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