Earlier quoted context omitted.
No country except Iceland or South Korea knows how many are infected, everyone else's numbers are horribly wrong. But death numbers and hospitalization numbers don't lie. Sure, different countries are counting deaths differently, making it hard to compare them to each other, but the trajectories don't lie. And if you look at growth trajectories, no country is experiencing uncontrolled exponential growth at this point…
> But death numbers and hospitalization numbers don't lie. Well... there is some indication hospital staff are being directed to assume all cases are COVID19 until proven different. Patients that die with presumptive COVID19 are reported as COVID19 deaths. So agree, numbers don’t lie. But... handling emergencies effectively can lead to problematic numbers.
When it comes to wearing surgical masks, yes, hospital staff are to assume that everyone's got it because it's pretty annoying to get it from a guy who came in for toenail fungus or a lady who came in for a prenatal screen and then be out of work for 2+ weeks. This is literally what has happened across Italy, China, New York, and other places. It's not like you write down in some electronic medical record "Man comes in with complaint of unattractive toenails. Presumed to be infected with COVID-19 without evidence." That's too damn much work.
On the other hand, when people die, some are being listed as presumed to have COVID-19 even in the absence of a positive test. Here's what the doctor sitting across from me says about how he's directed to fill out death certificates (yes, we're drinking Scotch, but this ought to still be accurate): On death certificates you are supposed to write a primary cause of death and then the interval between death and preceding underlying causes. For instance, if someone dies of ARDS preceded by dry cough, fever, difficulty breathing, you can say that they died of ARDS with presumed COVID-19 infection as an underlying cause. (You're apparently not really supposed to write "cardiac arrest" as a primary cause of death, because by definition, when you die your heart stops... so it's tautological in some sense and thus useless.) Another example: you could write "pneumonia" as primary cause of death, preceded by lung cancer preceded by asthma, and you could check a box for smoking but you couldn't write smoking down as a cause of death.
If you were hit by a bus and died of injuries, but you'd had COVID-19 symptoms beforehand, the certifying physician would need to write down "injuries from being hit by a bus", or rather in medicalese, "motor vehicle accident, pedestrian (ICD-10-CM subfamily V04)" [1]. COVID-19 in that case is not a cause of death, and that rando legislator from Minnesota who claims it is has a reading comprehension problem. My mom who works in the death certificate department will definitely be checking anything he signed.....
Why not only write down confirmed COVID-19 cases? Because, for instance, at the hospital at which the physician across from me works (in the COVID clinic, in fact), they serve about 100,000 patients but are allotted 25 rapid COVID tests a day. Since each patient needs two tests because of the high false-negative rate, that's 12 rapid-tested patients a day. Wowza. Yeah, let's use that on the guy who walked into the ER and got intubated within 20 minutes. Why bother?
Anyhow, interested to hear about your experiences.
[1] https://www.icd10data.com/ICD10CM/Codes/V00-Y99/V00-V09/V04-