主题：疫情爆发状态下，对新冠死亡数据是很难确证的 -- 夕曦
家园 疫情爆发状态下，对新冠死亡数据是很难确证的 看到有人讨论上海这波疫情死亡数据，这几天开始报出来了。之前30多万人感染没有死亡，对比国外的疫情死亡数据，产生了很多质疑的声音。
实际上对新冠死亡数据是很难确证的，至少可以出现三种类型，需要鉴别后才能准确统计。第一种就是新冠病毒直接引起肺炎，最终导致呼吸衰竭死亡；第二种是新冠病毒感染诱发病人基础疾病的发作，比如心梗、脑卒中等，主要经过基础疾病发作死亡；第三种情况是因基础疾病发作死亡，但入院时或入院初期新冠检测阳性。
如果严格定义，只有第一种情况是新冠死亡，第三种情况不应该算做新冠死亡，第二种情况应该细分为新冠相关死亡。但是鉴别区分后两种死亡情况需要使用大量的医疗资源和相当长的时间，在疫情大规模爆发情况下，通常来不及鉴别，病人遗体就被处理了，无法进行明确的病理解剖确定死因。
对流感病毒相关的死亡，由于临床上检测流感病毒很少，流感死亡数据就更加不准确了，只能通过监控医院采样进行估计，通常把大部分临床上因肺炎相关的死亡都当作流感死亡统计。
通宝推：审度,家园 上海只是老老实实的一直瞒报而已 这一波疫情过后，上海病亡数字大概要上五位数。
家园 美国CDC的统计方法就很科学 https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm
他们是先有个根据往年情况预估的一年里各周的平均死亡数，拉成曲线，然后把这两年的总死亡数分成两类，一类是排除新冠的，一类是包括新冠的。把它们放在一个图表里非常直观，可见排除新冠因素的死亡，和往年预估的平均数是高度吻合的，而包括新冠的死亡数，基本就是超额死亡了，高峰的几个周都要高出预估平均值的30-40%。
我个人以为，看这个图基本可以得出这么几个结论：
1.说今年的这波奥米克隆导致的死亡少于去年的说法可以休矣！
2.说美国新冠死亡的100万人，其实很多不是死于新冠的说法可以休矣！
3.奥米克隆致死的人都达到了平均寿命的说法可以休矣！
通宝推：strain2,曾伴浮云,青青的蓝,柴门夜归,老调重弹,审度,方恨少,MaverickZ,陈王奋起,桥上,家园 跟英美的标准保持一致可好？ 英国是新冠检测阳性28天内死亡的病例都算新冠死亡
美国好像是只要新冠检测阳性，这段时间死了都算新冠死亡
上海总不能自己推出一个标准吧?
要不上海委屈下，跟着国家卫健委那批乡下人定的标准走？
通宝推：审度,家园 弗洛伊德这种算进去了吗？ 也是感染新冠，但被跪杀。
难道真的像某些人说的，只要得了新冠，出车祸死的也会统计进去？如果这这样，感觉太不严谨了吧。
家园 英国新冠死亡统计标准有好几个，标准也不一样 比如一夜情在20年的时候统计叫Weekly provisional figures on deaths registered where coronavirus (COVID-19) was mentioned on the death certificate in England and Wales
标准是
For deaths registered from 1st January 2020, cause of death is coded to the ICD-10 classification using MUSE 5.5 software. Previous years were coded to IRIS 4.2.3, further information about the change in software is available.
具体解释在这里
https://www.ons.gov.uk/aboutus/transparencyandgovernance/freedomofinformationfoi/deathsfromcovid19brokendownbyicd10codeandsectionofthedeathcertificateandhowdeathsarecodedandrecorded
We report deaths 'due to' COVID-19 (where it was recorded as the underlying cause of death) and deaths 'involving' COVID-19 (where it was mentioned anywhere on the death certificate, either as underlying cause or as a contributory factor).
Our definition of COVID-19 (regardless of whether it was the underlying cause or mentioned elsewhere on the death certificate) includes some cases where the certifying doctor suspected the death involved COVID-19 but was not certain. For example, a doctor may have clinically diagnosed COVID-19 based on symptoms, but this diagnosis may not have been confirmed because no test was available, or the test result was inconclusive.
Of the 73,477 deaths 'due to' COVID-19, 4,009 (5.5%) were classified as "suspected" COVID-19. Including all deaths involving COVID-19, "suspected" COVID-19 was recorded on 5.6% (4,589 deaths) of all deaths involving COVID-19 in England and Wales. This information is available in the main article of the December 2020 monthly deaths publication (See definition of COVID-19).
In order to provide detailed cause information, such as a breakdown between ICD-10 codes U07.1 and U07.2, or a breakdown of data showing which parts of the death certificate had COVID-19 recorded, we would need to create bespoke analysis. Under the Freedom of Information Act 2000, Public Authorities are not obligated to create information in order to respond to requests. We therefore consider this to be information not held.
Once death registrations are finalised in July 2021, further breakdowns of deaths by cause will be published on our website in the annual deaths registered series and further bespoke analysis will be available on request (subject to legal frameworks, disclosure control, resources and agreements of costs).
具体的信息可以看原始网页
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2021年的报告标题没有变还是Weekly provisional figures on deaths registered where coronavirus (COVID-19) was mentioned on the death certificate in England and Wales
统计变化如下：
From week ending 26th February 2021 (week 8) new ICD-10 codes for COVID-19 issued by the World Health Organisation (WHO) have been implemented for deaths involving COVID-19. The new codes are U09.9 (Post-COVID condition, where the acute COVID had ended before the condition immediately causing death occurred) and U10.9 (Multisystem inflammatory syndrome associated with COVID-19 (also called Kawasaki-like syndrome), a specific, uncommon effect of COVID-19 in children). These are in addition to the existing codes of U07.1 (COVID-19, virus identified) and U07.2 (COVID-19, virus not identified, i.e. COVID-19 stated to be unconfirmed or suspected).
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而英国政府公布的数据，那个是Deaths within 28 days of positive test
https://coronavirus.data.gov.uk/
通宝推：菜根谭,家园 英美标准也有问题 “英国是新冠检测阳性28天内死亡的病例都算新冠死亡”，如果在规定期间转阴后因其它原因死亡，比如吸毒过量死亡等，是否也算新冠死亡？
在爆发情况下，面对大规模人群，监控一定时期内的死亡，操作难度非常高。
家园 第二可算诱发，老人确实有问题，无新冠则残喘 有新冠则反之，奈何？