Covid kills Russian music director
mainThe pianist Denis Matsuev has reported the death from Coronavirus of his friend Evgeny Ivanovich Shestakov, music director of the Tyumen Symphony Orchestra in Siberia since 2015.
Matusev writes: It’s hard to comment on something in such moments, because inside is a complete emptiness. Literally, we just recently discussed and approved the program of our festival for December this year. This news with his powerful Siberian energy and health in my head is never going to be in my mind. He has a young wife, a little daughter and another child who should be coming soon.
Tragedy. Tragedy for our Russian culture, culture of Tyumen and Siberia. Tragedy for the whole team: I can’t even imagine how they feel right now. Tragedy for the spouse. An evil coronavirus that spares no one. No one would have thought that such a healthy person would leave so suddenly.
Without a knowledge of his full medical history, a diagnosis is impossible.
He may well have had some underlying condition, making it a co-morbidity case. Current data would suggest few deaths are actually 100% cov-19 only.
Doc Martin, Nonetheless, death remains a tragedy, whatever the cause. “An evil coronavirus that spares no one” Can, under the circumstances, be seen generally. Grief looks for a cause or something or, someone to blame. You will have met this so often in your career. Anguished and frustrating times for those of your profession. Recently, I recieved a call from my consultant, who contracted this curse, truly, he sounded afraid. I wish you strength and huge health! Thank you for your committment to our best health.
I have no idea about how health works in Russia!
MD in Private Eye has some interesting observations.
Of the 30,260 excess deaths that is above the five year average expectation in private homes since March, less than 1 in 10 is attributed to cov-19. We don’t know why.
It might be because patients weren’t seen or tested. Many cannot drive five hours to attest centre and others are declined a test as ineligible. Frail older people are most at risk of death from any cause, including cov-19.
They often don’t have classic symptoms of any disease and just feel awful. The excellent cov-19 symptom tracker app (Zoe) found that the key covid-19 symptom in the elderly is delirium a new confused mental state which won’t qualify them for a test. So those most at risk from cov-19 are least likely to get diagnosis and treatment.
Each week 12,000 people die in the UK, many from conditions more treatable or preventable than covid-19. It could be that thousands have died from cardiac condition at home who might have been saved in hospital. We do few PMs especially at the moment, so will never know for sure (a lucky escape for the government).
But many consultants of my acquaintance are anxious about reductions in cancer and cardiac events reaching hospital. Hence the hard sell that “the NHS is open for all business”.
I should also add Cov-19 has led to a massive first appointment outpatient waiting list. In Northern Ireland its about 330,000, Ireland its over 600,000 and GB is 4m. Delaying treatment and diagnosis for these patients could well lead to even more problems than cov-19 in future.
Yes it is a great worry for so many people, doctors included.
Perhaps this film of yester year might possibly cheer you up. It reminds me of my days as a young medical student during the 1960s.
Fenella Fielding’s case is a salutary lesson not to crank the engine while it’s in gear as Sir Lancelot Spratt advises.
https://www.youtube.com/watch?v=BpWjUzEFEf8
Thank you DocMartin for your humour and erudition 🙂
…and yet, if he hadn’t gotten the virus, he would [presumably] still be alive — although, without his full medical history, there is no way to be sure.
No, he may have had an underlying issue eg cardiac related. Sars-cov-2 can tip it over the edge no doubt, impossible to say conclusively without seeing his full history, medication, treatment regime etc.
It is true Sars-cov-2 can cause pulmonary embolism, clots, reduced lung function.
Watch John Campbell on Long term covid-19.
https://www.youtube.com/watch?v=H7-pLxvf9dk
So does it count as a COVID death only if there are no comorbidities or underlying conditions?
Most if not all death certificates have at least 2 causes. I doubt many have just Cov-19 on them.
Eg you can die of say AMI or CAP with cov-19 as a secondary cause.
Have not seen just cov-19 alone.
Sepsis is often listed as a co-morbidity
I have survived Sepsis 5 times. It is awful. Terrible problems with my heart 2 paralyzing strokes and a partridge in a pear tree, but, seriously. I survive. What distresses me most, is, all these young people, stricken. Those, who survive then must endure the after effects. Whatever deities, protect us!
I think it’s pretty well established by now that that’s how COVID kills. Like most sicknesses, you’re worse off if you already have something else when you get it. I don’t hear much about how comorbidities contribute to deaths from influenza every year, but I’d be surprised if age and other chronic conditions don’t make a difference. Or maybe flu deaths only count as such if the person is in otherwise perfect health and in a certain age range.
Yet, some survive this blight. I wonder if one, already fighting ones ‘co-morbidities, helps? This is something which affectsall humanity in one way and another. All strength to you and yours 🙂
On a death certificate there will be the primary cause of death eg Pneumonia and a secondary eg urosepsis.
I suppose if cov-19 was the only cause it would be a rare certificate indeed. Most if not all death certificates have at least 2 causes listed. Given that most of the excess deaths in UK are in the over 60s, I would expect a secondary cause listed.
For DocMartin. Yes, indeed. I have a permanent bladder infection, and my last (I hope) Sepsis left me with Nephritis. However, I survive. I am certain many of us can survive and I wish them courage.I managed to read again, tho’ not scores,(playing is impossible) and to write and to speak. I ask myself? How? When so many young and vibrant people leave us—-at times when we need them? And so much hostility in this world. Often, it only takes a kind word. Courage, serenity and the best health to all 🙂
Nephritis sounds serious, it could lead to AKI, has your consultant checked for this? I hope you manage to recover.
I had a close relative with CAP who acquired urosepsis and AKI, please ask your GP or consultant for advice. Best wishes.
Sorry I missed this. I hope your relative is alright? I have a team on hand, and an APN., They alternate visits. I was admitted blue light. (N.H.S, too!!!) I had dehydrated overnight (New medicine making me vomitous) Decades ago, I had this when 16 y.o; a temp of 108. I do seem to survive with this big list of conditions.
Thank you Dr Martin for your good heart and solicitude, Stay well, we need your insight!
Docmartin, I did respond to this, lower down. but I forgot to head with your name. I would not be discourteous. Enjoyed your writing on Skriabin.
Of the 22,332 people who died in hospital in England between 31 March and 12 May, 5,873 (26%) suffered from either type 1 or type 2 diabetes, NHS England figures reveal.
That was the most common illness found in an analysis of what existing conditions patients had. The other commonest comorbidities were dementia (18%), serious breathing problems (15%) and chronic kidney disease (14%). One in ten (10%) suffered from ischaemic heart disease.
The finding about diabetes confirms anecdotal reports from intensive care doctors that many of the coronavirus patients they have been treating during the pandemic had underlying diabetes, as well as research by the UK’s Intensive Care National Audit and Research Centre.
The condition of being alive has a 100% mortality-per-lifetime prognosis.
Using your logic, every single fatality is a co-morbidity case, given their pre-existing condition of being alive.
Other associated factors invariably conducive to a lethal outcome are metabolism and respiration. Available data indicate that 100% of patients featuring metabolism and respiration will eventually die, present or absent any Sars-CoV-2 infections.
See? It’s easy.
Silly comment, being alive is not a pre existing medical condition in the sense of a disease. Most cov-19 cases have been with those with other illnesses eg Diabetes, obsesity.
No one seems to be listed on death certificates as Cov-19 only deaths.
With all due respect, that sounds like splitting hairs. I remember back in the 90’s when people were dying of “AIDS-related complications;” nobody tried to say those weren’t AIDS deaths just because pneumonia or whatever was the thing that killed them on the day.
There was a letter in BMJ some months ago about a Health Trust in England instructing doctors not to put cov-19 on death certificates. This was over ruled after Jolyon Maugham QC challenged it in the High Court.
You are comparing Apples and Oranges Bruce. AIDS and cov-19 are different diseases although some symptoms of cov-19 do resemble those in AIDs patients.
In the UK 999 out of 1000 citizens have not died from Cov-19 and only 1 in a 100 death certificates mention it.
The vast majority of those excess deaths died with cov-19, not due to cov-19. Most death certificates I have seen have 3 issues listed.
I’m not comparing AIDS to COVID. I’m comparing the way people talk about them.
What sadness. One can only wish the comfort of happy memories, but to two children, one of whom is not yet born, such will come from a mother who needs much solace, and hope, in the child she bears into a brighter future.
Well this short clip of Sir Lancelot Spratt doing a ward round will cheer you up. It is quite close to reality, that is how it was done in the dear old 60s.
His remark on diagnosis is still valid.
A black face cloth jacket and striped trousers and Homburg, my Prof wore the very same.
https://www.youtube.com/watch?v=oVWjAeAa52o
I came across this paper by van Dorp et al in Infection, Genetics and Evolution, which supports the view that Sars-cov-2 was about far earlier last year.
It started early October in Wuhan, Dr Giuseppe Remuzzi, Milan reported odd pneumonia presentations in November last year, my experience and that of my colleagues in A & E last Christmas certainly encountered odd flu cases which did not resolve within the expected timelines. It is quite conceivable. If bloods and samples taken end of last year are still available retesting should confirm these findings.
https://www.sciencedirect.com/science/article/pii/S1567134820301829
It’s already been done in Paris with predictable results. The restests showed clearly in Paris last December were Sars-Covid cases exactly at the same time the Chinese were lying to the whole world, about there being no transmission.
Other tests have revolved around analysis of sewage samples, (looking for antibodies) with much the same results. Sars-Covid was already well and truly on the loose autumn 2019 all over Europe, then all you needed was a few mutations and hey presto all the OAPs drop dead.
Ring a ring of roses….etc etc.
Why can’t people get over it, that far more deadly pandemics existed over 1000s of years, and like in 1918-9 killed more young people than the 1st world war.
Oh that’s a shame. He did a fine job bringing the Bendix symphonies to disc.