Covid-19, all the anomalies on autopsies revealed by digital documents
From documents stored digitally it is possible to detect some anomalies on autopsies related to deaths from Covid-19. The analysis by Roberto Ambra and Vitalba Azzolini for Agendadigitale
Since the Covid-19 tsunami hit the country, the issue of the numerical evaluation of people more or less severely affected by the virus, from the dead to the sick, has cyclically returned to the fore.
One of the profiles that raised the most controversy in recent months was that of the autopsies. And it is a relevant profile: only with an autopsy can the deaths really attributable to the virus and not to concomitant diseases be ascertained.
However, some anomalies have been found that lead us to reflect. And a premise is also needed. The anomalies that will be exposed below are detectable by documents stored digitally: thanks to the sharing that digital allows, the scientific community can submit documents and data to certain sieves that benefit everyone.
But digitally usable data is based on evidence. And also for this reason it is good to talk about autopsies, which allow us to have evidence on which to base studies and improve the approach to the disease, therefore, to its treatment.
DEATH FROM COVID-19, THE "ANOMALIES" ABOUT AUTOPSIES
It is likely that, in cases of respiratory failure due to probable bilateral pneumonia intubated for days, the doubts about the traceability of death to Covid-19 do not exist and not even an X-ray is needed to confirm (although in theory the autopsy would be useful for exclude any co-infections, perhaps by antibiotic-resistant bacteria).
But for the "unclear" Covid-19 cases? The autopsy must be carried out, also in consideration of the Istat data consolidated at the end of October (in March there was an increase in excess mortality of 47.2% at the national level and of 93.9% in the Northern division, compared to to deaths in the same month as the 2015-2019 average)?
The issue has recently come back to the fore thanks to Graziano Onder – geriatrician, author of the ISS Report on the Characteristics of Patients who died positive for SARS-CoV-2 infection in Italy – who stated in an interview with La Stampa : "While all of us who die and test positive for the swab are classified as deaths from Covid, this is not the case in other countries".
It may therefore be useful to return to the topic of autopsies. First of all, a warning: it is not intended here to reach scientific conclusions, but only, as we have already mentioned, to detect some anomalies.
THE FACTS
Let's move on to the facts. In May, a circular from the Ministry of Health raised controversy urging not to carry out autopsies (see screenshot below).
But in March, in the most complete opacity, an official report of the ISS of March (n.6 / 2020) was modified precisely in the part relating to the execution of autopsies for the Covid-19 diagnosis. This is the ISS COVID-19 Report n. 6/2020 – Procedure for performing diagnostic findings in patients who died with SARS-CoV-2 infection. Version of 23 March 2020 , released on 24 March 2020 (the date is indicated at the bottom of the page, near the link to download the PDF) but, as stated in the title of the web page and on the cover (see screenshot below), dated March 27.
Regarding this anomaly of dates – the report was published before it was written – it must be said that, by analyzing all 61 reports present in the ISS archive , another 13 reports present the same anomaly, ie a modified date.
But in all 13 reports the subsequently revised versions are transparently labeled with the words "Rev" or "Rev. 2 ", both on the cover and on the respective web pages. Therefore, the revision and, therefore, the change of date is justified in total clarity in this report, unlike report no. 6/2020 from which they started, the one that deals with autopsies.
These claims are easily verifiable. The official version of the 6/2020 report, dated 23 March (see screenshot below), can be downloaded from the archive of the newspaper Quotidiano Sanità : there is no indication of revision, as if the report had originally been written as it is read today.
But if you go to check the original version of the report , still published in the archive of the newspaper Quotidiano Sanità, you see at the turn of pages 5 and 6 a paragraph that is missing in the definitive ISS report: the opportunity to perform autopsies (see screenshot below).
The part that was deleted in the final report contained a clear invitation to carry out autopsies, since refusing to perform them, for fear of getting infected, would have been "illogical and unethical".
THE "CUTS" IN THE ISS REPORT THAT MAKE REFLECT
This recommendation, contained in an official ISS document, would clearly attest to the existence of doctors who refused to perform autopsies. A circumstance that has never been confirmed and which, instead, in the light of that recommendation, would have been expressly recognized.
In other words, if you are invited to do a certain operation, perhaps it is because there is evidence that it has not been done. And this could be the reason why the passage was deleted in the final version, the one with a cover date after the date of release, and without indication of the revision.
In the final version of the report there is also another part that is missing: that relating to the indication on what to do in case there are no conditions to perform autopsies safely. "If the pathologist considers himself insufficiently prepared on these infectious cases or is unable to give the necessary clinical-pathological conclusions on these cases, it is good that the autopsy is done by another center with appropriate experience".
According to these indications, if a hospital had not been in a position to perform an autopsy, it could have delegated it to another structure. But, since those indications have been eliminated, it is authorized to think that, in case of unpreparedness of the center where the pathologist is located, the autopsies can be avoided, rather than delegated to another structure.
CONCLUSIONS
In conclusion, the opacity of the revisions made on the document, disclosed as if it had never been revised, as well as the consequent opacity in the management of the autopsies relating to deaths related to Covid-19 and, therefore, the opacity of the search for the causes of deaths themselves, is perplexing. At a time when as much data should be digitally made available to experts, the clarity that would be needed is lacking.
While in the first "wave" of Covid-19 people died almost everywhere (indeed, in Italy a little less), lately in Italy more people die than in other countries, according to an elaboration by Johns Hopkins University.
Isn't it time to demand greater transparency?
Roberto Ambra (graduate in Biological Sciences, author of about 40 peer-reviewed scientific articles) and Vitalba Azzolini (jurist)
This is a machine translation from Italian language of a post published on Start Magazine at the URL https://www.startmag.it/sanita/covid-19-tutte-le-anomalie-sulle-autopsie-svelate-dai-documenti-digitali/ on Wed, 06 Jan 2021 06:45:44 +0000.