Cause of death is defined by a death certificate in the uk, this has two sections. section one is the direct cause and section two are other relevant health issues that are not a direct contributor but may be relevant.
Section 1 is broken down into 1a, 1b and 1c. Here 1a is the direct cause, if something triggered 1a this goes as 1b and if something cause this is goes as 1c. If someone for example gets lung cancer, gets chemotherapy which causes an impaired immune system leading to a chest infection and the patient also has diabetes the death certificate would be 1a) bacterial pneumonia 1b) iatrogenic neutropenia 1c) lung cancer 2) diabetes.
Part of the issue is that death certificates are based the health care professionals opinion and thus in the above situation I describe different doctors might put different things down. In addition the statistics quoted for flu related deaths produced by the ONS include cases where influenza is mentioned in section 2 of the death certificate. In such cases this would suggest that flu is in fact not the thing the patient died from in the view of the doctor but was mentioned as relevant none the less. So assessing how many patients died from flu is hard to actually quantify and largely subjective. In fact research by the ONS suggests that the cause of death is incorrect in about 22% of cases
(
https://webarchive.nationalarchives....ification.html)
To make the comparison even more difficult the PHE definition of a Covid death includes those who die within 28days of a positive Covid result. This is irrespective of the other circumstances so includes both patients on ICU recovering from Covid or someone hit by a bus.
As a result comparing flu deaths and Covid deaths is not useful due to the differences in definitions and underlying subjectivity.
As per gmc guidelines I must declare myself to be a hospital physician and health informatician when posting about medical issues and health informatics online.
Sorry for the long post but I felt this was important to share.
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