'Cause of death' is a tricky concept. 'A lot more people dying' isn't

The coronavirus pandemic cannot add a single death to this accursed planet where death is the only guarantee.

Every single person killed by the coronavirus was going to die anyway. Wuhan, New Rochelle, New Orleans, Bergamo — they were all populated by future corpses long before this virus caused its first human cough.

If you think the above is a flawed way to view coronavirus deaths, I agree. For the same reasons, I reject the arguments in the past couple of days that reported numbers of coronavirus deaths are dishonest and terribly misleading.

See this article, for instance, at Conservative Review:

The article, typical of an argument you will find all over Twitter and Facebook, suggests that our death counts are highly inflated because a) sick people would have died soon anyway, and b) some people with the coronavirus are really dying from other causes.

Causality, of course, is complicated. If a woman with a bad heart condition contracts coronavirus and then the stress of being intubated causes a heart attack and she dies, what killed her? Or what if a man simply has a heart attack and dies while walking down the stairs, and, only afterward, we learn he had the coronavirus? Maybe the virus exacerbated it. Maybe it played no role.

Without yet being able to interrogate God on the “real cause of death,” (I’m pretty sure that’s not a concept that exists outside the human mind, though), we could look at this mathematically.

In a few months, we will have good data on how many people died in the United States by all sorts of causes in each week of 2020. When we look back on March and April (and possibly May and June), we will see that some official causes of death will be lower in this stretch than normal, and some will be higher.

Yes, deaths counted as heart attacks or lung disease will likely go down. Statistically, some people who would have died of lung disease in September will instead die of coronavirus in April. Some people who died of a heart attack that would have happened anyway will count as coronavirus deaths.

Then there are deaths that might not be counted as COVID-19 deaths in a first accounting that may really be attributable to COVID-19. For instance, one investigation in New York City found that, while about 20 people typically die at home in a given day, these days, it was up to 200 per day. This is certainly true in many cities, and many of those municipalities will not count these as coronavirus deaths.

When we have enough numbers, months from now, we can set aside the question of causality in individual cases, where human error or bad methodology could lead us astray, and instead look at the big picture, in numbers.

Here’s a small sample of what this morbid “balance sheet” might look like.

It is overwhelmingly likely that, this spring, categories with more-than-typical deaths (a+b+c) will far exceed the categories with fewer deaths. And we will be able to see this because the total number of deaths from all causes nationwide will be much higher this March than in past Marches, and the difference will be even greater for April.

The result is that COVID-19 will have resulted, mathematically, in many thousand excess deaths. In other words, on net, this virus will be a mass killer, regardless of how we count some individual deaths.

Whether that matters to you, in a world where we are all bound for the grave, is up to you.