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6% What the What?

October 6, 2020

SCIENCE AND DATA ALERT! 6%, WHAT THE WHAT!?!?! It’s not what you may think.

Hi again. So unless you’ve been out of the country for the last few days (who am I kidding?) you are probably aware of the firestorm that has erupted in social media about this “report” from the CDC that “admits” that only 6% of people listed as COVID deaths actually died from coronavirus infection alone and that the other 94% had on average 2.6 additional comorbidities leading to their deaths. This has amplified the months-long argument that many (and according to this data, most) have in fact died “with” COVID as opposed to “from” COVID, and has led many to misinterpret this information and to assert (and reinforce for many) the idea that this whole thing is something of a hoax perpetrated on the American people for some nefarious purpose. Now if you’ve read any of my previous posts on the COVID you know that I am, to say the least, not at all enamored with the almost complete lack of science and data (and often abject stupidity) with which our illustrious leader here in NJ (and to be fair, leaders of many other states) has executed a game plan to keep us “safe”. Having said that, as we should all be looking for calmer heads to prevail, I feel compelled to throw some cold water on those who have doubled down on their conspiracy theories in light of this new “information”. The truth is, when looking at the death toll nobody can really have a good handle on the particulars; how many have died due to the COVID, is it more or less than the published number, how are we determining who is a COVID death and who is not, and so on. It’s very complicated for many reasons and when you start digging into the data you run into things like this: “The ‘surveillance’ package in R (2) was used to implement the Farrington algorithms, which use overdispersed Poisson generalized linear models with spline terms to model trends in counts, accounting for seasonality.” So there’s that. Most of us neither have the vibranium (shout out Marvel) pocket protectors to carry out these calculations nor, quite frankly the ability. I, of course do because you know, I can handle things. I’m smart. Not like everybody says. (shout out Fredo Corleone) Also, it is entirely possible that the 6% cited as deaths solely from the COVID may in fact have been people with undiagnosed comorbidities or simply death certificates that were not filled out properly due to the fog of war. But for those, like me, who realize that our response to this extinction-level-event has been way overblown, especially in light of some six months of data that should now be better informing our decision-making and more importantly our attitude towards this virus, there are some interesting tidbits to be gleaned from this CDC info (which, by the way, is not new). This information is probably more important for those who are still in Blues Brothers parade scene mode (ask the Google) and should help to adjust their outlook to a more rational one. So let’s take a look.

The information in question comes from the CDC weekly update document, Table 3 entitled “Conditions contributing to deaths involving coronavirus disease 2019…” Let’s explore some of those aforementioned tidbits.

The first column of this table is titled “Conditions Contributing to Deaths where COVID-19 was listed on the death certificate1” with the subheading of that column being “Total COVID-19 deaths2, as of 8/22/2020”. The superscript number 2 is explained as “Deaths with confirmed or presumed COVID-19, coded to ICD–10 code U07.1” Now this has been a bugaboo since back in April when New York City added some 3,800 deaths to their total by including those who “probably” died from (or is it “with”) COVID. At the time that addition increased the NYC death toll by some 60% overnight. It is simply not scientific to look at a subject, make an assumption (or guess) as to its properties, and then categorize it by that assumption.
Let me paint you a word picture. Close your eyes…no wait don’t close your eyes, then how could you read the words with which I will paint the picture in your mind. Never mind. Let’s say you’re walk through the park on the way to work and see me sitting on a bench with the intent of counting what kind and how many birds are in the park today. You think that’s fascinating and promise to pay me $100 for my effort if I can actually do it. At the end of the day you stop by and ask for my results. I tell you I saw 15 Blue Jays, 15 Cardinals, 10 pigeons, 20 sparrows, and 40 Yellow-bellied Sapsuckers. “Wow!” you exclaim, “That’s a lot of Yellow-bellied Sapsuckers.” I then admit that I really only positively identified about 15 Sapsuckers but I could not positively identify the other 25 birds so I just assumed they were Yellow-bellied Sapsuckers. Are you paying me the $100? I’m not saying there is any evil intent in counting those who somebody thinks “probably” died from (or “with”) COVID, but I am saying it ain’t science. Also, you will see many articles which claim the death count is much higher, but they justify that position by including those who may have died not from the virus, but from the lockdown measures and fear we have created with our response to the virus. That’s like saying your kid got caught with his hand in the cookie jar so you send him to bed right after dinner. This punishment causes your kid not to be able to do his homework and the next day when the teacher calls and asks why little Johnny didn’t do his homework, you blame him swiping a cookie as the reason. Not really legit.

Next tidbit. If you look down the first column you will see listings of many conditions listed as contributing factors to death. What we should all understand is that most of these comorbidities can, and most likely did, arise from the coronavirus infection itself. So things like pneumonia and adult respiratory distress syndrome and most of the others are quite probably a result of the infection and therefore should not be looked at as the “real” cause of death. There are, however, about a half dozen conditions which would not fall into that category. Things like chronic lower respiratory disease, hypertension, cancer, diabetes, and obesity were clearly not caused by the virus and can easily be seen in those who died as the “real” cause of their deaths. BUT, it must also be noted that a 68 year old obese, hypertensive, diabetic may have easily live many more years if not for the COVID. There’s no way to know, so it’s not fair to “assume” that guy was about to die anyway. As I said, it’s complicated. There is a number which adds some clarity to the “true” number of COVID deaths (maybe) which we’ll get to in a minute.

There are a couple of other points of interest to note. First, this chart lists just 330 deaths in people 0-24 years of age, and by looking at the listings of conditions it appears just about all of these young people were already sick. The most important number here may be that 79 out of the 330 are listed as obese. I’ll address this another time. But that’s 330 young people out of approximately 100 million Americans. A young person dying from or with COVID is a “man bites dog” story. And while all deaths are always tragic, especially if it’s a young person, we must use our rational minds when thinking of kids’ safety and put these kids back in school full time as usual. The harm we are doing to them psychologically, socially, and educationally far outweighs the risk of the virus. I will address the science and data showing kids are not a reservoir for spreading the virus to teachers or staff in another post.
Second, the next to last category under conditions contributing to COVID deaths is “Intentional and unintentional injury, poisoning and other adverse events”. The question is, why would this be listed at all? This cause counts for over 5.000 of the total deaths. What possible reason could there be for listing a death from a motorcycle accident, suicide, or drinking oneself to death (all actually happened) as a COVID death? There seem to be two possible answers. Either the people attributing these deaths to COVID are not particularly bright or they are liars in an attempt to further an agenda. Your choice. There is simply no legitimate reason to include those deaths as COVID deaths. Period.

But the inclusion of this category and these deaths brings in to focus the reason for my “SCIENCE AND DATA ALERT!” posts to begin with. In the absence of real science, data, and rational thinking, a vacuum will develop. As nature abhors a vacuum, within such space proves to be the very fertile ground for conspiracy theories of all kinds to sprout. And the presence of conspiracy theories, even if they actually have some validity, can do nothing but further divide us and in turn lead to more confusion and chaos. This ultimately leads to more scared (in my opinion quite unnecessarily) people.
So let’s take a look at some good news that can be taken from this issue. As stated earlier, we count only 330 deaths in kids up to age 24. Very good news. We count about 13,000 deaths total in people under the age of 55 and only about 33,000 under the age of 65 which accounts for about 270 million of us. And yes I know these numbers might be incomplete but a full accounting will not change them appreciably. Also, as 94% of people who have died had an average of 2.6 comorbid conditions, you should take comfort if you are an otherwise healthy person under the age of 65 in the knowledge that the chances of something bad happening to you from this virus are almost zero (calculated at 1/100th of 1%). I acknowledge that the term “otherwise healthy” is fairly elastic and that the majority of Americans are in fact metabolically unhealthy (a post for another day), but suffice it to say if you do not have multiple diagnosed illnesses, you really shouldn’t worry so much.
Finally, going back to a point alluded to earlier, a fairly reliable metric by which to judge if the death count is believable or not is to look at the overall excess death count. Right now the CDC reports that we are at about 109% of normally expected deaths in America. That puts us at about 180,000 excess deaths which is about where the COVID death count stands. This figure does not, of course, parse out the people who have died from my earlier cookie jar analogy so to end where we started who the hell really knows. But what we all should now understand is that if entering your house is like a scene out of The Andromeda Strain (ask the Google), you might want to try to get that more primitive, fear based part of your brain under control.

Click link for CDC provisional counts: https://www.cdc.gov/nchs/nvss/...

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