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Are COVID-19 deaths overcounted? More physicians say yes

The World Health Organization once had a page on their website that is no longer available, that stated the definition of a COVID-19 death:

A COVID-19 death is defined for surveillance purposes as a death resulting from a clinically compatible illness in a probable or confirmed COVID-19 case, unless there is a clear alternative cause of death that cannot be related to COVID-19 disease (e.g. trauma).

Image by Gerd Altmann from Pixabay

Since the beginning of the pandemic, there has been debate and disagreement whether the COVID-19 deaths were overcounted, undercounted or just right.

Dr. Deborah Birx, the Trump White House coronavirus task force response coordinator said in a press conference on April 7, 2020: I think in this country we’ve taken a very liberal approach to mortality…

There are other countries that if you had a preexisting condition and let’s say the virus caused you to go to the ICU and then have a heart or kidney problem, some countries are recording that as a heart issue or a kidney issue and not a COVID-19 death. Right now we’re still recording it and the great thing about having forms that come in and a form that has the ability to mark it as COVID-19 infection, the intent is right now that if someone dies with COVID-19 we are counting that as a COVID-19 death.

About five months ago, in an opinion piece in The Hill, Lao-Tzu Allan-Blitz, MD and Jeffrey D. Klausner, MD, MPH wrote of their hypothesis that COVID-19 deaths are being overcounted by the order of at least fourfold.

Florida COVID-19 death certificates examined

They also excoriated the routine testing of every hospitalized patient for COVID-19 and the CARES Act:

In order to stop routinely testing all hospitalized patients for COVID-19, we must remove the perverse incentive of the Coronavirus Aid, Relief, and Economic Security Act, which provides hospitals an additional 20 percent compensation for Medicare patients diagnosed with COVID-19. We must also change how we count COVID-19 mortality. Review of each COVID-19-related death certificate, like Los Angeles County, requires time and money. Utilizing the already-established Centers for Disease Control’s COVID-19 hospital surveillance program for surveillance is appealing, however, it is not clear whether COVID-19-related deaths in that surveillance program are under rigorous review. 

Regardless of strategy, we must end the recommended practice of adding COVID-19 as a contributing cause of death to every death certificate in all SARS-CoV-2 positive hospitalized patients. That practice is not only meaningless but also harmful.  

Last week, one of the most ardent COVID-19 scaremongers from time past, Dr. Leana Wen, produced a piece in the Washington Post that states flatly that we are overcounting COVID-19 hospitalizations and deaths.

She writes that the CDC states the US  is experiencing around 400 covid deaths every day. At that rate, there would be nearly 150,000 deaths a year.

Then she asks the most important question: But are these Americans dying from covid or with covid?

In interviews with two infectious-disease experts, they lay out that overcounting of deaths is highly likely.

One of the interviewees is Robin Dretler. He’s a physician at Emory Decatur Hospital and the former president of Georgia’s chapter of Infectious Diseases Society of America, estimates that at his hospital, 90 percent of patients diagnosed with covid are actually in the hospital for some other illness.

“Since every hospitalized patient gets tested for covid, many are incidentally positive,” he said. A gunshot victim or someone who had a heart attack, for example, could test positive for the virus, but the infection has no bearing on why they sought medical care.

Dretler also sees patients with multiple concurrent infections. “People who have very low white blood cell counts from chemotherapy might be admitted because of bacterial pneumonia or foot gangrene. They may also have covid, but covid is not the main reason why they’re so sick.”

If these patients die, covid might get added to their death certificate along with the other diagnoses. But the coronavirus was not the primary contributor to their death and often played no role at all.

Dretler is quick to add that the imprecise reporting is not because of bad intent. There is no truth to the conspiracy theory that hospitals are trying to exaggerate coronavirus numbers for some nefarious purpose. But, he said, “inadvertently overstating risk can make the anxious more anxious and the skeptical more skeptical.”



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