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Upstate NY Banter and General Discussion..


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32 minutes ago, OSUmetstud said:

The cdc standard is that covid contributed to the death actually. Its not just a positive test before death. 

Pretty sure that CDC is simply pulling ICD codes. That modifier(when covid positive) has to be on every chart because of how effects level of care.

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3 minutes ago, Luke_Mages said:

Pretty sure that CDC is simply pulling ICD codes. That modifier(when covid positive) has to be on every chart because of how effects level of care.

This is from their website. 

https://www.cdc.gov/nchs/nvss/covid-19.htm#understanding-death-data-quality

Certifiers are asked to use their best medical judgment based on the available information and their expertise. When a definitive diagnosis cannot be made, but the circumstances are compelling within a reasonable degree of certainty, certifiers may include the terms “probable” or “presumed” in the cause-of-death statement.

Cause of Death and COVID-19

When COVID-19 is reported as a cause of death on the death certificate, it is coded and counted as a death due to COVID-19. COVID-19 should not be reported on the death certificate if it did not cause or contribute to the death.

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9 hours ago, OSUmetstud said:

Nice post man. It's really disappointing that people on what should be a science forum stop caring about science and think some large conspiracy is afoot. 

Perhaps it's not always thinking it's a conspiracy, but a wise decision to not accept the gazilliions of "science" informational bits that are being presented with nothing but guesses. I think it's smart to not just jump on some "theory" when the science has literally been changing week to week.

That's where it IS becoming politicized...to push the agenda through.

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31 minutes ago, TugHillMatt said:

Perhaps it's not always thinking it's a conspiracy, but a wise decision to not accept the gazilliions of "science" informational bits that are being presented with nothing but guesses. I think it's smart to not just jump on some "theory" when the science has literally been changing week to week.

That's where it IS becoming politicized...to push the agenda through.

Lol alright buddy. 

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1 hour ago, Wmsptwx said:

It’s crazy to me how normalized 200,000 people dying of a still out of control virus is.

It’s because the rate is so low. That may seem like a lot of people but in a country of 330,000,000 that’s a drop in the bucket. Over 80% of those 200k people are over 65 and 94% of all of them had a comorbidity. IE they were already clinically sick.  For comparison over 800k people have died so far this year of heart disease and cancer in the US. 

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37 minutes ago, Luke_Mages said:

It’s because the rate is so low. That may seem like a lot of people but in a country of 330,000,000 that’s a drop in the bucket. Over 80% of those 200k people are over 65 and 94% of all of them had a comorbidity. IE they were already clinically sick.  For comparison over 800k people have died so far this year of heart disease and cancer in the IS. 

With a lot of that being preventable if Americans didn't have such a terrible diet.

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3 minutes ago, BuffaloWeather said:

Hit up 2 more high peaks this last weekend. Now up to 15!

LNxgN5o.jpg

We were up there from Saturday til yesterday... good for you!! we drove up Whiteface and hiked the cobble lookout next to it.. that was good enough for me.

it’s nice up there for sure but I was kinda disappointed in the area in general..Covid shutdowns didn’t help. Only one place open for breakfast yesterday in all of lake placid.. i guess I just like the actual rocky aspect of the mountains out west versus the green tree filled mtns  up there...

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On 9/2/2020 at 12:26 PM, BuffaloWeather said:


If you’re going to make a claim that hospitals and doctors are deliberately miscoding diagnoses and causes of death, then you should say so, rather than hinting that something is happening due to the CARES Act, but not saying anything that can actually be evaluated as true ir false.

But it sure sounds like you’re claiming that providers are falsely billing Medicare for COVID treatment that isn’t being provided. Medicare billing fraud is a very serious crime. By implying that COVID statistics are so significantly inflated that the count of 180k+ deaths is not credible, you’re alleging that a conspiracy of doctors, examiners, and hospitals is working together to falsely bill Medicare for a huge amount of money... tens of billions, apparently, considering that CARES establish a $100 billion fund for reimbursing costs of treating COVID patients. That’s very serious claim, and if you’re going to hint that corruption exists on a vast scale among providers of healthcare across the country, then back it up with more evidence than a few anecdotes reported by a local TV station in Oregon.

We can agree to disagree about opinions, but I’m not agreeing to disagree about matters of fact. If you think doctors and hospitals and medical examiners are engaged in tens of billions of dollars in Medicare fraud, then show some evidence.

 

 

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11 hours ago, OSUmetstud said:

They do, but those aren't available yet in many countries. 

You know it is possible to be anti-lockdown/business closure while being honest about the virus is and isn't, scientifically speaking. 

 

You hit the nail on the head. There is a valid debate about whether the benefits of a shutdown are outweighed by the consequences. And there a valid debate about how much of an economic safety net the government should provide to the many people who are economically harmed by shutdowns, and if so, who should pay for it. 

But it’s dishonest and wrong for someone to decide that because they are opposed to a shutdown, they’re going to do everything they can to undermine confidence in objective, neutral facts about the pandemic. Likewise, denying that a major shutdown causes real harm to many people would be dishonest (although I can’t think of anyone who actually has claimed that shutdowns don’t have negative effects on many people.

There are people who hold the view that letting the weakest members of society die because the cost of a shutdown is too much to bear. Unfortunately, that viewpoint is often accompanied by claims that the death toll is inflated and/or denial about growing evidence of dangerous complicated for people who recovered from acute COVID infections. But the people who acknowledge the medical  reality of COVID but still think a shutdown isn’t worth it get credit for honesty. That hard nosed survival of the fittest live is a hard sell once it comes down to sacrificing your own 78 year old mother just so you can eat inside a McDonalds.

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10 hours ago, Luke_Mages said:

It’s because the rate is so low. That may seem like a lot of people but in a country of 330,000,000 that’s a drop in the bucket. Over 80% of those 200k people are over 65 and 94% of all of them had a comorbidity. IE they were already clinically sick.  For comparison over 800k people have died so far this year of heart disease and cancer in the US. 

To have a communicable disease as third leading cause in death in the US is a huge deal, and I don't believe has been the case since 1918. It will likely end up being the leading cause of death in both NY and NJ this year and potentially other states depending on how things go in the fall. 

I actually think people care a great deal about it, but the people who don't are get more amplification via social media. If the majority of people didn't care about the disease or didn't take precautions, it would have already gone through the US population with way more deaths than now as a result. You see obvious population level risk aversion over the whole world in both mobility and open table data, which has slowed down the disease spread considerably from its native Ro. 

https://www.the-scientist.com/news-opinion/no-the-cdc-has-not-quietly-updated-covid-19-death-estimates-67902

Comorbidity does not mean a preexisting condition, so this 94% claim you're making is false. In the case of Covid, many other causes of death can be listed on the death certificate along with COVID. 5 of these listed here are or can be caused by COVID itself. Obviously, many older people do have preexisting conditions. 

The top comorbidities, or underlying medical conditions in a COVID-19 death include:

  • Influenza and pneumonia
  • Respiratory failure
  • Hypertensive disease
  • Diabetes
  • Vascular and unspecified dementia
  • Cardiac arrest
  • Heart failure
  • Renal failure
  • Intentional and unintentional injury, poisoning and other adverse events
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12 hours ago, Polarbear said:

We were up there from Saturday til yesterday... good for you!! we drove up Whiteface and hiked the cobble lookout next to it.. that was good enough for me.

it’s nice up there for sure but I was kinda disappointed in the area in general..Covid shutdowns didn’t help. Only one place open for breakfast yesterday in all of lake placid.. i guess I just like the actual rocky aspect of the mountains out west versus the green tree filled mtns  up there...

Yeah you have to really enjoy hiking up there right now as lots of stuff is not completely open. I went to dinner at pickled pig, it was incredible. We ate outside with the dog on the patio. There are still lots of places to eat and drink in lake placid. I'm also a big fan of breweries so I really enjoy that region. I'm a lover of all mountains and the diversity of each. As soon as I hike all 46 in NYS I plan to tackle the presidents in NH and than the 14 in Colorado. I just love the silence and calmness of hiking the woods. It's my favorite thing to do. In winter its even better. 4-5 feet of snow everywhere, just you and nature. Ah cant wait! 

It's also a great way to keep in shape. My hikes burn anywhere from 4-8k calories. 

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10 hours ago, WNash said:


If you’re going to make a claim that hospitals and doctors are deliberately miscoding diagnoses and causes of death, then you should say so, rather than hinting that something is happening due to the CARES Act, but not saying anything that can actually be evaluated as true ir false.

But it sure sounds like you’re claiming that providers are falsely billing Medicare for COVID treatment that isn’t being provided. Medicare billing fraud is a very serious crime. By implying that COVID statistics are so significantly inflated that the count of 180k+ deaths is not credible, you’re alleging that a conspiracy of doctors, examiners, and hospitals is working together to falsely bill Medicare for a huge amount of money... tens of billions, apparently, considering that CARES establish a $100 billion fund for reimbursing costs of treating COVID patients. That’s very serious claim, and if you’re going to hint that corruption exists on a vast scale among providers of healthcare across the country, then back it up with more evidence than a few anecdotes reported by a local TV station in Oregon.

We can agree to disagree about opinions, but I’m not agreeing to disagree about matters of fact. If you think doctors and hospitals and medical examiners are engaged in tens of billions of dollars in Medicare fraud, then show some evidence.

 

 

You don't get it. It doesn't have to be fraud. If they test positive for Covid they are positive for Covid. However, they can have ZERO symptoms from covid and still be positive for covid. But on the death cert. it will be listed as a potential cause. Either on A,B,C,D portion of the cert. Trust me I see them every week. There is no fraud involved because technically they still had covid from the test. But it had nothing to do with their death. It was the cancer, heart disease, stroke, etc... that caused the death. 

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2 hours ago, OSUmetstud said:

To have a communicable disease as third leading cause in death in the US is a huge deal, and I don't believe has been the case since 1918. It will likely end up being the leading cause of death in both NY and NJ this year and potentially other states depending on how things go in the fall. 

I actually think people care a great deal about it, but the people who don't are get more amplification via social media. If the majority of people didn't care about the disease or didn't take precautions, it would have already gone through the US population with way more deaths than now as a result. You see obvious population level risk aversion over the whole world in both mobility and open table data, which has slowed down the disease spread considerably from its native Ro. 

https://www.the-scientist.com/news-opinion/no-the-cdc-has-not-quietly-updated-covid-19-death-estimates-67902

 

My argument all along is that the bolded above will happen and that all we're doing is delaying it. Even if a vaccine is developed it will take more than a year to produce enough for just the US population. If the economic slow down continues indefinitely you will start to see economies collapse. If the US economy some how collapsed you're talking mass chaos and war. 

Look at some of the industries that are operating at losses right now. Our local healthcare system is 80M in the hole even after 60M in federal aid. And next month the airline industry will lay off over 100k employees.

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2 minutes ago, BuffaloWeather said:

You don't get it. It doesn't have to be fraud. If they test positive for Covid they are positive for Covid. However, they can have ZERO symptoms from covid and still be positive for covid. But on the death cert. it will be listed as a potential cause. Either on A,B,C,D portion of the cert. Trust me I see them every week. There is no fraud involved because technically they still had covid from the test. But it had nothing to do with their death. It was the cancer, heart disease, stroke, etc... that caused the death. 

@OSUmetstud This is exactly the case. It HAS to be coded as covid for hospitals to be reimbursed properly. 

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3 minutes ago, Luke_Mages said:

My argument all along is that the bolded above will happen and that all we're doing is delaying it. Even if a vaccine is developed it will take more than a year to produce enough for just the US population. If the economic slow down continues indefinitely you will start to see economies collapse. If the US economy some how collapsed you're talking mass chaos and war. 

Look at some of the industries that are operating at losses right now. Our local healthcare system is 80M in the hole even after 60M in federal aid. And next month the airline industry will lay off over 100k employees.

You should go on a public tour of the world and convince everyone to get on with it. Sorry people aren't acting in accordance with your worldview. 

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11 minutes ago, BuffaloWeather said:

You don't get it. It doesn't have to be fraud. If they test positive for Covid they are positive for Covid. However, they can have ZERO symptoms from covid and still be positive for covid. But on the death cert. it will be listed as a potential cause. Either on A,B,C,D portion of the cert. Trust me I see them every week. There is no fraud involved because technically they still had covid from the test. But it had nothing to do with their death. It was the cancer, heart disease, stroke, etc... that caused the death. 

When did you see these patients and get your M.D? 

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Just now, BuffaloWeather said:

But as long as covid is listed on there. Symptomatic or not gets counted as a covid death. Unless I am mistaken on that? 

This is from their website. 

https://www.cdc.gov/nchs/nvss/covid-19.htm#understanding-death-data-quality

Certifiers are asked to use their best medical judgment based on the available information and their expertise. When a definitive diagnosis cannot be made, but the circumstances are compelling within a reasonable degree of certainty, certifiers may include the terms “probable” or “presumed” in the cause-of-death statement.

Cause of Death and COVID-19

When COVID-19 is reported as a cause of death on the death certificate, it is coded and counted as a death due to COVID-19. COVID-19 should not be reported on the death certificate if it did not cause or contribute to the death.

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5 minutes ago, OSUmetstud said:

This is from their website. 

https://www.cdc.gov/nchs/nvss/covid-19.htm#understanding-death-data-quality

Certifiers are asked to use their best medical judgment based on the available information and their expertise. When a definitive diagnosis cannot be made, but the circumstances are compelling within a reasonable degree of certainty, certifiers may include the terms “probable” or “presumed” in the cause-of-death statement.

Cause of Death and COVID-19

When COVID-19 is reported as a cause of death on the death certificate, it is coded and counted as a death due to COVID-19. COVID-19 should not be reported on the death certificate if it did not cause or contribute to the death.

This is where I think it gets difficult. Its a judgement decision and obviously MDs know more than I do. But maybe my case is rare. But I have 2 clients in which they battled with cancer for years and were in stage 4 and died and later found out they were positive for Covid. On their certs it listed covid as main contributor. The one family fought with Florida about it and got it overturned. The other didn't care. It helps the family if it gets listed as covid though, they get federal funding so I'm not sure why they would decline it. 

There are too many unknowns with the virus to know 100% sure if COVID contributed or not. Or it was the natural evolution of a disease. They had covid so technically they can list it and the federal funding helps the families so if you were a doctor would you list it? Its not fraud, but they would have likely died anyways. 

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