JABSOM Library: Library Updates

COVID-19 Mortality Math

In a better world, math might be allowed to be just math. But we live in strange and, uh, politically adventurous times.  One particular conspiracy theory has been making the rounds. The allegation is that the CDC is lying about the true numbers of Americans killed by COVID-19. Just why the CDC might do such a thing depends on whether the conspiracy theorist is coming from the ideological left or right. Either way, confirmation bias is often handily provided by naked political influence from the executive branch. Skepticism is healthy, so let's take a look.

Here's a screen cap detailing the alleged conspiracy and even more alleged math:

Here is the claim:

1. The CDC is overstating the number of Americans killed by COVID-19, for whatever reason.
2. They are doing this by fudging the numbers from death certificates.

There are two major problems with this claim:

1. A willful misunderstanding of "cause of death."
2. A massive underestimation of the bureaucracy of death.

First of all, let's talk cause of death. Many death certificates that list COVID-19 also list comorbidities like blood clots, acute respiratory distress syndrome, heart failure, etc. What that means is that COVID-19 caused the ARDS that led to death. Without COVID, there would be no ARDS, and no death. In the same way, an HIV+ patient might die of pneumocystis carinii pneumonia. Did the PCP cause the patient's death? Yes. Did HIV? Also yes.

Secondly, the bureaucracy. We'll try to make this painless. Death certificates are legal documents that are created an issued when a person dies. Before it can be filed, the death certificate has to be signed by a coroner, medical examiner, attending physician, an NP, or a forensic pathologist. Depending on state law, others may be able to sign. That death certificate goes to your county or state vital records office. After that, it goes to the NCHS at the CDC.

Are you still awake? Okay, good.

So. In order for the original claim to be true, the following must also be true:

1. ARDS, embolisms, and heart failure must be occurring independent of COVID-19 infection. Patients must be dying "with" COVID rather than "of" COVID. They're all suddenly developing pneumonia and their organs are failing, but it's not because of COVID, it's just happening spontaneously.
2. A massive cover-up is underway nationally involving physicians, coroners, ME's, autopsies, nurse practitioners. AND county records clerks. AND state offices of vital records. AND the NCHS.

And for the record, as of 2 September 2020, the US COVID-19 death count is 185,699.