There’s no doubt COVID-19 kills people. But there is doubt about how many.

And that doubt has been created and fomented by the very people charged with keeping the grim tally.

Since the pandemic’s beginning, the system for counting those deaths has been messy. And that messiness has understandably led to serious questioning of the veracity of the death toll, which is dangerous in itself.

This week, the Texas Department of State Health Services said it would now count deaths marked on death certificates as caused by COVID-19. Previously, the state relied on local and regional public health departments to verify and report deaths. State health officials said Monday the policy change would improve the accuracy and timeliness of their data. Texas law requires death certificates to be filed within 10 days.

Consider this odd statement by the Texas Department of State Health Services: “This method does not include deaths of people who had COVID-19 but died of an unrelated cause.”

We can only hope so.

Because since the pandemic, health officials — locally and in the highest levels of government — have openly conceded that some people who died of other causes such as heart disease, kidney failure, influenza and pneumonia, to name a few, but were infected by the coronavirus were classified as COVID-19 deaths.

Essentially, some people who died “with” COVID-19 have been included in the count with those who died “of” COVID-19. There’s a big difference. Some people — dozens, hundreds, thousands, nobody knows — who were days away from death from other causes, but also contracted the virus while in hospice or hospitals, were classified as COVID-19 deaths.

“I think a lot of clinicians are putting that condition (COVID-19) on death certificates when it might not be accurate because they died with coronavirus and not of coronavirus,” Macomb County, Michigan, Chief Medical Examiner Daniel Spitz said in an interview with The Ann Arbor News in April.

In April, at a White House coronavirus press conference, task force member Dr. Deborah Birx said that while some countries are reporting the coronavirus fatality numbers differently, in the United States a person was counted as a victim of the pandemic if he or she had tested positive for the virus, even if something else was the cause of death. For those attempting to follow the science, that’s a real stumper.

Dr. Philip Keiser, who serves as the Galveston County local health authority, early in the pandemic echoed Birx’s statement when explaining about how deaths were being classified locally. To be fair, Keiser and the health district have been dutiful in explaining that people who have been classified under COVID-19 deaths have had preexisting conditions making them more vulnerable to the disease.

Still, it’s impossible to get a clear picture about whether all 73 people in the county whose deaths were classified under COVID-19 deaths actually died of COVID-19 or with COVID-19.

People who question death rates shouldn’t automatically be accused of fanning conspiracy claims “from the planet Pluto and not caring about the lives lost to COVID-19,” as Gov. Jay Inslee, governor of Washington state, accused the Freedom Foundation when it called out the Washington State Department of Health for including multiple deaths caused by gunshot wounds in the state’s COVID-19 fatality count.

“We currently do have some deaths that are being reported that are clearly from other causes. We have about five deaths — less than five deaths — that we know of that are related to obvious other causes. In this case, they are from gunshot wounds,” Dr. Katie Hutchinson, health statistics manager for the Washington State Department of Health, said in May, according to reports.

Extracting what we hope are isolated cases such as in Washington state but adding the sometimes questionable cause-of-death designations and lack of standardized methods of compiling causes of death, it’s remarkable that the state this week concluded it had undercounted COVID-19 deaths, raising Texas’ toll by more than 600. In Texas, 5,713 deaths have been attributed to COVID-19, according to the state health services department.

If we can’t trust the numbers about counted deaths, how do we trust the speculation about undercounted deaths? It’s a simple question without satisfying answers.

COVID-19 is bad enough. People are dying from it. Hospitals are dealing with influxes. We should all take precautions every day.

Falsely classifying deaths under COVID-19 might be derived from human error, governmental inefficiencies, chaos, confusion, politics, good intentions or all of the above. But the ultimate outcome is deception that fuels counterproductive anger and risky behavior.

Questioning the numbers doesn’t necessarily make people crackpots or uncaring or deniers. It makes them truth seekers.

Likewise, overestimating the numbers and attempting to hoot down people who question them serve no good purpose. Both can feed a false narrative that forms the context in which policies are made that undermine our ability to lead productive, independent lives.

One aspect of false narrative already has become a given, almost holy writ, in the national conversation about COVID-19 — it’s relatively worse in the United States than anywhere else. Not so, according to data about two key measures: deaths per 100,000 people and the observed case fatality rate, compiled by Johns Hopkins University.

As of Tuesday, the U.S. deaths per 100,000 was 45.24; the case fatality rate was 3.4. Meanwhile, for example, in the United Kingdom deaths per 100,000 was 68.95 and the fatality rate was 15.2, and Belgium was 85.99 and 14.8. France’s deaths per 100,000 was slightly better at 45.10, but its case fatality rate was 13.7 — four times the U.S. rate.

And many countries held up as examples of how to do it better have higher case fatality rates, at least so far: Canada, 7.7; Switzerland, 5.7; Denmark 4.5; Germany 4.4; Finland 4.4.

The point is, we can’t successfully battle this pandemic by chasing numbers, and certainly not by hyping them.

It comes down to this: If we’re to trust the science, we need to be able to trust the data.

• Laura Elder

 Laura Elder: 409-683-5248; laura.elder@galvnews.com

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(12) comments

Susan Fennewald

I'm a scientist by training - and a numbers person. I long ago learned to appreciate the value, and limitations, of numbers and have been following the numbers for COVID-19.

It's good that those generating the numbers are trying to get them right - but it doesn't really matter for our understanding of the situation whether there were 5282 deaths, or 5862 deaths (or whatever). It doesn't really matter if 5 people might have died from gunshot wounds but were counted among the COVID cases or if 5 people who are listed as dying of kidney failure would've lived another 2 years but had their health compromised by COVID. Clearly, there are thousands of deaths involved, and multiple factors can contribute to a death.

As far as comparing us to other countries - everyone likes to cite the numbers that make their country look best. Maybe its "cases per 100,000", or "deaths per 100,000", or "deaths per case". The US does better in some categories than others. Because the US has LOTS of people and LOTS of cases we hold the record on the “total cases”. Because at this later point months into the pandemic we have lots of tests run and are trying to track and contain the virus, we identify people who are younger and not too sick but can spread the virus. So we have a lower case fatality rate, and our “deaths per 100,000” aren’t at the top (yet). It was noticed early on that if you only test very sick people, then your case fatality rate is higher than if you test everyone. I noticed that Laura Elder cited Belgium which has one of Europes’s highest deaths per 100,000(about 85) in that category, instead of Germany which has a rate of about 11. She was spinning the numbers.

“Questioning the numbers doesn’t necessarily make people crackpots or uncaring or deniers. It makes them truth seekers.” It doesn’t NECESSARILY make them crackpots or deniers. But if in their next statements they use the questioning of the numbers to totally dismiss the numbers and claim it is all a hoax - then they are crackpots and deniers.

I'm a scientist by training - and a numbers person. I long ago learned to appreciate the value, and limitations, of numbers and have been following the numbers for COVID-19.

It's good that those generating the numbers are trying to get them right - but it doesn't really matter for our understanding of the situation whether there were 5282 deaths, or 5862 deaths (or whatever). It doesn't really matter if 5 people might have died from gunshot wounds but were counted among the COVID cases or if 5 people who are listed as dying of kidney failure would've lived another 2 years but had their health compromised by COVID. Clearly, there are thousands of deaths involved, and multiple factors can contribute to a death.

As far as comparing us to other countries - everyone likes to cite the numbers that make their country look best. Maybe its "cases per 100,000", or "deaths per 100,000", or "deaths per case". The US does better in some categories than others. Because the US has LOTS of people and LOTS of cases we hold the record on the “total cases”. Because at this later point months into the pandemic we have lots of tests run and are trying to track and contain the virus, we identify people who are younger and not too sick but can spread the virus. So we have a lower case fatality rate, and our “deaths per 100,000” aren’t at the top (yet). It was noticed early on that if you only test very sick people, then your case fatality rate is higher than if you test everyone. I noticed that Laura Elder cited Belgium which has one of Europes’s highest deaths per 100,000(about 85) in that category, instead of Germany which has a rate of about 11. .

“Questioning the numbers doesn’t necessarily make people crackpots or uncaring or deniers. It makes them truth seekers.” It doesn’t NECESSARILY make them crackpots or deniers. But if in their next statements they use the questioning of the numbers to totally dismiss the numbers and claim it is all a hoax - then they are crackpots and deniers.

Bailey Jones

[thumbup]

Charlotte O'rourke

Valid points Susan. I thought your comments were excellent.

Jean Ann Glass

I also thought this article was very good and I have the same concerns.

Bailey Jones

There's no such thing as perfect data. In the signal processing world there is the signal, and then there is the noise the signal lives in. Sometimes it's absolutely necessary that the signal be noise free - like if you're measuring components for a chemical reaction. Other times, what matters most is the trend. That's the case with COVID numbers. It's less important that you know the exact number of deaths than that you know whether the number of deaths is increasing or decreasing - since that's the metric we use to gauge whether or not we're containing the virus.

Dan Freeman

Public Health Officials live with the tears behind the data.

Jose' Boix

We continue to be overwhelmed by data and numbers; none with enough consistency to show if what we are doing is (or is not) working. We continue to talk about the "cresting" or "leveling" of the curve, but no curve is shown. Data and numbers fatigue are setting up. Let us try to focus on say local trends rather than show and discuss data from other counties and/or other countries. Let us "zoom in" on say Galveston County. Just my thoughts, again.

PD Hyatt

With all of the numbers being skewed is why many of us do not believe all that Fauci and CDC are saying. Besides H1N1 was far worse than this and we did not shut down the world like the MSM has been advocating since the beginning....

George Caros

12500 died of H1N1 150000 died from covid19 and the worst is not over. Drump supporters don't like facts

Carlos Ponce

If Hillary had been president, the numbers would have been higher.

Gary Miller

Dead with Covid but not dead from Covid? Compromised health has killed every since humans wanted to know why someone died. Now a political party uses the "reported" death rate as a political tool. The numbers reported are as dishonest as that political party.

Wayne D Holt

Thanks, Laura, for continuing to question the prevailing "wisdom" that we are in a medical catastrophe from Covid-19. We ARE in a catastrophe but it is economic, social and even psychological in nature.

What started out as flattening the curve so our medical resources would not be overwhelmed has become absurd political theatrics as we struggle to fight a virus with a mean fatality rate eight years beyond average life expectancy, speaking of Galveston. This is the mark of an obsession that refuses to accept reality...the reality that we have destroyed our economy in this effort.

Nearly every metric of economic damage is off the charts; worse than anything seen during the 2008-2009 Financial Crisis, worse than any post WWII recession, worse than the Great Depression of the 1930s, worse than the periodic depressions of the 19th century. There is simply nothing remotely comparable to the destruction wrought on America's industries, businesses and citizens. And the destruction is just beginning. We will soon have tens of millions of Americans facing evictions, with no prospects for employment in an economy that looks like Gen. Sherman passed this way.

People continue to obsess on the mote of masking while ignoring the beam of our nation's wealth, productivity, social fabric and spirit of freedom being consumed in this bonfire.

I heard somewhere that people go mad in crowds but only return to their senses one by one. We're quickly running out of time for common sense to return to America. What lies ahead of us is an abyss if we don't pull out of this insane medical malpractice very soon.

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