Data from a sizeable NHS Trust suggests that in the “first wave” of the covid pandemic, there were three asymptomatic “covid deaths” for every one symptomatic covid death.  The question is: how does someone die from a disease for which they have no symptoms?  It’s not a trick question and you don’t have to be a doctor to know the answer – they didn’t die from covid.

John Dee is a former head of clinical audit specialising in clinical outcomes at a busy NHS teaching hospital. Before this, he headed a statistical modelling section as a G7 UK government scientist, providing consultancy for both public and private sectors.

He has been publishing a series of articles titled ‘Catastrophic Health Collapse’ on his Substack. The series details his analysis of data on respiratory illness admissions for an Accident & Emergency Department of a sizeable NHS Trust.  The period of his analysis covers 2017 to 2021.

In Dee’s latest article, the seventh in the series, he compares in-hospital deaths of acute respiratory death and chronic respiratory death; and, in-hospital deaths of asymptomatic and symptomatic covid deaths.  By classifying deaths into these major categories and showing the data graphically, he highlights some obvious anomalies that, even to an untrained eye, raise some questions.

John Dee begins his analysis with a detailed explanation of what a “respiratory death” means in terms of ICD-10 codes. The International Classification of Diseases (“ICD”) codes are widely used by countries that are following the diktats of the World Health Organisation (“WHO”).  They are being used by 100 countries.  In England, OPCS-4 and ICD-10 are fully implemented and embedded in NHS standards and mandated for use by Health Care Providers.

The section of the ICD codes for ‘Diseases of the respiratory system’ has 452 codes and sub-codes – people could die with a common cold or they can die from acute respiratory failure, so we’re looking at respiratory death within a very broad spectrum of associated conditions rather than primary uni-causal death.

With the detail offered by ICD-10 coding, it is possible to separate acute/severe/life-threatening respiratory conditions from chronic/minor. The assumption Dee makes is that if somebody is going to die from covid then they’ll enter an acute respiratory phase at some point. If they don’t enter an acute phase, then their case should not be treated as a symptomatic covid death. Equally, if somebody suffered from bacterial pneumonia or other non-covid viral pneumonia then this case should not be treated as symptomatic covid death.

“In this way,” Dee explained, “we can separate out those cases deserving of the classification of symptomatic covid death; that is to say, these are deaths whereby SARS-COV-2 is the one and only pathogen causing an acute respiratory condition leading directly to their demise. All other cases yielding a positive test result are thus coded as asymptomatic covid.”

Another point to note about ICD codes that makes the classification of covid easily identifiable is that covid is coded specifically within ICD-10 rather than generalised as a respiratory condition.   Within Dee’s explanation of the “games” coders can play on how the data is presented, he wrote:

Please note that I’ve also carefully used the phrase ‘it was primarily coded as’ because the meaning of covid-19, like the virus itself, has moved on and mutated. We now have a whole bunch of covid codes … Covid is a very slippery customer, which means covid death will be a very slippery customer.

Please do bear in mind that even symptomatic covid death cannot be assumed to be causal. All we may glean in retrospect is that a medical diagnosis of covid-19 (that may or may not have been supported by a positive test and other diagnostic results) was declared at some point. For example, it is possible to bring a patient back from acute respiratory failure (covid or not) only to have their liver function collapse or sepsis set in. Then we have bacterial pneumonia doing all the damage in the shadow of a positive test result. Such is the nonsense of primary uni-causal death data coded by MUSE, as published by the ONS.Catastrophic Health Collapse (part 7), John Dee, 24 April 2023

Respiratory Death 2017 – 2021

In the graph below, Dee uses person-years and not persons to minimise the sample/survivor bias. Grey dashed lines have been provided to mark the very beginning of the pandemic, nominally set to 2020/w5 (w/e 31 January 2020), and the very beginning of vaccine rollout during 2020/w50 (w/e 11 January 2021).

While looking at John Dee’s graph below, bear in mind that “acute” relates to a serious or life-threatening condition and “chronic” relates to more minor conditions, and that if someone dies from covid they will enter an acute phase.

Catastrophic Health Collapse (part 7), John Dee, 24 April 2023

Acute respiratory death, the red line in the graph above, declines after the start of the pandemic and then picks back up to a moderate hump. This trend is in keeping with historic trends. “It is not until 2020/w41 (w/e 9 October 2020) that incidence of acute respiratory death could be construed to be problem of sorts,” Dee noted, “and even then, this autumnal surge might not be anything special if we search back in time before 2017 (the first few data points suggest as much).”

“What is more interesting is that peak acute respiratory death occurred six weeks after vaccination rollout began. This may well turn out to be evidence of vaccine harm, though it is impossible to say without digging deeper.”

Covid Death 2020 – 2021

The graph below shows covid deaths from the beginning of the “pandemic,” nominally set to 2020/w5 (w/e 31 January 2020), and the grey dashed line marks the very beginning of vaccine rollout during 2020/w50 (w/e 11 January 2021).

Asymptomatic covid death is those who tested positive but never developed an acute respiratory phase.

Catastrophic Health Collapse (part 7), John Dee, 24 April 2023

In the “first wave” by far the most “covid deaths” were asymptomatic. The obvious question that arises is how is it possible to die from a disease for which you have no symptoms?

“I can’t help but think that NHS staff may well have thought they were knee deep in covid death when they were merely knee deep in non-respiratory death that got tagged as covid following a positive test result that tells us nothing about infection and, in fact, nothing about viral presence (a primer sequence is not a genome),” Dee wrote.

During the “first wave” a rough rule of thumb suggests three asymptomatic deaths for every symptomatic death.  But things changed during the second and third waves; for every symptomatic covid death, there was an asymptomatic covid death.

If vaccines were efficacious as claimed then why do we see a peak in symptomatic covid death 6 weeks after rollout began? And why does symptomatic covid death mirror asymptomatic covid death in the vaccine era?

I’d sure like to get my hands on the case notes because I’d bet good money that what we’re calling asymptomatic covid deaths are deaths from other causes that were labelled such simply because of a single positive test result rather than the considered diagnosis of an experienced medic unfettered by WHO and NHS protocols.

In this regard, I’ve had three NHS clinical coders confide they were instructed by management to code a case as covid even though Senior House Officers were writing ‘NOT COVID’ across case notes.

It is a shame we can’t offer job protection for whistle-blowers like these, but even if we could a big problem lies with the fascist views and aggressive attitudes of colleagues. Several healthcare professionals have provided me with reports of utterly shameful behaviour of senior staff when they’ve tried to raise genuine concerns: I no longer recognise the service in which I once served.Catastrophic Health Collapse (part 7), John Dee, 24 April 2023

That NHS clinical coders were instructed to code non-covid cases as “covid” in some way supports statements made by Sai, a former NHS Director of End-of-Life Care, in January: 

“Patients being admitted and dying with very common conditions such as old age, myocardial infarctions, end-stage kidney failure, haemorrhages, strokes, COPD and cancer etc. were all now being certified as covid-19 via the Medical Examiner System.

“Hospitals were switching to and from the Medical Examiner System and the pre-pandemic system as [and] when they pleased. When covid-19 deaths needed to be increased, the hospital would switch to the Medical Examiner System.”

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