05/09/2020
I am exhausted.
After a quarter of a century of learning/training and half a million dollars invested...I am just an extremely
exhausted doctor navigating this pandemic both professionally and personally. And, still, I remain committed and dedicated to serve another day.
But, some folks watch a video or read a post from questionable, biased, unqualified sources to earn their own doctorate from Facebook University, becoming self-certified experts in frankly foolish, sometimes dangerous, mostly selfish denialism. To borrow from W.H.O. Director-General Tedros Adhanom Ghebreyesus, the “moral bankruptcy” highlighted by irrational views on our current reality seems so pervasive and gives my spirit such unrest.
I hope you take a few minutes to read this science-based update below posted. It is written to be easily understandable by those seeking to actually understand.
There have been rumors, and tweets, and screenshots, and who knows what else stating that only 6% of CDC’s COVID19 death count is due to COVID19.
Thought I would clear the air from an epidemiological point of view. Here we go....
What happened?
• CDC updated its regular statistics page stating: "For 6% of the deaths, COVID-19 was the only cause mentioned." For the other 94% of people that died of COVID19, "individuals had an average of 2.6 additional conditions or causes per death".
What does this change?
• NOTHING. 182,885 people have still died from COVID19 in the US. COVID19 is still the third leading cause of death in the US.
What does the science say?
1. The CDC (and basically every scientist across the world) has consistently stated that individuals with underlying health conditions are more likely to die from COVID19. This is probably one of the first facts that we DID know. We shouldn’t be surprised of this “low” 6%
2. Long-term conditions (like obesity, diabetes, or heart disease) are “chronic” because they last for a long time. Most are, in fact, manageable thanks to modern science. Someone with diabetes (that wasn’t “supposed” to die this year) can manage to get infected with COVID19 and die quickly because their immune systems get overwhelmed.
3. The health of our nation has been terrible, even before the pandemic. 60% of adults have a chronic condition. Among those aged 65 and over, 80% have multiple chronic conditions. Minorities and low-income populations have more chronic conditions too. So, if you take a random sample of people who die, the majority will have at least one chronic condition.
4. There are many lines on a death certificate. This includes the “immediate cause of death”, “sequentially conditions leading to the cause of death”, and “other significant conditions contributing to death”. Which ties to #3…it would be odd if a chronic condition WASN’T listed on a death certificate in the US given the health of our nation overall and given COVID19 touches every organ system. Death certificate instructions are below if you’re curious how this data is collected.
5. If there is nothing else, just look at an excess death graph for 2020 (see Figure). We are WAY above our deaths this year compared to past years. Period. This doesn't just randomly coincide with a pandemic.
In epidemiology (and science), it’s very weird for us to beat a dead horse. We typically accept the conclusions of a room full of scientists with decades of experience until another room of scientists with decades of experience proves them wrong. We don't change our mind from a tweet that is taken out of context (no matter who it's from). The public should follow suit.
I guess I should just be happy that everyone (and I mean everyone) now pays attention to public health.
Love, YLE
CDC link to deaths causing the commotion: https://www.cdc.gov/nchs/nvss/vsrr/covid_weekly/index.htm
Chronic conditions and of COVID19 death: https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-at-increased-risk.html ;
Chronic conditions, overall, in the US: http://www.fightchronicdisease.org/sites/default/files/TL221_final.pdf; https://www.cdc.gov/chronicdisease/resources/infographic/chronic-diseases.htm
Death certificate instructions:https://www.cdc.gov/nchs/data/dvs/blue_form.pdf
Excess Deaths posts: https://yourlocalepidemiologist.com/excess-deaths/;
COVID19 as a leading cause of death: https://yourlocalepidemiologist.com/leading-causes-of-death/
Image from: Weinberger lab, updated on August 14, 2020
