Inconsistent protocols, limited resources, and a patchwork of decision-making has led to a Significant Understatement of Coronavirus-Related Deaths.
Across the United States, even as coronavirus deaths are being recorded in terrifying numbers — many hundreds each day — the true death toll is likely much higher.
In many rural areas, coroners say they don’t have the tests they need to detect the disease. Doctors now believe that some deaths in February and early March, before the coronavirus reached epidemic levels in the United States, were likely misidentified as influenza or only described as pneumonia.
Late last week, the Centers for Disease Control and Prevention issued new guidance for how to certify coronavirus deaths, underscoring the need for uniformity and reinforcing the sense by health care workers and others that deaths have not been consistently tracked. In its guidance, the C.D.C. instructed officials to report deaths where the patient has tested positive or, in an absence of testing, “if the circumstances are compelling within a reasonable degree of certainty.”
Reasonable Degree of Certainty
Only now is the official counting supposed to be with a "reasonable degree of certainty". The key words are "supposed to be counted".
The question: What constitutes a "reasonable degree of certainty".
States and especially governors of states who were late to issue stay-at-home mandates want massive underreporting if they can get it.
Recall that CDC incompetence led to a situation the US did not even have tests to any significant degree until at least until mid-March.
Cannot Get Tested
Every day I hear stories of people trying to get tested but cannot.
The New York Times article above noted several instances including that of Julio Ramirez whose official death certificate said pneumonia.
The hospitals refused to test Ramirez. His wife hired a private company to do an autopsy. He tested positive.
Why do these stories still persist?
Pneumonia, Flu Linked to More than 8% of U.S. Deaths in Last Week
In its latest FluView report, released Friday, the CDC said that 39 million people have been sickened by the flu in 2019-20.
In all, so far this winter season, the flu has caused death in roughly 24,000 people across the country, the CDC estimates, including 162 children. The percentage of U.S. deaths attributed to the virus during the week ending March 28 is above the agency's "epidemic threshold" of 7.2 percent.
Nationally, roughly 400,000 have been hospitalized as a result of the illness. However, the percentage of visits to healthcare providers for "influenza-like illness" dropped during the most recent analysis period, from 6.3 percent to 5.4 percent.
Similarly, the percentage of laboratory-confirmed samples testing positive for strains of influenza declined sharply over the same period, from 7.3 percent to 2.1 percent. More than 50 percent of the samples testing positive so far this winter have been for influenza A.
- Only 2.1% tested positive for the flu. What was the rest?
- 24,000 died from the flu, pneumonia or something else?
- How many people had the flu and Covid-19?
Email From a Friend
The girlfriend of my partner's son tested positive this week. It took over 7 days for the results to come back. It took many tries for her to get tested, even after she told them she had symptoms and had been in contact with a confirmed case. The girlfriend lives with her two sons, and they have been back and forth to her house many times. The girlfriend is now symptom free, but, she could still infect people.
So far my friend and her husband are isolating and have no symptoms.
The testing authorities asked NO QUESTIONS about whom the girl had contacted, how much she had moved around, etc. even though she is of university student age and lives 1 mile from a major, globally-ranked university.
That email came in this morning.
Unfortunately, I do not find my friend's email at all shocking.
The article above cited such cases. I read similar stories very day of the week and have been reading them for weeks. I see numerous references on Twitter every day.
Global Coronavirus Cases
Global Testing Leader
President Trump like to brag the US is the global leader in testing. It's hardly a fair comparison. Let's even it out and compare the EU with the US.
EU vs US Testing
- Spain: 355,000
- Italy: 691,461
- Germany: 918,460
- France: 224,254
- Belgium: 70,000
- Netherlands: 75,415
- Austria: 108,416
- Portugal: 86,370
The EU consists of 26 nations. That subset of 8 has conducted 2,529,376 tests.
EU 8 Subset vs US
- EU 8 Subset: 2,529,376
- US: 1,729,314
Did the EU Lose Any Tests?
That question might seem a bit bizarre but not in light of this.
"Well, I'm telling you, I'm still missing 50% of the data from reporting," she said. "I have 660 (thousand) tests reported in. We've done 1.3 million. ... So, we do need to see -- the bill said you need to report. We are still not receiving 100% of the tests."
What good are tests if you do not have the data? Did we really do that many tests in the first place?
Hopefully, this is an analysis delay rather than a case of permanently lost data, but the latter would not surprise me.
Regardless, the US is still way behind the EU on testing even if those missing results eventually turn up. That's the valid comparison.
US Covid-19 Deaths
Let's return to the key idea.
The US reports 9,444 Covid-19 deaths.
How many is it really?
Second Key Question
How many deaths and hospitalizations would we have were it not for widespread shutdowns?
We cannot answer either question. But we can say much, much higher to both.
Most importantly, we can say the numbers clearly indicate this is Far Worse Than the Flu™.
Mike "Mish" Shedlock