Actual cause of death

Dear editor:

I’ve been watching and reading the debate concerning what is the true number of deaths from the coronavirus. Some believe the numbers to be accurate and others believe them to be inflated or greatly exaggerated. Why do they feel this way? They claim that people dying of their underlying diseases while simultaneously testing positive for the virus are being incorrectly recorded as coronavirus deaths (when they haven’t died of respiratory failure).

As a physician, when a patient died, it was my duty to fill out the U.S. Standard Certificate of Death. It instructs the doctor to record the immediate cause of death. But then also to record if the immediate cause of death was due to or a consequence of another medical problem.

It clearly states not to use cardiac arrest as the cause of death since everyone ultimately dies of a cardiac arrest. It also states that if you die of respiratory arrest you are to show the etiology (cause) of the arrest (what was it due to).

In the case of the majority of patients with the coronavirus, if I was filling out their death certificates, I would fill in the boxes recording that the death was due to respiratory insufficiency (not getting sufficient oxygen to live) due to or a consequence of pneumonia due to or a consequence of infection with the coronavirus. Had the patient never gotten the coronavirus, they would not have developed pneumonia leading to respiratory insufficiency and death.

I believe the controversy may lie with listing other significant conditions contributing to death. We hear constantly that those who have underlying conditions are more likely to die of the coronavirus that those who are healthy. So, if you have diabetes, kidney disease, heart disease and especially lung disease, you are more likely to die if you get infected. More likely to die of respiratory failure but also more likely to die of kidney failure, congestive heart failure or even a sudden heart attack; an underlying medical problem you may already have.

But here’s the point. Had you not contracted the coronavirus in the first place and had your body not been placed under new and additional stress, you would not have died at that time due to your chronic illness. Therefore, if you died of kidney failure or heart failure, it was due to or a consequence of contracting the coronavirus. Therefore, I believe it is accurate to ascribe those deaths as coronavirus deaths. Had the patients not been first infected with the coronavirus, they would have lived to die sometimes in the future.

Therefore, I believe the recorded number of coronavirus deaths in the U.S. are, for the most part, accurate. Jack Sternberg, MD Hot Springs, AR