‘Died from’ or ‘died with’ COVID-19? We need a transparent approach to counting coronavirus deaths


Marc Trabsky, La Trobe University and Courtney Hempton, Deakin University

The COVID-19 death toll is reported every day by state and federal governments. These numbers are often used, alongside case numbers, to assess how public health policies are faring in controlling the pandemic, and to gauge the success of various drugs or interventions.

There’s been confusion, however, over whether reported death statistics reflect those who’ve died from COVID-19, or those who’ve died with the virus. Often it’s hard for medical practitioners to determine which of these categories a death falls into.

But the COVID-19 death toll publicised daily on Australian state and territory government websites and reported to the press does not differentiate between the two. It includes all people who’ve died with SARS-CoV-2 (the virus that causes COVID-19) in their body. It’s unclear if the federal government currently makes this distinction or not.

Lumping these statistics together makes it hard for the public to understand the true impact of the virus. Clarifying what’s being counted as a COVID-19 death is necessary for understanding the impact of the virus, and for informing public health and clinical responses to the pandemic. If we know who is susceptible to dying with COVID-19 because of pre-existing conditions, public health responses could more effectively target and protect potentially vulnerable people and communities.

We are not suggesting this is a reason to downplay the seriousness of the virus, but rather that successful public health engagement requires open communication of death causation data, especially in a pandemic. Therefore, we need a transparent approach to counting and reporting coronavirus deaths in Australia.

Cause of death is not straightforward

Federal Deputy Chief Medical Officer Nick Coatsworth acknowledged that determining cause of death is complex when questioned by reporters on Tuesday, saying:

I remember as a junior doctor trying to do death certificates – it’s not always an easy thing […] I don’t, by any stretch of the imagination, think it’s a reason to underplay the severe impact that COVID has on people who have [pre-existing] conditions.

Indeed, distinguishing between dying with and dying from COVID-19 may require a more complex investigation into the cause of a death, beyond citing a positive SARS-CoV-2 test that was completed prior to the person’s death.

For example, Victoria’s coroner is currently investigating the death of a man in his twenties, who was widely reported as being Australia’s youngest coronavirus death. The coroner is investigating whether his death was primarily caused by SARS-CoV-2, or whether the virus contributed less substantially to his death.

While this death was reported on August 14 in Victoria’s daily death toll, according to The Sydney Morning Herald, as of August 28 it wasn’t counted in the federal COVID-19 death tally. It remains unclear whether the death has been added to the federal count as of today.

Generally when a person dies a medical practitioner is responsible for indicating the cause of death. The doctor will complete a “medical certificate of cause of death”, and inform the Registry of Births, Death and Marriages in their state or territory.

In some circumstances, the cause of a death can also be reported by a coroner, but they typically investigate deaths that are sudden, unnatural, violent or accidental, or which occur during or after medical procedures. The cause of death may be initially unclear at the beginning of a coronial investigation. Sometimes, the determined cause of death may be multiple, while other times it may change when more information is revealed, for example through a post-mortem examination or toxicology tests, or when new information comes to light about how a virus affects the body.

We don’t know the true death rate

The lack of nuance in Australia’s COVID-19 death tally means the true death rate may be unknown, and may be adjusted in the future.

For example, on August 31 Victoria recorded only eight COVID-19 deaths from the previous 24 hours, but also added 33 historical deaths to the toll. According to the state’s Chief Health Officer Brett Sutton, this backlog was due to changes in how aged care providers reported COVID-19 deaths, and differences in reporting methods between the state and federal governments.

On September 4 there were six deaths recorded over the previous 24-hours, but a further 53 historical deaths were added to the daily toll, 50 of which were related to aged care.

There is a lack of transparency about why there is a discrepancy between how Victoria and the Commonwealth count COVID-19 deaths.

A spokesperson for federal Aged Care Minister Richard Colbeck suggested delays in data collection and reporting are the primary reasons for the discrepancies. But there appeared to be confusion in early August in the aged care sector about the necessity of reporting “all COVID-19 related deaths, including those involving other causes or comorbidity factors”, according to a letter written to Victorian aged care providers from the secretary for the Department of Health, Brendan Murphy.




Read more:
Have there been uncounted coronavirus deaths in Australia? We can’t say for sure, but the latest ABS data holds clues


Delays may have been caused by aged care providers struggling to verify not only residents who died from COVID-19, but also those suspected to have died with the virus.

The Victorian and Commonwealth governments are reportedly working to reconcile how COVID-19 deaths are counted and reported. But it may be months or years before detailed death data can be analysed.

In the meantime, we need more detail about what’s being reported in the daily COVID-19 death data, and governments should be transparent about what is (and is not) being counted as a COVID-19 death.The Conversation

Marc Trabsky, Senior Lecturer, La Trobe Law School and Director, Centre for Health, Law and Society, La Trobe University and Courtney Hempton, Associate Research Fellow, Deakin University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Accurate. Objective. Transparent. Australians identify what they want in trustworthy media



File 20180925 85761 3hpz92.jpg?ixlib=rb 1.1
Trust in media is low in Australia, which is why traditional news values like accuracy and objectivity matter.
Shutterstock

Sacha Molitorisz, University of Technology Sydney

In an age of social media and smartphones, people are accessing more news than ever. The problem is, they don’t believe much of it.

Three-quarters of Australian news consumers say they have experienced “fake news” and are very concerned by it. In the US, two-thirds of adults get their news from social media, but more than half of people expect this news to be “largely inaccurate”.

This is in stark contrast to public trust in journalism before the rise of the internet. In the 1970s, more than two-thirds of Americans trusted news media. By 2016, that figure had fallen to less than one third.

This question motivated new research at the Centre for Media Transition at UTS, which was funded by Facebook as part of the company’s APAC News Literacy initiative, but conducted independently by my colleagues and me.

Our findings suggest that what Australians want most from their news media is accuracy and objectivity, not necessarily accessibility and friendliness – the hallmarks of social media.

What can be done to restore trust in news media?

In the first stage of our research, we compiled an extensive, annotated bibliography of the academic and non-academic literature focusing on trust and the news media. That bibliography includes more than 200 titles and many more authors.

Among these authors is Rachel Botsman, who argues that institutional trust in the media has largely been replaced by what she calls “distributed trust”. Where people used to trust banks, the church, the government and the news media implicitly, she argues, they now tend to trust their friends, family and even strangers.

This is evident in the success of social media, but more obviously in the rise of companies such as Uber and Airbnb, which exemplify the “gig economy” and “collaborative consumption.”.




Read more:
FactCheck Q&A: Has confidence in the media in Australia dropped lower than in the United States?


Drawing on Botsman and other authors, we postulated that today’s news consumers want a different type of news media: one that is more peer-to-peer and less top-down. And so in the second stage of our research, we held four qualitative workshops in Tamworth and Sydney to ask participants about their relationship with the news media.

In one exercise, we asked participants to design their ideal news source by choosing from a list of 13 characteristics, including “interactive”, “accurate”, “transparent”, “easy to access”, “objective” and “vulnerable” (by admitting and correcting mistakes). We also included “like a friend” and “less ‘voice of god’”. These last two, we suspected, might well be popular, especially among the young. (Of our participants, half were under the age of 35.)

But the results surprised us. Overwhelmingly, participants both young and old did not want their ideal news source to be like a friend or less like the “voice of god”. These two attributes were the least popular. Conversely, top of the list were three highly traditional journalism values: accuracy, objectivity and being in the public interest.

A closer look, however, revealed that participants did value some elements of a peer-to-peer news media – they also wanted their ideal news source to be transparent, easy to access and interactive.

Trust goes deeper than the source

If our participants are typical, these results suggest that Australians want the news media to be aligned foremost with traditional journalistic values, but also enable consumers to be part of the news-sharing, and sometimes even news-making, process.

In other words, Australians seem to want news that blends elements of institutional and distributed trust.

The workshop participants repeatedly expressed grave concerns about trusting news on social media. However, our results also suggest that Australians believe the trust problem is not wholly the fault of social media. According to our participants, part of the problem is that journalists themselves need to be better at accuracy, objectivity and working in the public interest.




Read more:
Outlawing fake news will chill the real news


This corresponds with the results of the Digital News Report: Australia 2018, published earlier this year, which found the most common form of “fake news” encountered by Australians is “poor journalism”.

In another exercise, we asked our participants to rate six trust-enhancing strategies currently being trialled by media outlets in various forms.

Tellingly, the most preferred option was “go behind the story”, which involves informing readers why a story was written and what the journalist was unable to find in his or her reporting, among other details. The second preferred option was a clear labelling of news, comment and advertising.

Clearly, consumers want a higher degree of transparency from their news sources.

People will pay for media they trust

The good news emerging from research globally is that there has been a rebound in trust in journalism. Currently, 50% of Australian news consumers trust the news, up from 42% last year. By contrast, only 24% of people trust the news they find on social media.

In his 1995 book Trust, US political scientist Francis Fukuyama argued that high-trust societies tend to be thriving societies. And this is where the media play a crucial role. As philosopher Onora O’Neill says:

If we can’t trust what the press report, how can we tell whether to trust those on whom they report?

Our workshops suggest that Australians want to trust the media, but are suspicious. This must be addressed, not least because, as the Digital News Report: Australia 2018 found, there is a strong link between trust in news, concern about fake news and people being prepared to pay for their news.

This raises an interesting prospect: if we can successfully address the issue of trust and news media, we might even begin to solve journalism’s revenue crisis.The Conversation

Sacha Molitorisz, Postdoctoral Research Fellow, Centre for Media Transition, Faculty of Law, University of Technology Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.

THE GREEN BIBLE


A now established form of the Bible is the red lettered versions with the speech of Jesus coloured red. Now comes the ‘Green Bible’ from HarperCollins. The Green Bible will have all references to nature coloured forest green to show Christians and readers of the Bible that Christianity was meant to be environmentally friendly.

True Christianity will always be environmental friendly for Christians are meant to care for the world into which we have placed and to use the resources given to us from our gracious God in a responsible manner. This further ‘user friendly’ version of the Bible is yet another gimmick obviously designed to sell further Bibles and create more wealth for HarperCollins. It is a very transparent marketing ploy surely.

What will be next? Perhaps a homosexual Bible with all verses relating to homosexuality in the colour pink – however, that will probably not catch on as the Bible’s teaching on homosexuality is quite different to the world’s and institutionalised Christianity’s.

Read more on the Green Bible at:

http://www.time.com/time/magazine/article/0,9171,1842268,00.html