COVID-ATTRIBUTED DEATH RATES ARE WRONG
Yes. Absolutely true. The exact number of deaths attributable to the COVID-19 virus is unknown. The numbers that we see every day (and that number is now over 75,000 in this country) are tabulated from reported data, primarily from healthcare organizations.
So, it is absolutely appropriate to ask whether those numbers are high or low.
I have recently been sent a series of emails and links that question the accuracy of the death counts. There have also been a number of talking heads that question those numbers. It is particularly interesting to me that virtually all of these sources question the death numbers with the specific intent of demonstrating that LESS people have died from the virus than the numbers reported indicate. This always seems to suggest an agenda, that COVID-19 is less lethal than we think; that we have closed the country irrationally; that if we open the country there will actually be much, much less death than some of us have projected.
I watch and/or read these items. I try to be impartial, but the science and the logic is simply weak or non-existent. Let’s take a few moments to look at the reasons that the numbers are, in fact incorrect. But we will analyze both sides: why the numbers may actually be too high as well as why they may actually be too low.
What could make the numbers of deaths recorded be too high? The basic arguments here are twofold. First, we may be counting deaths due to the virus when those deaths were actually from people whose underlying conditions were such that they were about to die anyway. Or, second, we may be counting people who have died in which virus infection had never been proven.
The first of these arguments has some merit. People die in hospitals every day. They come in with cardiac problems, complications from cancer, pneumonia, etc. So, if they come in and die, and we find out that they also had positive tests for COVID-19 virus, then we choose to record them as having been killed by the virus. They may have been dying anyway, so the virus simply was present and had no role in the death. One can be certain that this is the case in some people. However, it is critically important that this conclusion be made judiciously. After all, human beings die. This is unfortunately a result of life. The question is whether we will die this week, this year, this decade or hopefully, later.
Think of this in this way: Let’s assume that you have a weak heart. You are at risk of dying from a heart attack at any time. Now, what happens if someone shoots you with a gun? The odds of you surviving that gunshot may be much lower than someone who is more healthy. Your weak heart may well have killed you at some time in the future, and it certainly made you more likely to die from the gunshot, but the gunshot killed you. The police, the CDC and the hospital will all list your death as due to a gunshot, not due to heart disease. So, too, when a person with a comorbidity dies as a result of complications from COVID-19, it is because of the virus, not because of the underlying condition.
The statistics on deaths, therefore, always include warnings that comorbidities make one more vulnerable to an infection and serious complications including death. The same is true for influenza. When a person dies from influenza, it is recorded as a viral infection death, not a cardiac event. When a person overdoses on an opiate, it is recorded as drug overdose, not as a death caused by malnutrition.
With regards to COVID-19 attributed deaths without proof of infection, that is a weak argument. Virtually every person who is hospitalized is tested for virus at or before admission. As we have said often, that testing is critical for determining the conditions under which to place the patient and how to protect the healthcare staff.
Now let’s look at how the numbers recorded may actually be lower than those actually occurring.
There are again two basic arguments for the numbers being low. There may be people who do not present at hospitals and die at home, unrecorded as viral deaths. And there may be people who, although not infected with the virus, die because the healthcare system was overwhelmed.
The first argument is quite strong. We have seen evidence of a number of people in NYC who, having died at home, were then found to have been infected, or who have infected people in their household. In Detroit and Boston, the statistics of people dying at home have skyrocketed in the last month over previous years because they are simply not going to hospitals. These deaths are seldom added to the hospitalized deaths, although NYC has begun to add them. We can assume that across the country there are many deaths due to virus occurring at home that have not as yet been cataloged or assigned as virus deaths. When they are, the total number of deaths will retrospectively increase.
The second argument is also well documented. People are dying at home after heart attacks and strokes. Although these are not directly linked to the virus, these deaths are a sequalae of the virus because those individuals and families have tried to survive their health issues at home, out of a fear that going to a hospital would be too dangerous.
In NYC the fire department has been instructed that if they cannot revive a heart attack patient on site, they SHOULD NOT bring that patient to the hospital. The fire department is now in the business of triaging health. Some of those patients may have been able to be saved if the hospitals were able to take them in, provide emergency care and long-term recovery. Those patients died BECAUSE of the virus, not because they HAD the virus.
We do not include those statistics along with the death totals, but they are deaths that would not have occurred had there been no pandemic.
Basically, there may be some factors that are inflating the death count, and some that are deflating it. More likely, there are deaths whose attribution to the virus are lagging behind the current figures. No matter how you record, catalog and tabulate the deaths, the numbers still come out to thousands per day, over 10,000 per week and 50,000 per month. Wishing these numbers down won’t affect the reality.
VP Pence said on April 24: “I truly do believe that if we all continue to do that kind of social distancing and other guidance broadly from federal and state officials, that we’re going to put this coronavirus in the past. I believe by early June we’re going to see our nation largely past this epidemic.” As head of the nation’s Coronavirus Task Force he knew better then, and he knows better now. Between today and June 1, there are 25 days. I hope and pray that he is right and that by June 1 the number of deaths in this country will be down to a few hundred per day. Reality and arithmetic suggest that there will be at least an additional 50,000 deaths by June 1, bringing the US total to over 125,000, and that the daily death rate will be over 2,000.