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How on earth does that happen? were old people just more or less - killed?

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That will be for the courts to decide, but iatrogenic death is a distinct possibility. This doesn't have to be deliberate (that's murder) but it can come about through negligence as well as misinformed practice. You can also 'nurse a patient to death' with the very best of intentions. Each month my surgical unit assembled to discuss each and every single death in detail to ensure we had done our very best and hadn't f*cked up. Sometimes we had, and that was hard to take for the teams. When it comes to medical care iatrogenic death is unavoidable, so we need to ask if these spikes could have been avoided.

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Don’t put your blanket on yet JD. What about all those deaths in early 2021? It’s that purple line sticking out in Heneghan’s Nightingale chart (what a superstar statto she was). I’ve just eyeballed all your graphs again and that period only shows up when you add Covid deaths back into respiratory. That was the supposed Kent variant (renamed alpha) which conveniently coincided with the rollout of the unmentionables during lockdown 2 (or was it 3?).

Had the powers that be learned from their April 2020 mistakes? Were all iatrogenic deaths being put down to Covid? Were the vaccine deaths categorised as Covid? I cannot believe a second wave was more deadly than the first wave, given all the natural immunity. Most of my work colleagues got alpha and it was a bad cold at worst.

There’s more thinking to do!

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Oh yes indeedy! I'm lining up ideas to try next...

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JD, as I said yesterday this is awful and the more I think about it the more horrific it becomes. I cannot for the life of me find an alternative explanation, however unlikely, to these being iatrogenic death. Do you mind if I do a Twitter thread using your charts (and obviously crediting you as the source)? I will also bring this to the attention of a journalist I know slightly who works for one of the major daily newspapers.

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Yes indeed. Few analyses have made me weep over the years and this is right up there for I am at a loss to explain this other than catastrophic breakdown of care leading to loss of life. It would be good for others to check the data for themselves and I shall be re-checking everything to ensure I haven't made an error. By all means start a thread and use whatever material you think useful.

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“When you have eliminated all which is impossible, then whatever remains, however improbable, must be the truth.” ~ Arthur Conan Doyle, The Case-Book of Sherlock Holmes

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Just gone over the figures by hand just in case of spreadsheet glitches and the analyses are kosher. You can see the problem emerging back in the mortality rates...

https://jdee.substack.com/p/trends-in-causality-for-england-and

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I'm usually pretty creative and imaginative, and today I was doing something that usually stimulates the brain enormously - (painting and decorating are great for clearing the head of clutter and garbage, and we are doing up an old terraced cottage we bought nearby in a local Scottish village for our son, who has a learning disability, so that he can get a bit of independence before we all get too old and cruddy, so this is especially life enhancing) -

And I'm coming up blank. Totally blank. No new ideas, just the old ones.

We probably murdered these poor old people, didn't we?

We treated them as contaminated waste, we neglected their vital needs for company, care, and human kindness, we shoved them around like a problem, and they just died - mostly because they lost the will to live.

And if nothing else, I'm good on the quotations today:

Think about the harmless old Irish tramp in 'Clockwork Orange':

[Alex has the tramp pinned down]

Tramp : Well, go on, do me in you bastard cowards! I don't want to live anyway, not in a stinking world like this!

Alex : Oh? And what's so stinking about it?

Tramp : It's a stinking world because there's no law and order anymore! It's a stinking world because it lets the young get on to the old, like you done. Oh, it's no world for an old man any longer. What sort of a world is it at all? Men on the moon, and men spinning around the earth, and there's not no attention paid to earthly law and order no more.

[He starts singing another song, and Alex and his droogs proceed to beat him to death]

For no reason apart from the fact that they are young, angry, and filled with hate, and have a few minutes freedom to get away with murder.

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I find it ironic that the film Clockwork Orange was effectively banned for decades: I saw it when it was first released , and following massive criticism and lambasting by the Tory media (Mary Whitehouse Brigade HQ, who also opposed Life of Brian) , the director actually withdrew it from release. I finally got the DVD from a source in Amsterdam, decades later.

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The word iatrogenic implies illness and death caused by medical examination or treatment, and with the greatest respect I think is a gross oversimplification of a complex situation. It also scapegoats clinicians and that can only lead to defensiveness and closing of ranks. I wouldn’t hold my breath for a public inquiry being anything but a whitewash and expect cognitive dissonance will prevail. If we are to prevent this from happening again we have to start with an openness and willingness to do a proper and thorough root cause analysis, but will that happen? Not whilst those with the loudest voices are wedded to the myth that lockdowns had a net benefit.

The synchronous spike in non-Covid deaths followed hot on the heels of the first national lockdown. There was a climate of fear and moral panic, with a deliberate and highly effective strategy to increase the perceived level of personal threat among those who were considered to be complacent. Communication about risk was shockingly awful and indiscriminate. Those who tried, early on, to contextualise risk, were effectively silenced.

How does fear affect decision making? Poor choices were made, without fully considering the ramifications. Healthcare was rationed in anticipation of a tsunami of Covid death, and to ‘keep people safe’. Senior managers and NHS leaders setting policy worried about being held culpable for deaths of healthcare workers, worried about a fragile health service being overloaded and worried about being held responsible for vulnerable people acquiring Covid in a healthcare setting. They were no more immune to the emotional impact of media images than the general public (coffins in Lombardy, ‘a generation has died’ etc) and the old pandemic plan was torn up in a panic. Implementation of ‘covid-safe’ policies and ritual eased anxieties. Barriers to accessing healthcare has many aspects. People also presented late or not at all, out of fear of getting Covid in hospital or dying alone in hospital without visitors, or doing their bit to protect the NHS.

I can think of 20 reasons for a spike in non-Covid deaths off the top of my head, none of which involve midazolam.

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But it's the best single word I can use unless you can think of anything better! Absolutely the situation is extremely complicated and healthcare professionals of all manner have told me so. As it so happens I've just come off the phone with Jonathan Engler (HART) and we've been going over all that you have put here and more. Sure there are many and varied reasons for a spike in excess death but ill-advised use of midazolam may also form part of that picture. Use of this and other drugs in care home settings, as well as implementation of EOL protocols, is being investigated by certain teams, so we shall have to wait the outcome. These highly synchronised spikes across age groups and chapters represent a big, big problem even for a list of 40 reasons. As yet nobody can furnish anything approaching an answer.

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Technically I think it probably is the correct word, but I've noticed when used in this context it tends to narrow down the focus of discussion. That may lead to erroneous conclusions as to the significance of midazolam in the wider context. We do need to step back and make a broader, more holistic appraisal. It was a culture of fear that resulted in systemic iatrogenicity and people making ill-informed decisions. It's just when I think back to what happened and why, from the perspective of a healthcare worker, I can't think of one reason, but I can probably think of 40 reasons. I'd be happy to share these thoughts further, but I'm sure you have had these discussions with your contacts and appreciate you are aware of the complexity.

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I've just been having a long hot soak and have come up with the notion of a catchy acronym with a rather broad meaning - CHEC (Catastrophic Health Collapse) - to cover everything beyond medical iatrogenesis (e.g. people with chest pain dying from STEMI at home for fear of going into hospital). I'm just about to revise the articles accordingly and see how this goes!

FYI my lengthy conversation with Jonathan ended with us focusing down on the culture of fear as the primary driver behind what I'm now calling CHEC, which takes us into the military intelligence arena. We also discussed the problems with folk latching on to midazolam - that could well be a red herring that wastes time and takes the focus off the real problems

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Don't know anything about military intelligence but that strikes me as appropriate. People had internalised the state of emergency and were behaving as though this was a war, where usual decision-making no longer applied and we needed to create an entirely new system overnight. It was a mad and disturbing period. This was very much driven by those in the most senior positions of power and influence. Also, many people wanted to be locked down, or thought they wanted to be, not knowing what the consequences would be. Others seemed to thrive on the fear, whipping things up in the media and social media.

I've always found Jonathan Engler's reflections considered and perceptive.

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Ps back in 2021 I did make a flow chart of what I saw as the root causes of non COVID adverse health outcomes caused by the pandemic response. It spanned 3 pages and was a tangly mess.

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This “may” explain the spikes in this series.

https://twitter.com/jikkyleaks/status/1623140333390561281?s=61&t=R2K8aHR4m7P6ZdUUHc0ndw

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Quite. I am in contact with legal types who have been working on this for some time. The evidence they have is solid, detailed and extraordinary but I'm not at liberty to say any more than that.

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