The Problem With How We Identify the True Covid-19 Death Rate
The infection rate is much greater than the case rate, and which one is used to calculate fatality rates makes a huge difference.
The US and the world are entering the ninth month of the Covid-19 pandemic. Sadly, there is still no agreement on the actual chances of dying from the disease. Fatality rates based upon case rates in the US are currently about 2%. If the estimated infection rate is used as the denominator in the calculation, that rate could be as low as 0.1–0.2%. The implications are enormous. It is easier to rationalize lockdowns and life-style restrictions if two out of 100 people die than only two of 1000. Unfortunately, estimating the correct infection rate is about as easy and nailing jello to a wall.
Death rates should be easy. But in our ultra-partisan political environment, even the accuracy of that has been questioned . This past summer, in Florida, treating doctors, rather than medical examiners, were tasked with assigning the cause of death as due to Covid-19. The reason was that the medical examiners were being overwhelmed. “The shift from the medical examiner to the treating physician as the person who signs off on the death certificate has created inconsistency and questions about whether COVID-19 deaths may be going unreported”. People on the Right argue that too many cases are wrongly signed out due to the virus. Some on the Left argue the actual deaths due to Covid are undercounted. And then there is this. Conspiracy enthusiasts say case counts are too high because hospitals are getting more reimbursements for ICU patients if designated as a Covid patient.
Case rate counts should be simple. A person gets symptoms, gets a test for the virus antigen, and is either positive or negative. But all of this depends upon how each state counts its cases. Positive cases are counted only once in Florida. Yet, at the same time, repeated negative tests in the same individual are counted every time they are tested . Critics argue this causes an undercounting of the real case rates since negatives are “weighted” more than positive ones. It turns out that some states do “total test encounters” and ignore “unique results per individual.” The Covid-19 Tracking Project, independent of any government agency, has outlined how complicated and difficult case counting can be.
One criticized study from Stanford University examined minimally or asymptomatic people who never got tested. When they screened Santa Clara County residents in California for the coronavirus antibody, they found the infection rate was 50 times higher than estimated by positive antigen tests. Other studies have estimated a lower rate of asymptomatic carriers. But it is clear that more asymptomatic people with the virus can spread it than positive antigen cases reflect.
And so here we are; no national standards for reporting cases or deaths. If we can get more than half of the US population vaccinated in one year, these glaring discrepancies will become moot. But right now, real people with real jobs at stake are suffering because of governmental ineptitude. And that is just another tragedy of this pandemic.
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