I’m always interested to see the lengths science and reality deniers will go to maintain their delusions. For instance, apocalyptic cults that believe with all their hearts that the end times will come on a specific date and time. When that date and time passes, you’d think that the cult would be over. But no! They just decide that their prophet was speaking metaphorically when he said he’d be back within their lifetime, or whatever. Because when you build your entire identity around a particular belief, most humans can’t just give that belief up in the face of irrefutable facts. So, they change the facts to fit their belief, easing their poor troubled mind.
Anyway, that’s been happening with COVID-19. Back in January, the official word from conservatives was, for some reason, that it’s no big deal, it would have the exact same impact on the US as our annual influenza, and we should just ignore it. They stuck with that even as the virus spread like wildfire from China to other Asian countries and to Europe, where it absolutely destroyed Italy. They stuck with that as we got our first cases in the US, trusting President Trump and Fox News when they told us that these cases would quickly disappear and that governors like my own, Gavin Newsome, were overreacting by listening to epidemiologists and ordering shelter in place. I heard many reasons why the US would not be like Italy: our population is younger, more spread out, we have a better healthcare system, etc etc.
Well, it’s been a few weeks and the evidence is overwhelming that COVID-19 is a Very Big Deal. The US now has twice as many confirmed cases as Italy. More than 4,500 Americans have died. We are nowhere near the apex. States like California sheltering in place managed to help the numbers tremendously, so we won’t see the worst case scenario of millions dead, thanks to the fact that in a pandemic that rises exponentially, small changes (like only one state quarantining while others persist with everyday life) can have big effects. But despite that, even the Trump administration is now hoping we “only” lose upwards of 240,000 people. Last year’s flu season, for comparison, took 34,000 people.
To me, this has always been a very obvious big deal, because I trust epidemiologists to come to a sensible consensus. I put science above my ideology. For instance, if you were to ask me if I would ever want my government telling me I couldn’t go outside, I would say “fuck you I do what I want.” Especially Trump! I already think the man is a fascist, so his administration controlling my daily movements is positively anathema to me. But in this case, I know that the scientists are right. Staying home is right. I will swallow my feelings about the government and do what they say.
But for the conservatives who have been distrustful of the scientists for two months, it’s not so easy. They’ve invested a lot into the idea that this virus isn’t a big deal, so I decided to see how they’re reacting in the face of what I feel is incontrovertible evidence they’re wrong.
What I discovered is that commentators like Brit Hume are amplifying a claim that people who doctors say are dying of COVID-19 are actually dying of other things, but they happened to test positive for COVID-19 and so they become part of the statistic, inflating the actual number of people dying. So for instance, if you have COVID-19 and you get in a car accident and die on the way to the hospitall, you’d be considered a COVID-19 death.
Let’s unpack that a bit. The claim comes from a random guy on Twitter named Adam Townsend who lists a few points to back up this idea: first, one doctor in Germany who wrote a letter questioning whether or not too many Germans were considered to have died of COVID-19, with no evidence to support the idea.
Second, John Ioannidis, well-known for publicizing the replication crisis in science, wrote an article saying we don’t have enough information to make informed decisions on shutting down the economy, which is true. We don’t have enough information because the US didn’t react early enough and isn’t testing enough people, so we’re forced to take drastic measures. Nothing he says offers any evidence that COVID-19 is being overly blamed for deaths.
Next he mentions a French study without linking to anything, so I can’t comment on it. Next he links to a NY Times opinion piece saying that we shouldn’t shut down the economy to stop the virus. Not related to the point at all.
Next he cites Italy’s Professor Walter Ricciardi, stating that the Professor claimed “only 12% of the test-positive deceased in Italy considered the coronavirus as a causal factor, which corresponds to a few dozen people per day. The normal all-cause mortality in Italy is around 1800 people per day.” If you click the link, you’ll find that he’s obfuscating. Ricciardi said that 12% of COVID-19 deaths showed “direct causality,” meaning that there is undeniable proof the patient died of COVID-19. In the other cases, and I quote from the article, “This does not mean that Covid-19 did not contribute to a patient’s death, rather it demonstrates that Italy’s fatality toll has surged as a large proportion of patients have underlying health conditions.” These co-morbidities are things that half of all Americans have: cardiovascular disease, diabetes, asthma. Diseases that the majority of us are living long, happy lives with. The people who count as COVID-19 deaths are counted that way because if it weren’t for COVID-19, they would still be alive today. That’s how diseases work. That’s how they kill people. People don’t always just die of, say, “cancer.” They die because their immune system is taxed and something else gets in, or because some particular organ fails, or because some infection takes over that they can’t fight.
Townsend’s next tweet gives up the game: “Experts have already explained situation in Italy has less to do w/corona virus than with local risk factors = extreme air pollution, mass panic, collapsed health system, curfew itself, median age of deceased is around 80 years, 99% had previous illnesses”
Yes! Exactly what we’ve been saying! The virus is deadly to people at high risk, but it becomes even deadlier if you don’t flatten the curve enough to make sure the healthcare system stays operational. Because once you overwhelm your hospitals with COVID-19 cases, suddenly people with other conditions can’t get the care they need and they die.
There’s simply no evidence that doctors are failing to do their jobs and just willy-nilly labeling anyone who dies with COVID-19 as being a death caused by that. In fact, here in California a teenager was initially thought to have died from the virus, but doctors took the time to confirm what happened and publicly announced that they were wrong and that he had died from other causes. That’s how science works — the evidence changes the outcome, and as we get more data we can get a more accurate picture of how the world is.
The complete lack of preparedness and testing here in the US impedes that to the point that if anything, COVID-19 may be underdiagnosed and it may have caused many more deaths than known. How many people were unable to get tested, unable to afford to go to the hospital, and died at home? How many people even died in the hospital before testing was widespread? My fellow Skepchick writer Jamie Bernstein pointed out that a nursing home had 26 deaths in a month, compared to their usual rate of 3-7 deaths. Only half of the deceased were tested for COVID-19, so those are the only ones that went into the statistics. What about the other 13? We just don’t know.
That’s why we won’t actually know the true mortality of COVID-19 for another few years. You can’t just look at the death certificates and come up with a number, which is what we’re doing now because that’s pretty much all you can do in the midst of a pandemic. I actually tried to get the total number of all-cause deaths for various states for March of 2020 but that data is very hard to access, as it should be because we really don’t need more armchair epidemiologists making our lives miserable. But one thing actual scientists can do in the future is look at, for instance, how many people died in New York in March of 2017, 2018, and 2019 and compare it to March of 2020. Then we’ll know the impact COVID-19 had.
Just kidding! That still wouldn’t tell us, because there are always mitigating factors. Did fewer people die of car accidents because fewer people are out driving? Did more people die while sheltering in place due to common accidents around the home? Did fewer people die because they were surrounded by family who could take care of them? Did more people die because of an increase in domestic violence?
This is why we have people study their whole damn lives to crunch this data. And this is why you should trust them instead of some, uh, “extreme salesman” Gish Galloping on Twitter.