The government should pay.
2K dollars each means 500,000 autopsies costs a mil.
A million is peanuts for the US government.
Not a lot of money if we look at what is spent on research.
A lot of research grants these days are upwards of 2 or 3 million.
Somewhere I read a different reason, that doctors were too worried of contacting the virus.
I think your reading list needs an upgrade. Postmortem exams in the US are nearly always done by certified pathologists, not treating physicians, and the patients are…dead. No coughing, no active incubation of infection. Usually cold and in the frig a day or two. More worried about prion disease than viral in most cases.
There really should be more autopsies but around here, the local counties wind up paying for them, and have a limited budget. If someone has been under medical treatment with a known likely cause of death, the local official is likely to sign off on the the death certificate. Generally suspected criminal activity, accidental death, and deaths within 24 hours of hospital admission are autopsied. (It is thought that after 24 hours, adequate testing usually has the cause of death nailed down in most cases. Definitely not a perfect system.
From what I have seen, the vast majority of the public already knows that viruses can cause pneumonia. You seem to be the extreme outlier.
This is a perfect example of an anti-science conspiracy theory.
The virus is what causes the immune reaction. To use an analogy, you are trying to argue that a man ridden with bullet holes didn’t die from gunshots but instead died from blood loss.
What am I missing? Wouldn’t it be two dollars each for 500,000 autopsies which would total a million dollars in cost? Two thousand dollars each would then cost a billion dollars.
That is what I thought too but this medical examiner thinks different. She says autopsies on covid patients’ bodies too dangerous to undertake. (less than 2min video)
Experts say autopsies too dangerous to perform on COVID-19 patients - YouTube
I agree with you. But the autopsies are not done. And why shouldn’t the federal government step in on this occasion since it is a major problem. @MarkD kindly corrected my maths (I thought when I wrote a mil that it looked a bit on the cheap side) it is a billion dollars. However to get this into perspective, the US government spent more than 2 trillion on the Iraq war. Surely this is more important than weapons of mass destruction that ooops didn’t exist.
Iraq war costs U.S. more than $2 trillion: study | Reuters
Why would you need extensive autopsies? It’s pretty obvious that they died from a viral respiratory infection. Coroners aren’t in the business of entertaining fringe beliefs pushed by people on the internet.
There was already a shortage of pathologists in the US so who would be doing all the extra autopsies? In addition you would also need the necessary storage space for the bodies and facilities to do the autopsies. Pathologists are probably triaging classified as Covid-19 deaths and do cases which would yield the most medically useful info (e.g., particular treatment’s effects for better or worse, atypical cases). This would be on top of their usual work.
Interesting opinion article regarding autopsies with stats from 2018.
https://www.ahajournals.org/doi/pdf/10.1161/CIRCULATIONAHA.118.033236
It seems currently hospital autopsy rates are at about 4%. From a practical standpoint, families often refuse autopsy even when asked as it can delay funerals, and is considered by some to be an unnecessary violation of the body.
Some comparison data for other countries : https://gateway.euro.who.int/en/indicators/hfa_544-6400-autopsy-rate-for-hospital-deaths/visualizations/#id=19639&tab=table
Though I’m not sure of accuracy (I found another article which gave a considerably lower rate for UK autopsies).
I suspect there are a fair number of autopsies done on Covid-19 victims because researchers need to figure out how the disease can kill people.
From one paper:
Postmortem examinations, or autopsies, are the gold standard for the elucidation of the underlying pathophysiology of disease. Despite an explosion of literature addressing the clinical impact and molecular microbiology of SARS-CoV-2, autopsy studies remain underrepresented. Due to legitimate concerns about infection risk and limited personal protective equipment (PPE), early postmortem studies were initially either gross examination only, postmortem biopsies, restricted to certain organs, or case reports, with a few comprehensive series and some reviews emerging more recently In this comprehensive series, we report the findings from 100 consecutive autopsies of patients who died due to COVID-19 and summarize key histopathological findings within each organ system. We present the spectrum of our findings in the context of existing literature to advance the discussion of possible disease mechanisms.Bryce, Clare, Zachary Grimes, Elisabet Pujadas, Sadhna Ahuja, Mary Beth Beasley, Randy Albrecht, Tahyna Hernandez, et al. 2021. “Pathophysiology of SARS-CoV-2: The Mount Sinai COVID-19 Autopsy Experience.” *Modern Pathology* , April. https://doi.org/10.1038/s41379-021-00793-y.
I suspect pathologists have to balance doing a lot of autopsies briefly or fewer but more in depth (plus the risk of catching whatever killed the person).
Scientific America
COVID-19: What the Autopsies Reveal - Scientific American
They begin with:
“We know this new coronavirus damages the lungs, but how exactly?”
and in the next paragraph they say:
“But it’s really hard to determine from lab tests and fuzzy medical images whether it’s the virus damaging these other organs—or whether the body’s own immune system is fouling up the works, as it generates a massive inflammatory response to combat the coronavirus.”
I am questioning does the virus cause the excessive inflammation?
Or is the ideas spread by the media, most especially “dangerous virus doing damage”. IMO it would be quite reasonable that anyone who has the flu and begins to stress over damage in their lungs would end up with an over-reaction of the immune system.
Dr. Mike Hansen M.D. states that the inflammation in the autopsies done is inconsistent with the viral load and I have seen in some site that there are cases where there is no viral load, most likely the massive immune response destroyed all the virus AND THEN killed the patient!
I don’t think that the virus is actively causing the immune system response. The presence of the virus and cells signaling of a viral presence initiates the immune response. The virus is destroyed by the immune response. Why would it have presumably evolved to ignite a massive immune response? For what evolutionary advantage? lol
Ventilators do stress the lungs and possibly indirectly also the heart since the heart and lungs are two parts of one system. The ventilator forces air into the lungs/ alveoli and then also sucks air out, which stresses the lungs and does damage. This damage becomes an area for opportunistic bacteria to cause further infection But in any case the damage itself is also a cause of inflammation since there is damage done.
Ventilator-associated pneumonia (nih.gov)
Furthermore why the discrepancies in who dies of covid 19
Why is COVID-19 mild for some, deadly for others? | Cornell Chronicle
It says:
" Men and women appear to get COVID-19 at roughly equal rates, but in most countries men are much more likely to die of it. In Italy and Ireland, for example, males account for about 70% of COVID-19 deaths."
And in that same link, this amusing contradiction.
" moreover, patients with these disorders often use corticosteroid immune-suppressing drugs, which reduce immunity to respiratory infections. In general, any serious underlying medical condition can make a vital organ less able to withstand the biological stresses caused by an infection and resulting inflammation."
They are effectively saying taking immuno-suppressive drugs makes you more vulnerable due to reduced immunity BUT at the same time less able to cope with the biological stress of infection AND resulting inflammation! The inflammation is caused by an over-reaction of the immune system and on immuno-suppressive drugs??? How so? Can someone enlighten me how this happens?
Good questions, and I think that led to a lot of the uncertainties of treatment in the early stages. Corticosteroids which blunt the immune response are commonly used in other similar conditions like ARDS but the Chinese evidently did not have much success with them, perhaps due to too high of dose, or inappropriate selection. Steroids are a two edged sword in that have a lot of side effects, and can leave a patient vulnerable to secondary bacterial infection. Later, a more measured application of steroids was found to provide benefit and is commonly used in treatment. Finding the right dose for the right patients took time and analysis of data as it became available, and is ongoing.
I am tied up and do not have time to run down specific articles at present, but will follow and comment as I can.
Great question Immunity is very complex. To compare, the immune system is not helpful when you have asthma, eczema, Crohn disease, or inflammatory arthritis. However, it’s necessary to kill invaders. Our immune system also makes inflammation in both cases. We need white cells to release free radicals, which oxidize invaders; and do other inflammatory things to kill invaders. However, we have to cripple part of our immune system with steroids or biological modifiers like Humira in certain cases, like rheumatoid arthritis and lupus.
It’s not just in Covid, but we can over react with our immune system against other invaders. Sometimes, fevers are not good for us–usually if they are too high–but usually, they actually can help us fight off infection. Steroids are used to help with ARDS and other problems when we have pneumonia or asthma, especially if they are complicating our reaction to the invader.
You can see why giving someone a generic immune “booster” could be a problem, if it works. In the same vein, it’s thought that mega vitamins that mop up free radicals may counteract our ability to treat infection or even our ability to kill cancer cancer (if they work).
We see people on chronic steroids and immune suppression (chemotherapy that sometimes has to suppress white cells and the immune system as a byproduct of killing cancer cells) can die much more easily with Covid. On the other hand, you can treat over reaction from Covid with steroids.
You do not treat Covid with dexamethasone if you don’t have the severe, respiratory over-response. Like @jpm wrote, it has taken time to do better. Francis Collins was interviewed as saying that he even doesn’t like dexamethasone, because it’s got too many side effects in a certain subset. I can send you some papers by PM if you like.
WHY???
I think we would all agree that stress can modulate immune reactions. However, that still doesn’t cast doubt on the fact that the virus is the primary cause.
I think most would agree that this is true for many infections. That still doesn’t cast doubt on the fact that the virus is the primary cause of the immune reaction. To use the analogy again, you are arguing that the gunshot really didn’t kill the victim because there were no bullets found in the body itself, ignoring the rather obvious fact that the bullets passed through the body and created the damage seen.
Nothing in that paragraph casts doubt on the fact that the virus is the cause of the immune response.
That does not cast doubt on the fact that the virus is the primary cause of the immune response.
Exactly. Modulating the immune system is a two edged sword. This doesn’t cast doubt on the fact that the virus is the primary cause of the immune response.
Yes please Randy. I am interested in reading scientific articles on covid 19.
On immune suppressants they can die from the infection because they don’t have any or enough immunity to fight the infection, but they don’t die of excessive inflammation.
When covid is treated with steroids, it is the over-reaction of the immune system that is halted. Please correct me if I am wrong here.
Stress. as in a fight or flight response, will “modulate” the immune system in that it will be, to some extent declined.
However if the person is stress with ideas about “dangerous virus doing damage” they are effectively giving their body instruction that there is damage. This will ignite the immune system to clear away the damage. If the idea is bogus and there is no damage, then the immune system response ends up doing damage. This was seen in the early chemotherapy drug trials but they have gone by the wind. There is however Dr. Lissa Rankin M.D., just about the only doctor on the net (although I have seen a few others that I don’t recall at the moment), who is mentioning this, but unfortunately only in passing.
Is there scientific proof we can heal ourselves? | Lissa Rankin, MD This one is one of her TED talks but she had a longer video, which seems to have vanished where she discussed this in more detail.
| TEDxAmericanRiviera - YouTube
At 06:48 The opposite is also true, so if you give people a placebo
06:52 and you tell them it’s chemotherapy,
06:54 they vomit, and they lose their hair.
This was indeed the early chemotherapy drugs targeting rapidly dividing cells. In the control group they gave a sugar pill in those days. That is what she is calling the placebo. Why would they vomit and lose their hair on sugar?
The reality is that they wanted to believe they had the real drug and the real drug killed/ damaged rapidly dividing cells. As a result their immune system went into action to clear away the damaged cells but the inflammation was erroneous and did damage, which is why they lost their hair and spilt their guts.
Now, you are the one that needs to show evidence.
Why would any pathogen cause an immune system reaction that destroys not only themselves, but the very cells that are needed to replicate? This is the nitty gritty. You need to explain that.
I saw an incident when I was only 12 years old that made an impression.
My parents had a shop and they had several Greek friends that often visited when they were not busy and they sat and had coffee and chatted. One of them one day asked my father to sell the shop to him. My father refused. The man hassled for weeks but my father continued to refuse.
Then my father started to feel unwell, then sick and after a month or so became very sick. They had to get my father’s brother to help in the shop. My father finally got pneumonia and was in bed for months. Then the doctors took X-rays and told him he had shadows on his lungs. A bronchoscopy however was inconclusive for lung cancer. It became a case of wait and see.
Seeing he wasn’t getting any better, my father finally agreed to sell the shop to the Greek “friend”. The contracts were signed and exchanged which finalizes the sale. Within days my father improved enough to be out of bed and within two weeks the pneumonia and pleurisy he had evaporated. How did that happen? No doubt he was being stressed but there had to have also been ideas being put to him that the bacterial infection was damaging his lungs. Then when the sale was finalized the stressing stopped and his body recovered.
One big problem is that medical science wants to limit everything to the physical. Unfortunately it is not that simple.
It would be more accurate to say that the immune system is repressed. That can have the effect of tamping down an overreaction, but it also suppresses basic immune function which can allow the virus to keep spreading through the body.
Thanks, yes, “immune system is repressed” is better wording.
Where is the science to back this claim, specifically with viruses?
Anecdotally, there were people who though COVID-19 was a hoax and didn’t think it was dangerous. They ended up dying in hospitals from COVID-19. You would also need to explain why we are seeing so many deaths with this virus and not others.
There is decades of research demonstrating how viruses illicit immune reactions. Just google “virus immune reaction”.
The information is out there:
The short answer is the virus doesn’t know any better. They aren’t that smart. Your immune system ends up killing you in its attempts to kill the virus. The human immune system can’t evolve to handle new viruses because the human generation time is 25 years. This is especially true when viruses jump from one host species to another. For example, Ebola causes a mild infection in bats which is its regular host species, but that same virus causes a massive immune response in humans that is often very deadly.
You would need to explain a world wide pandemic.
It sounds like your father had a terrible experience of being ill… I am sorry.
Pneumonia was a terrible disease back then. People often died or took months to get better, particularly if they had TB, which was quite common till the 1960s, at least in the US.
This alternative reality kind of makes a mockery of all our public health campaigns, doesn’t it? I mean, smoking won’t really damage your lungs, any more than germs will make you sick.
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