I don't know about other countries but in Austria nurses were highly incentivized to report deaths immediately following a vaccination or weeks after an infection has passed as a covid death in the sense of national statistics.
I would not be surprised if this "nudging" of on the ground reports over the course of the pandemic has rendered the data around covid deaths unreliable.
The death counts from Canada from that era are very questionable.
As early as June of 2020, the "public health" authority in Canada's most-populous city (4th highest population in North America) revealed that the counting of deaths was being done using a methodology that sounds quite dubious:
"Individuals who have died with COVID-19, but not as a result of COVID-19 are included in the case counts for COVID-19 deaths in Toronto."
Attributing what happened in Ontario to the whole of Canada is something that happens way too often.
As a Western Canadian resident, I don't think it's fair or reasonable to extrapolate about all of Canada from a single tweet from a TO health authority, and an article with a disclaimer about it's own accuracy.
There well may be problems, but please keep in mind that while 50% of Canadians live between Montreal and Toronto, 50% of Canadians don't, and many of us live lifestyles that have absolutely nothing to do with that region and it's governance.
The very questionable counting of deaths seems to have been going on in the other more-populated non-Ontario provinces, too.
Alberta was using a dubious death-counting approach, as described in this April 2021 article:
"According to Dr. Deena Hinshaw, any death that has been flagged where COVID-19 is a possible cause is included in the initial count, even if the official cause of death remains unknown."
Quebec's counting of deaths as of May 2022 (and apparently before that) was also dubious:
"Quebec’s interim public health director, Dr. Luc Boileau, has acknowledged that the province has seen a “huge” number of deaths linked to COVID-19. Quebec’s high death toll, he said last Thursday, is explained by the fact the province counts a COVID-19 death as any death involving someone who has the disease.
He said a government study from January indicated that around 30 per cent of the official COVID-19 deaths in the province’s hospitals involved people who tested positive for COVID-19 but whose principle cause of death was not the disease. He said about 40 per cent to 50 per cent of official COVID-19 deaths in the province involve people who had the disease but who died of other causes."
What is the standard way of “counting deaths” for a disease that can be co-morbid?
Does the method chosen differ from other countries and diseases?
Strictly speaking, no one does of HIV virus, they die of opportunistic infections made possible by AIDS.
For COVID, the disease can kill you, as well as make it easier for other things to kill you. If you die of a heart attack while COVID positive, on a ventilator, with super low blood O2 readings, did you die of a heart attack, or did you die of COVID? Is there any reason why your death must be limited to a single disease for statistical purposes?
You say that counting COVID deaths this way is dubious, but is it out of line with regular epidemiological practice?
I don't have reference from the top of my head, but I seem to remember that the UK also started with the same counting methodology, then fixed it a few months into COVID. If my memory serves, the difference between the curves was pretty negligible.
In the US, deaths within 28 days of a positive covid test were counted as a covid death, unless they were vaccinated, in which case they also had to be sick (IIRC). So our data about how many lives vaccination saved is really corrupt, the unvaccinated count higher than it should be.
On top of that there was also monetary incentive for hospitals to add covid as a cause of death for anyone who died.
I’m not offering a source, but I’ve seen those claims made repeatedly, with no real rebuttal.
At this stage, I’m willing to take the claims at face value.
Even if the letter of the guidance was honest and impartial, I’m absolutely certain second order effects would come to bear.
If I recall right, there was even an attempt to have /all/ deaths during lockdown attributed to COVID on the misguided assumption that the only possible response was tight lockdown, and so any collateral was attributable to the cause of that lockdown, i.e., COVID. (Lots of groupthink there…) So even though we didn’t get that written into the guidance, I’m sure there would have been a strong bias to being very conservative when attributing cause to anything other than COVID.
Point is that I don’t think we even need to go as far as malicious intent to render the figures highly questionable. But then if you want to also layer nefariousness on top, the numbers become almost unbearably meaningless.
So take excess mortality. Surprise, nothing changes. Did you read the article, the part where it mentions all the little things people try and bring up on the path to confirmation bias?
I would not be surprised if this "nudging" of on the ground reports over the course of the pandemic has rendered the data around covid deaths unreliable.