The annual Flu death tally is not what it seems 

It’s another bubble I don’t want to pop. Thanks for sticking in there in the quest for data that counts.

People worry that doctors are inflating the number of Coronavirus-deaths by listing other kinds of deaths in the Covid category. Fair enough. But they miss that this has effectively already been done with the famous flu death count.  The national discussion is stuck in a rut, because it’s trying to compare confirmed cases of Coronavirus with modelized broad category influenza “burdens”.

It’s tempting to cite the current toll of 72,000 US Coronavirus deaths and wonder why we’ve reacted so differently to the worst influenza season where 62,000 people died of the flu (supposedly). But the actual confirmed cases of influenza deaths in the US are only 3,000 – 15,000 annually. Coronavirus really is on a different scale.

The headline grabbing flu numbers are modeled guesses based on assumptions about things like how many people go to hospital, how many get tested, or what other diseases were around at the time. It’s called the Influenza Disease Burden, not the List of Those Who Died, because it’s statistics and word-games. And probably the biggest adjustment of them all  is that the big killer, pneumonia, is bundled in with influenza when it could be caused by as many as 30 different things. Thus a whole range of viral, bacterial, and mycoplasma-related pnumonia cases get collected under the “influenza” banner. It’s as if we are comparing all known respiratory diseases with the new one on the block.

Death is messy and multifactorial. There will be heart attacks labeled as “Covid” that shouldn’t have been, but there will be Covid deaths labeled as heart attacks that never got tested for Covid. And somewhere there will even be someone sitting behind a wheel who’s tired with coronavirus, who makes a mistake they wouldn’t have made… The best we can do is look at is all-cause-mortality  or at least, confirmed cases. What matters is that we compare like with like to decide what to do.

As Doctor Jeremy Faust noticed, despite all the deaths he’d seen, he could hardly remember more than a single person who had died from the flu, and nor, he found, could his colleagues:

Comparing COVID-19 Deaths to Flu Deaths Is like Comparing Apples to Oranges

Jeremy Samuel Faust,  Scientific American

…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.

Based on the CDC numbers though, I should have seen many, many more. In 2018, over 46,000 Americans died from opioid overdoses. Over 36,500 died in traffic accidents. Nearly 40,000 died from gun violence. I see those deaths all the time. Was I alone in noticing this discrepancy?

I decided to call colleagues around the country … Most of the physicians I surveyed couldn’t remember a single [flu death] over their careers. Some said they recalled a few. All of them seemed to be having the same light bulb moment I had already experienced: For too long, we have blindly accepted a statistic that does not match our clinical experience.

 He calculates that in the worst ever week of both covid and flu deaths, the confirmed covid deaths were 10 to 44 times higher:

 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.

… we have to compare counted deaths to counted deaths, not counted deaths to wildly inflated statistical estimates. If we compare, for instance, the number of people who died in the United States from COVID-19 in the second full week of April to the number of people who died from influenza during the worst week of the past seven flu seasons (as reported to the CDC), we find that the novel coronavirus killed between 9.5 and 44 times more people than seasonal flu.

My kingdom for good statistics

We want good stats, but we’ve got what we’ve got. Both Flu and Covid contribute to heart attacks and strokes (and undoubtedly others too — as the burden of a major disease adds one more straw to any condition.) We just know Coronavirus bodies clot so fast, from head to toe that even Heparin can’t stop it. But even with a $5000 autopsy for every patient — which won’t be done — we won’t always be alble to say if the heart attack was 46% Covid, or 64% Covid. And then there are the people who die in their homes and will never be tested.

US testing statistics for Covid are still inadequate and missing some cases — with a positive rate (positive results per test) up in the 20% range — it means  there are still more people out there with Covid who don’t know it, than are showing up in tests.

Deaths from coronavirus are almost certainly underestimates:

If Coronavirus were stealing bodies from the cardiovascular tally — the all-cause-mortality numbers would show that. Instead there’s a wave of people dying above and beyond what we’d expect in places like London and New York, and there are deaths even above and beyond what we’d get from adding normal deaths to Coronavirus deaths. It’s likely thousands of people in corona-hot-spots are also dying of strokes and heart disease or things related to clotting and inflammation.

 

Whatever it is running through the biggest cities of the Northern Hemisphere (and places like Ecuador) looks like a deadly pandemic, spreads like a deadly pandemic, and kills like a deadly pandemic…

Lawrence Solomon, who wrote “The Deniers” –a book about climate skeptics who stood up to global warming hysteria — wrote in 2014 that the CDC were inflating flu numbers as a way to market flu vaccines.

Don’t Believe Everything You Read About Flu Deaths

Lawrence Solomon, Huffington Post.

“U.S. data on influenza deaths are a mess,” states a 2005 article in the British Medical Journal entitled “Are U.S. flu death figures more PR than science?” This article takes issue with the 36,000 flu-death figure commonly claimed, and with describing “influenza/pneumonia” as the seventh leading cause of death in the U.S.

“But why are flu and pneumonia bundled together?” the article asks. “Is the relationship so strong or unique to warrant characterizing them as a single cause of death?”

 Dr. David Rosenthal, director of Harvard University Health Services. “People don’t necessarily die, per se, of the [flu] virus — the viraemia. What they die of is a secondary pneumonia.”

The CDC itself acknowledges the slim relationship, saying “only a small proportion of deaths… only 8.5 per cent of all pneumonia and influenza deaths [are] influenza-related.”

“Cause-of-death statistics are based solely on the underlying cause of death [internationally defined] as ‘the disease or injury which initiated the train of events leading directly to death,'” explains the National Center for Health Statistics. Because the flu was rarely an “underlying cause of death,” the CDC created the sound-alike term, “influenza-associated death.”

Using this new, loose definition, CDC’s computer models could tally people who died of a heart ailment or other causes after having the flu. As William Thompson of the CDC’s National Immunization Program admitted, influenza-associated mortality is “a statistical association … I don’t know that we would say that it’s the underlying cause of death.”

The CDC’s response was its “Seven-Step ‘Recipe‘ for Generating Interest in, and Demand for, Flu (or any other) Vaccination,” a slide show Nowak presented at the 2004 National Influenza Vaccine Summit.

So the same team that hyped flu deaths cannot be trusted on Coronavirus deaths  either, but the freezer trucks are backing up to hospitals and the morgues are overflowing. At least “all cause mortality” just amounts to the counting of bodies and those coronavirus deaths all have names.

We know corruption is endemic, but hopefully we can still, at least, count the dead.

 

Things worth knowing about Coronavirus:

• Quarantines work: 12 days after lockdowns, quarantines and isolation, Coronavirus slows. This is text book microbiology.
• The stroke virus? Covid causes hundreds of microclots throughout the lungs (and everywhere else)
• Coronavirus causes clotting: hold the ventilators, stop blood clots instead
• Coronavirus can affect brains, may increase stroke risk.
• Solve Vitamin D deficiency first to help beat Coronavirus.
• New York is “like mass casualty event”: coronavirus and other deaths are up three-fold
• Coronavirus may be man made. Why did the CCP destroy the evidence?
• Looks like we can extinguish Coronavirus: Australia and NZ tracking to zero.
• Large coronavirus random tests in Austria show only 1% infected
• Read Crush the Curve — save the economy

 

h/t David and Joseph.

REFERENCES

Excess Mortality in the US state by state. https://www.cdc.gov/nchs/nvss/vsrr/covid19/index.htm

Fluview Interactive Mortality Surveillance from the National Centre for Health Statistics  https://gis.cdc.gov/grasp/fluview/mortality.html

US State by State Testing of Covid data