Numbers Gathering Misconceptions

Among the misguided  “Patriots” protesting with Matt Shea and far right religious leaders at the courthouse in Spokane last Friday was “…a group of young people holding signs claiming that COVID-19 death counts aren’t accurate and that the novel coronavirus is a hoax.” 

“Covid-19 death counts” aren’t perfectly accurate. Gathering death statistics is not just counting corpses. These young people are questioning the motivation of the numbers gathers, suspecting them of intent to deceive. In short, these sign carriers and their ilk are conspiracy theorists. They hold that in common with the conspiracy theorist in chief, Donald Trump, a man who started his run for office on the birther conspiracy, a man for whom the entire government is part of a “deep state” conspiracy against him personally.

Here is my starting place: Without quality data on the world in which we live we are lost, rudderless, unmoored (exactly the way some would like us to be). People in government and medicine tasked with assembling this data are doing their very best to get it right. What it takes to come close to the right number is an effort most of us don’t appreciate or understand. It is time to look.

Consider influenza statistics. How are they gathered? Does each corpse dead of influenza get a stamp on its forehead, “DIED OF THE FLU”? No. Most every corpse has a story of intercurrent chronic and acute illnesses, diabetes, coronary disease, alcoholism, dementia, any one of which, in the absence of positive gold-standard test for the influenza virus, might be labelled the cause of death by the individual responsible for filing out the death certificate. 

Each year good faith efforts are made by an army of honest workers in government and medicine to assemble the best estimate of deaths due to influenza. They examine a multitude of data. They hone their methods in conferences and academic arguments. Finally a number is published (typically two years later). It’s a completely non-political effort, but one that carries policy implications. (Check out this CDC website page for a glimpse at the complex methodology used to estimate “Influenza-Associated Deaths.”)

Doug Muder puts it this way (his whole article at that link is a good read):

The flu comparison is even less appropriate than the numbers make it sound. In Scientific American, Dr. Jeremy Samuel Faust concludes that the comparisons we hear about flu deaths vs. Covid-19 deaths are misguided.

When reports about the novel coronavirus SARS-CoV-2 began circulating earlier this year and questions were being raised about how the illness it causes, COVID-19, compared to the flu, it occurred to me that, in four years of emergency medicine residency and over three and a half years as an attending physician, I had almost never seen anyone die of the flu. I could only remember one tragic pediatric case.

He began asking other emergency-medicine doctors, and found that their memories match his. They remember lots of opioid deaths, gun deaths, and traffic-accident deaths — which are supposed to happen in similar numbers — but not flu deaths. Flu death totals, he came to understand, are not counted deaths — deaths of particular people whose doctors write “influenza” on their death certificates — they’re extrapolations based on models. The models assume that many people die of the flu outside of hospitals, and aren’t officially counted.

In the last six flu seasons, the CDC’s reported number of actual confirmed flu deaths—that is, counting flu deaths the way we are currently counting deaths from the coronavirus—has ranged from 3,448 to 15,620, which [is] far lower than the numbers commonly repeated by public officials and even public health experts.

In other words, (and I [Doug Muder] am commenting here, not quoting or summarizing Dr. Faust) the flu death totals we usually hear are more comparable to the Covid-19 death totals we’re starting to get from excess-death demographic models — which show much higher numbers than the 65,000+ you commonly see reported. But if we compare counted Covid-19 deaths during the second week of April to counted flu deaths during the worst week of an outbreak “we find that the novel coronavirus killed between 9.5 and 44 times more people than seasonal flu”.
The young people in last Friday’s protest, with their claims that Covid-19 death counts are inaccurate and the novel coronavirus is a hoax, need a reality re-adjustment, a window into the complexities of honest efforts to gather information intended to provide the intellectual and scientific framework to deal with the pandemic. Instead, they parrot their parents’ and right wing media memes that they are the victims of some vast government conspiracy. They are the misbegotten descendants of a long Libertarian effort to discredit and shrink government, an effort that now threatens us all.

Covid-19 is not the flu. It is both more contagious and more deadly.

And these people are not Patriots. 

Keep to the high ground,

P,S. Fox News and Trump propaganda bellowed for weeks that Covid-19 was just “mild flu,” disingenuously citing the very highest of the CDC estimates, 61,000 from 2017-18 (the average over nine years is actually 37,000) using the number as though 61,000 were accurate and usual. Note that we blew past 61,000 in Covid-19 deaths nearly a week ago–and this number is almost certainly an undercount. 

P.P.S. Correction: I am indebted to Eric Johnson, retired statistician, accountant, and curious polymath, for taking seriously my request to “check my work” at the end of last Wednesday’s post Viruses–an Orientation. After all the assumptions I made to calculate the number of average-sized atoms that might fit into the 18nm wide, 300nm long cylinder of a tobacco mosaic virus, I neglected to multiply by pi at some point. The recalculation of number of atoms yields 97 million, not 24 million.