Aug 5

Aug 5 The Ugly Uncertainty About Covid-19 Deaths

By TATIANA PROPHET

COVID UNCERTAINTY NO. 1: Overall U.S. deaths have risen; but non-Covid deaths appear to be sharply dropping compared with 2019 (year-to-date).

Every year, CDC death records include top causes of death -- and then any remaining causes as a bulk number.

*Preliminary data shows that total deaths YTD for 2020 went up by 153,388 from YTD 2019. But the total "selected" (top-15 plus Covid) deaths use overlapping categories, and they went up by 278,496 (see bar graph).

*We would expect the remaining deaths to stay flat or grow if Covid-19 were causing excess deaths. But instead, non-Covid deaths appear to be headed for a steep drop in 2020 compared with previous years (see lowest bar for 2020). In fact, the “selected” deaths suddenly make up 80 percent of all deaths instead of 70 percent for all previous years since 2014, and did not go up in proportion with the remaining deaths as a portion of the whole.

*Examining a few of the categories not listed as part of the top 15 and Covid-19, we see that there was not a steep drop in the number of opioid-related deaths (which, being unlisted in the top 15, fall into the 'residual' category). *On the contrary, opioid deaths rose in 2020. So did the grand total. What can we deduce from these unexpected numbers? The *possibility* that deaths categorized as Covid-19 were not actually caused by Covid-19, all other things being equal; or that a pneumonia or influenza-like illness is being coded as Covid-19 because the authorities are allowing the *same coding without a test.* (see screenshot of guidelines below).

Covid-19 cause of death would include the guy who died in a motorcycle accident & the man who died of Stage 4 cancer, and any other deaths showing the person positive for Covid-19, or even if the health care provider said the patient was positive! Even if it's not the underlying cause of death, it gets the same *billable code* of U7.1 Covid-19.

UPDATE August 9, 2020: The World Health Organization did create an international code for Covid-19 deaths that have not been laboratory confirmed. However, the Center for Health Statistics under the CDC declined to use the code because “laboratory tests are not typically reported on death certificates” in the United States. See screenshot:

When in doubt, put Covid (U7.1), Part 2.

COVID UNCERTAINTY NO. 2: OVERLAPPING CATEGORIES

"Top 15 With Covid-19" Includes overlapping deaths in more than one category such as “all deaths involving influenza with or without Covid-19 or pneumonia,” and all deaths involving pneumonia with or without Covid-19, excluding influenza,” and finally “deaths involving pneumonia, influenza, or Covid-19.” Such imprecision could obviously affect the totals we see, even to the point where non-Covid deaths may have been miscategorized as Covid being the cause of death, when it was simply an asymptomatic case.

The counterargument is that Covid-19 AND other deaths could be undercounted because not all totals are entered in multiple categories, given that some states are weeks behind in reporting.

UNCERTAIN FUTURE, BUT PREPARATION IS KEY: WILL WE REGRET THE DECISIONS WE MADE TODAY, NOT KNOWING WHAT WE WILL EVENTUALLY KNOW?

In the year 2022, when the National Center for Health Statistics publishes the final death count for 2020, causes of death will be revised.

It remains to be seen whether the amount of expected deaths for non-Covid causes of death will be comparable to previous years. If they are drastically lower than previous years, there will be multiple reasons, but one of them will have to be that some portion of Covid deaths -- possibly very large -- had co-morbidities that would have happened anyway. This is because the CDC is counting deaths "with or without Covid" together, as well as "Covid or influenza or pneumonia," also together. The overlap makes it impossible to separate out which ones had influenza, and not Covid, or pneumonia that was bacterial or some other virus.

This is because in spite of all the testing our country has conducted (62.3 million with a 7.9 percent positivity rate), there are clearly tens of thousands of Americans who died who were not actually tested.

We know this as fact because if the CDC knew that they had a confirmed laboratory case of Covid, then they would not need to put the death in the category of "Covid or influenza or pneumonia." There would be no point.

It's possible that in the end, all respiratory deaths will show a spike for 2020. It's also possible that overall non-Covid deaths will come in much lower than previous years, with a multitude of reasons for the change -- some disturbing and some enlightening. When and if that happens, the NCHS (under the CDC) will make the information public.

Either way, in 2022, it will be too late to change the actions we are taking now. With a mortality rate still hovering between 1 percent and 2 percent in many U.S. states (because of the high amount of cases), and 94 percent of all closed cases recovered worldwide, in a couple years we may regret the "cure" more than the pandemic.