogging through a slow, brutal, worldwide mass-fatality event. Whatever the final tally, it will be a terrible one."
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