Sine Qua Non COVID-19

"Sine qua non".

In legal parlance, it introduces the "but for" legal concept.

To quote from FARLEX: "In order to be liable in negligence, the defendant's conduct must constitute the proximate cause, or direct cause, of the plaintiff's injury. The concept of proximate cause encompasses both legal cause and factual cause, and the "but for" rule pertains to the latter. It is also referred to as the sine qua non rule, which means "without which not," or an indispensable requirement or condition. The "but for" rule is a rule of exclusion, in that the defendant's conduct is not a cause of the event, if the event would have occurred without it."

Why do I bring this up?

(The following is very long and may make some people very uncomfortable.  It may seem heartless - but it isn't meant to be.  It may seem cruel - but it isn't meant to be.  It is meant as analysis - nothing more.  And as unfortunate as it may seem, sometimes analysis appears heartless and cruel - even though it isn't.)

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In a recent briefing, Dr. Birx said (can't find the exact quote) that any deaths involving COVID-19 are being counted as "COVID-19 deaths".

We also know, again from Dr. Birx, that those with preexisting medical conditions appear to be the most susceptible to the damaging effects of the COVID-19 virus.

But what we don't know is how many of those deaths would have occurred solely due to COVID-19, or - to put it more succinctly - how many of those deaths involved COVID-19 as the "proximate cause".

To make it even simpler: how many people with "pre-existing conditions" would have died from other similar medical conditions - conditions that severely attack an already impaired system - such as influenza, pneumonia, or non-COVID ailments?

Ok, let's reverse it.  Removing those who died due to complications arising from pre-existing conditions that had already weakened their systems, how many would have lived "but for" COVID-19?  How many previously healthy individuals died solely because of infection from COVID-19?

We're hearing some really distressing numbers about deaths.  But we're not getting the full picture.  ANY death due to a disease is tragic, but it would be even more tragic to blame a death on the wrong cause - or, in this case, to hold COVID-19 responsible for deaths that were (sorry) inevitable.

Governor Cuomo recently said the same thing.  He noted that all deaths are tragedies, but there were some people that could not be saved "no matter how hard we tried" (his exact words).  If some of those people had (as an example) COPD, they already had seriously impaired lungs and already had difficulty breathing (some are on oxygen all the time).  COVID-19 was a contributory cause of their deaths... but was it the primary cause of their deaths?

So the question is:  "if not for" COVID-19, how many of those counted as COVID-19 deaths would have fully recovered to their previous state of health?

Yes, it seems cruel to ask, but it's important to know the answer.  Here's why:

If 30% (just a guess, but a reasonable guess) of those who died would have died from another contributory cause (influenza, pneumonia, etc), then the number of COVID-19 specific deaths was inflated by 30%.  This brings the COVID-19 specific death rate down.  That would be good news in a time of nothing but bad news.

Consider this as well: CDC numbers show 30,000 to 60,000 deaths annually from "the flu" (yes, just plain "flu" - influenza).  Again, these deaths are tragic but probably not preventable due to the age and medical conditions of those who died.

We are not currently counting the number of people who are dying from only "the flu" (influenza).  That count has been suppressed because of the severity of the current COVID-19 outbreak.

How many of those who would have died from complications due to "the flu" died due to complications from COVID-19?  Is the number similar, or are there two "tracks" here: one specific to COVID-19, and one specific to influenza?  Are we keeping track of the deaths separately, or are we lumping all of the deaths together?

Moreover, have deaths due to "the flu" been reduced by "social distancing"?  Are those who might have succumbed to "the flu" still alive (thank goodness) because we are now more aware of the need for washing our hands, maintaining cleanliness, and preventing unnecessary contact that might spread non-COVID-19 germs and viruses?

THIS IS IMPORTANT TO KNOW.  We need to know exactly how dangerous COVID-19 is, especially considering the efforts we have taken to prevent the spread of COVID-19.  These efforts range from social distancing to the speedy creation of new testing machines and methodologies, the evaluation of existing pharmaceuticals for possible treatment, and the overwhelming pressure placed on the economy (people who aren't working can't pay for food, rent, insurance, or any of the other necessities of life).

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When the immediate crisis has passed and we are able to finally begin the process to restart our lives, these questions should be answered if only to understand how to truly measure the impact on our lives for the next pandemic... and, to be sure, there will be another one.  It's inevitable in a world where bacteriological and virological agents can travel to the other side of the world in less than a day.