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Cont: 2019-nCoV / Corona virus Pt 3

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Dept of health have said that without family permission the hospitals can't release cause of death information so figures might not be right.

I would think there would be a difference between "releasing" versus "reporting". i.e. they probably are not allowed to make a public statement that might be picked up in the press, but I assume they are allowed to report it to central authorities tracking the virus.
 
I don't know about them, but the reason that I returned to China last week was that I was worried about flights being cancelled and not being able to return if I waited any longer.

Very astute!

I don't understand this. Except for critical essential travel, why the hell is anyone flying after a pandemic is declared?

It's one of the many things I tear my hair out trying to understand.

We "raised the drawbridge" two weeks ago, yet, the number and origin of flights hasn't fallen off so far.

A full week after the much-vaunted closing our borders, planes were still arriving from Europe, and people were walking through Customs without even being asked if they were going to self-isolate.

The response everywhere has been shambolic and too late in every case.

Here in Hawaii we are truly, finally calling out the selfish, ignorant and evil of people knowingly bringing this crap to each other. Its unthinkable to me, but hey, our morbid obesity makes texas look lean

Your state, Aussie & Japan are not adhering to the script. Cases & deaths aren't exploding. Aussie's case rate is only up 10% today, with very weak distancing measures and few schools shut. The lucky country! And Aussie are testing a lot.

Also, by any measure I can think of, you should be struggling to get out of your house past the temporary morgues - if ever a people were ripe for plucking by this virus, heavyweight Polynesians would be expected to be right up there, but they're not. Japan's been inexplicable since the start. They let infected passengers out and there haven't been outbreaks, while one cruise ship to NZ started two clusters in different cities.

I'd have thought that would be something we need to know very urgently.
 
Cause of death is a public record and therefore available for anyone to see. It is simply a compassionate policy to seek the relatives permission before releasing it and the death certificate being lodged. If you think about it if it was a legal requirement how would the death of people without known relatives be recorded?

You are quite right once the death is registered, the death certificate becomes a public record and anyone can go and look up what it says on the death certificate. That is the law, so a duty of confidentiality (if any existed with regards to the records office) is overridden. The hospital is still bound by confidentiality until (and technically even after) the death is registered. There is no law exempting the hospital / health service from the strict laws of confidentiality around medical records in this instance. The exemptions are the legally required notifications. Confidentiality does not end with death.

This not about whether the information will be disclosed, but who is entitled to do so. The next of kin is. The records office is by the process of registering the death and making it a public record. The hospital is not.
 
Dept of health have said that without family permission the hospitals can't release cause of death information so figures might not be right.

Which country are you talking about?

In the US, you can release the cause of death without the name of the person. And currently the numbers are being reported to the public health.

The public health has been releasing information like this:
These additional deaths include:

A woman in his 70s, who died on 3/21
A man in his 70s, who died on 3/21 at EvergreenHealth
A man in his 80s who died on 3/22 at EvergreenHealth
A man in his 80s, who died on 3/22 at Swedish Issaquah
A woman in her 70s, who died on 3/22
A woman in her 90s. who died on 3/22
A man in his 70s, who died on 3/22
A woman in her 90s, who died on 3/22
A woman in her 60s, who died on 3/22 at Swedish Cherry Hill
A man in his 60s, who died on 3/21 at Swedish Cherry Hill
A man in his 60s who died on 3/22 at University of Washington Medical Center
A man in his 60s who died on 3/22 at Virginia Mason
 
Very astute!



It's one of the many things I tear my hair out trying to understand.

We "raised the drawbridge" two weeks ago, yet, the number and origin of flights hasn't fallen off so far.

A full week after the much-vaunted closing our borders, planes were still arriving from Europe, and people were walking through Customs without even being asked if they were going to self-isolate.

The response everywhere has been shambolic and too late in every case.



Your state, Aussie & Japan are not adhering to the script. Cases & deaths aren't exploding. Aussie's case rate is only up 10% today, with very weak distancing measures and few schools shut. The lucky country! And Aussie are testing a lot.

Also, by any measure I can think of, you should be struggling to get out of your house past the temporary morgues - if ever a people were ripe for plucking by this virus, heavyweight Polynesians would be expected to be right up there, but they're not. Japan's been inexplicable since the start. They let infected passengers out and there haven't been outbreaks, while one cruise ship to NZ started two clusters in different cities.

I'd have thought that would be something we need to know very urgently.

Once you have in country spread of covid-19, closing the borders becomes pointless. Why Spain has bothered to close its borders to people from outside is obscure, those from abroad are less likely to be infected than those already in Spain. The modelling suggests closing borders in this situation is of no value.

I think this more something that is done for show than effect. South Korea has kept its borders open.
 
I'm looking for the data that would let us compare the "usual" number of deaths compared to the pandemic , would this be a good reference to use https://digital.nhs.uk/data-and-information/publications/clinical-indicators/shmi/current

If for England the weekly death returns from the national statistics office you can down load an excel file
https://www.ons.gov.uk/peoplepopula...nalfiguresondeathsregisteredinenglandandwales

You can compare to previous years for the same weeks , by age and by region.
 
It may be because those people die from a crime rather than because of a disease. HIPPA covers the diseased, but not the murdered.

I think.
HIPAA covers all medical information. The hospital one dies in would follow the same rules. They will give information in the public interest limited to the level of severity. So, 'critical, deceased, stable, things like that, again without releasing names.

If the patient or family members are able to consent or deny consent you might find times where they don't give any information at all or they give very specific information.

As part of a criminal report the police are allowed to say things like they "found two people in the house that were deceased by apparent homicide." Other than releasing information without names, I don't know what specific rules are for police reporting crimes to the public that involve medical information when the police are investigating a crime.

Perhaps one of our resident police members knows. Or someone can look it up.
 
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HIPPA HHS regs don't prevent reporting of coronavirus outcomes/tests/status as long as specific patients are not identified.

https://www.hhs.gov/sites/default/files/february-2020-hipaa-and-novel-coronavirus.pdf

However, HIPPA may be used as an excuse. Regulations are complex and there is often a default to say nothing since that is the safest thing to do.
HIPPA has a specific section for what is called "public health information". If I have employees exposed to someone and want to find out if patient A that had symptoms of pertussis or TB or meningococcal disease, etc had the suspected infection or not, the law allows me to find that information out. I have the patient's name obviously.

If an employee I am seeing for said exposure needs further medical followup they can inform another provider of the exposure but not the name of the person they were exposed to.

If public health is notifying members of the public they've been exposed, they often will not tell the exposed persons who the source of the exposure was. They may not even tell exposed persons where it was. That depends on a number of factors.
 
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They were citing data protection laws. If they release cause of death then a person could be identified.

Sometimes that happens. The data might still be released, again in the US.

I suspect the UK has similar laws re releasing information without the names.
 
Once you have in country spread of covid-19, closing the borders becomes pointless. Why Spain has bothered to close its borders to people from outside is obscure, those from abroad are less likely to be infected than those already in Spain. The modelling suggests closing borders in this situation is of no value.

I think this more something that is done for show than effect. South Korea has kept its borders open.

Getting in a plane and potentially adding dozens or hundreds of cases all at once to a health care system that has a total of 400 ventilators?

I bet you can see why there is concern.

And officially our community spread is 1 or 2 potentially 5 cases out of more than 120. So yes airlines are still a big problem
 
Not just doctors.

https://www.npr.org/sections/goatsa...onavirus-patients-test-negative-then-positive

But some Wuhan residents who had tested positive earlier and then recovered from the disease are testing positive for the virus a second time. Based on data from several quarantine facilities in the city, which house patients for further observation after their discharge from hospitals, about 5%-10% of patients pronounced "recovered" have tested positive again.

:boggled:
Does that article say they have a strain which has diverged from the original infection?

I thought they were documenting probable relapse, not reinfection. It's not that uncommon with viruses to test negative but sill have virus in some cells not tested.

For example HIV can be undetectable in the bloodstream, but stop suppressive treatment and it will come right back.

Some of those who retested positive appear to be asymptomatic carriers — those who carry the virus and are possibly infectious but do not exhibit any of the illness's associated symptoms — suggesting that the outbreak in Wuhan is not close to being over....

...Could that second positive test mean a second round of infection? Virologists think it is unlikely that a COVID-19 patient could be re-infected so quickly after recovery but caution that it is too soon to know....

...It is possible they were first given a false negative test result, which can happen if the swab used to collect samples of the virus misses bits of the virus. Dr. Li Wenliang, a whistleblowing doctor who later died of the virus himself in February, tested negative for the coronavirus several times before being accurately diagnosed.

In February, Wang Chen, a director at the state-run Chinese Academy of Medical Sciences, estimated that the nucleic acid tests used in China were accurate at identifying positive cases of the coronavirus only 30%-50% of the time.

Another theory is that, because the test amplifies tiny bits of DNA, residual virus from the initial infection could have falsely resulted in that second positive reading.
 
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Which is untrue.

Clearly reporting such information to your version of public health then ends up with released information when they do contact tracing. It's not just that these are notifiable infections, public health then needs to contact potentially exposed persons. So obviously confidential information is being released.
 
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