Dr John Lee, writing in The Spectator (paywall, but free access to a few articles), explains what pathologists do, and goes on to say:
We are still struggling to understand coronavirus. I can think of no time in my medical career when it has been more important to have accurate diagnosis of a disease, and understanding of precisely why patients have died of it. Yet very early on in the epidemic, rules surrounding death certification were changed — in ways that make the statistics unreliable.
We’ve moved from needing two doctors to certify death, to only one if the cause is believed to be Covid-19. And sometimes the ‘cause’ is decided from a statement from care-home staff, who are not usually trained medical professionals.
So at a time when accurate death statistics are more important than ever, the rules have been changed in ways that make them less reliable than ever. In what proportion of Covid-19 ‘mentions’ was the disease actually present? And in how many cases, if actually present, was Covid-19 responsible for death? Despite what you may have understood from the daily briefings, the shocking truth is that we just don’t know. How many of the excess deaths during the epidemic are due to Covid-19, and how many are due to our societal responses of healthcare reorganisation, lockdown and social distancing? Again, we don’t know. Despite claims that they’re all due to Covid-19, there’s strong evidence that many, perhaps even a majority, are the result of our responses rather than the disease itself.
It sometimes seems like we’re trying, as a country, to handle this whole thing as badly as possible.