What if there was a new disease that never killed you by itself, but undermined enough systems in your body that it made existing weaknesses worse, including those previously unknown to you? I am obviously taking some aspects of covid and expanding it to an extreme for my hypothetical, but it wouldn't have to be a virus. It could be a poison or a toxin that spreads throughout an area differently, something that is a common ingredient in the food, perhaps, as people speculate there already are ubiquitous toxins that kill us now. It would have to be speedier by far than those ingredients are supposed to poison us, but imagine it a bit. Either way. It doesn't kill you, but it attacks so many systems that it makes your heart and circulatory system a little worse, your breathing a little worse, your lymphatic system a little worse. Or it activates some of the bad cells already circulating in the body, setting off cancers or other hidden problems.
So heart attacks go up, and COPD and pneumonia go up, and cancers go up, some of them quickly, and they each kill some people. When this illness or toxin gets untracked, the death rate actually starts going up a lot, and we begin to look around wondering why it is that so many of us are dying of a variety of causes all of a sudden. It would be, as with covid, those who already had some compromise who are most vulnerable. If you had already had one heart attack, or already had COPD, when ten body systems were all weakened, you wouldn't get a chance to see what else the disease was going to do to you, because you'd already be dead of that first one. Or even if you recovered, you would now know you were really on the edge in that one spot, perhaps forever.
And as we learned more everyone would know that they had been weakened in some way, even if they had started out quite healthy and didn't feel so bad right then, and didn't feel so bad right now. Their heart and lungs had been taken down a peg. If you start from a good level, no biggie.
I haven't been able to think of a clever name for this illness or I would have already been using it throughout. Underminitis or something. If you can do better, please suggest.
Not a single death certificate would have the name of this disease on it. It would say Congestive Heart Failure or Pneumonia or Pancreatic Cancer. Nor would we be able to tell whether this particular heart attack was caused by underminitis or would have happened anyway. If there weren't cancer cells to activate, underminitis wouldn't create them (though we all have many cancers already growing in our bodies - it's just that nearly all of them are so slow that they won't take us out for another fifty years, making them ignorable for people like me. Tangent. Sorry.). We wouldn't even be able to say that these people died "with" underminitis, not "from" underminitis, because they would have already recovered a month or a year ago from it. No one dying from it, no one dying with it. All we would know is that this disease was weakening a lot of our people and we were dying more quickly, sometimes a lot more quickly.
We would then conclude that the distinction between from and with in this scenario was irrelevant. Were some doctors trying to cover up underminitis, making no reference to it in their notes? That would neither save nor kill a single person. Were some doctors trying to raise awareness about underminitis and working it into discussions anywhere they could shove it in? It would create no change in the death rate. Were hospitals getting paid more if someone had had underminitis along the line - was it this year's fashionable diagnosis that was getting stuck onto everything? It would not matter in the slightest. All that would matter was whether more people were dying, or not. What we called it would be irrelevant.
I hope this exaggeration illustrates why it doesn't matter in the least with covid either. I have gone so far as to call the distinction artificial, but it now occurs to me that it is not even that. Are people overattributing or underattributing covid in death diagnoses? Only the final number matters. The number of people more than expected that we lost tells us the death count for covid, even if the documentation of exactly where that is is shoddy. There are a couple of escape holes, of "maybe it's more suicide, maybe it's people who didn't get medical care because of lockdowns, maybe it's anxiety from being forced to wear masks, maybe it's loneliness from being isolated, maybe it's homicides from being cooped up together..." Yes, maybe. And we can measure those things to a near approximation as well, even if all the medical personnel in America were screwing up the paperwork, just by looking at the final numbers. In 2020, we can say with some certainty that only one of those things happened, the increase in drug OD's, which were a small part of the total and already on the rise beforehand. So nice theory, could have been true. The data did not support it. Some deaths might be debatable whether they were CHF or covid, but if we have thousands more of those overall, with no other possible explanation other than "covid either killed her directly or set of a chain of bad things happening to her heart, which killed her three days later" then you have to put the hospital count, the state count, the national count down to thousands more covid deaths.
As we go forward, covid will look more like underminitis every year, with people dying of heart disease or breathing difficulties months or even years later, but still sooner, on average, if they had covid at any time in their lives. Much worse if they were hospitalised with it or were in ICU, only a little if they had a mild case, but still measurable. The American life expectancy has gone down two years in 2020-2021. A million extra people died. They died of something. Discovering that covid tests sometimes can't tell the difference between colds, flu, and covid matters for treatment, but it doesn't matter for the death totals. Even if you want to sell the idea that hundreds of thousands of people are suddenly dying of colds and the flu, you have to have an explanation why these last two flu seasons were each 20x worse than average, back-to-back. Besides covid, what else have you got?