Coronavirus Deaths: How Badly Undercounted Are They?

Mish

Official counts of coronavirus deaths are certainly understated. But by how much?

Inconsistent protocols, limited resources, and a patchwork of decision-making has led to a Significant Understatement of Coronavirus-Related Deaths.

Across the United States, even as coronavirus deaths are being recorded in terrifying numbers — many hundreds each day — the true death toll is likely much higher.

In many rural areas, coroners say they don’t have the tests they need to detect the disease. Doctors now believe that some deaths in February and early March, before the coronavirus reached epidemic levels in the United States, were likely misidentified as influenza or only described as pneumonia.

Late last week, the Centers for Disease Control and Prevention issued new guidance for how to certify coronavirus deaths, underscoring the need for uniformity and reinforcing the sense by health care workers and others that deaths have not been consistently tracked. In its guidance, the C.D.C. instructed officials to report deaths where the patient has tested positive or, in an absence of testing, “if the circumstances are compelling within a reasonable degree of certainty.”

Reasonable Degree of Certainty

Only now is the official counting supposed to be with a "reasonable degree of certainty". The key words are "supposed to be counted".

The question: What constitutes a "reasonable degree of certainty".

States and especially governors of states who were late to issue stay-at-home mandates want massive underreporting if they can get it.

Recall that CDC incompetence led to a situation the US did not even have tests to any significant degree until at least until mid-March.

Cannot Get Tested

Every day I hear stories of people trying to get tested but cannot.

The New York Times article above noted several instances including that of Julio Ramirez whose official death certificate said pneumonia.

The hospitals refused to test Ramirez. His wife hired a private company to do an autopsy. He tested positive.

Why do these stories still persist?

Pneumonia, Flu Linked to More than 8% of U.S. Deaths in Last Week

UPI reports Pneumonia, Flu Linked to More than 8% of U.S. Deaths in Last Week

In its latest FluView report, released Friday, the CDC said that 39 million people have been sickened by the flu in 2019-20.

In all, so far this winter season, the flu has caused death in roughly 24,000 people across the country, the CDC estimates, including 162 children. The percentage of U.S. deaths attributed to the virus during the week ending March 28 is above the agency's "epidemic threshold" of 7.2 percent.

Nationally, roughly 400,000 have been hospitalized as a result of the illness. However, the percentage of visits to healthcare providers for "influenza-like illness" dropped during the most recent analysis period, from 6.3 percent to 5.4 percent.

Similarly, the percentage of laboratory-confirmed samples testing positive for strains of influenza declined sharply over the same period, from 7.3 percent to 2.1 percent. More than 50 percent of the samples testing positive so far this winter have been for influenza A.

Questions Abound

  1. Only 2.1% tested positive for the flu. What was the rest?
  2. 24,000 died from the flu, pneumonia or something else?
  3. How many people had the flu and Covid-19?

Email From a Friend

The girlfriend of my partner's son tested positive this week. It took over 7 days for the results to come back. It took many tries for her to get tested, even after she told them she had symptoms and had been in contact with a confirmed case. The girlfriend lives with her two sons, and they have been back and forth to her house many times. The girlfriend is now symptom free, but, she could still infect people.

So far my friend and her husband are isolating and have no symptoms.

The testing authorities asked NO QUESTIONS about whom the girl had contacted, how much she had moved around, etc. even though she is of university student age and lives 1 mile from a major, globally-ranked university.

INCOMPETENCE.

That email came in this morning.

Unfortunately, I do not find my friend's email at all shocking.

The article above cited such cases. I read similar stories very day of the week and have been reading them for weeks. I see numerous references on Twitter every day.

Global Coronavirus Cases

Image placeholder title

Global Testing Leader

President Trump like to brag the US is the global leader in testing. It's hardly a fair comparison. Let's even it out and compare the EU with the US.

EU vs US Testing

  1. Spain: 355,000
  2. Italy: 691,461
  3. Germany: 918,460
  4. France: 224,254
  5. Belgium: 70,000
  6. Netherlands: 75,415
  7. Austria: 108,416
  8. Portugal: 86,370

The EU consists of 26 nations. That subset of 8 has conducted 2,529,376 tests.

EU 8 Subset vs US

  • EU 8 Subset: 2,529,376
  • US: 1,729,314

Did the EU Lose Any Tests?

That question might seem a bit bizarre but not in light of this.

"Well, I'm telling you, I'm still missing 50% of the data from reporting," she said. "I have 660 (thousand) tests reported in. We've done 1.3 million. ... So, we do need to see -- the bill said you need to report. We are still not receiving 100% of the tests."

What good are tests if you do not have the data? Did we really do that many tests in the first place?

Hopefully, this is an analysis delay rather than a case of permanently lost data, but the latter would not surprise me.

Regardless, the US is still way behind the EU on testing even if those missing results eventually turn up. That's the valid comparison.

US Covid-19 Deaths

Let's return to the key idea.

The US reports 9,444 Covid-19 deaths.

How many is it really?

Second Key Question

How many deaths and hospitalizations would we have were it not for widespread shutdowns?

We cannot answer either question. But we can say much, much higher to both.

Most importantly, we can say the numbers clearly indicate this is Far Worse Than the Flu™.

Mike "Mish" Shedlock

Comments (75)
No. 1-33
tokidoki
tokidoki

Both lying (CCP) and incompetence lead to the same result.

How shocking.

Also, Boris Johnson has been admitted to the hospital because of persistently high fever. Will he be the first world leader casualty?

Maximus_Minimus
Maximus_Minimus

Viruses and bacteria don't cooperate. You can have flu and covid-19 at the same time, and when the immune system is weakened, pneumonia.

kurtzumd
kurtzumd

This is really just a page out of Disaster Capitalism. The shock occurs; our ongoing economic collapse that started in mid-Sept. with Repocalypse and the Fed's multi-trillion dollar response, then the outbreak of this bio-weapon, SARS grafted onto a virulent coronavirus, which leaked from Fort Detrick around the same time and earned the place a shutdown from the CDC.

The people of the World are divided and scared, then the looting begins.

Tengen
Tengen

China alone represents huge undercounting. It's ridiculous that Singapore routinely beats China for new infections and Hong Kong does fairly often too. The loss of 21 million cell phone users in China, stories of thousands of cremation urns packed together, and long lines at funeral homes also point to a serious impact.

Photos and video have emerged from Ecuador of morgues overflowing with bodies plus some bodies being burned in the streets due to overcapacity, yet the country counts only 180 total deaths.

There are surely other countries massaging numbers too. Egypt was accused of bottling up reports for a while. Even Japan wasn't really testing until after the Olympics postponement, when daily totals suddenly multiplied by a factor of 5 to 10. Plenty of countries have motivation to look comparatively "good" so they lie.

njbr
njbr

Undercounts will be a factor everywhere...

....Less than two weeks ago, Italian newspaper Corriere Della Sera published the results of an informal study that appeared to show that, in some regions of the country, non-coronavirus deaths were rising at an alarming rate alongside confirmed COVID-19 deaths — that the total death count was up as much as sixfold from previous years. Those deaths officially attributed to the coronavirus accounted for barely a quarter of the increase.

And Italy isn’t alone. In Spain, El País obtained a study that showed mortality rates in some regions had almost doubled, with only a fraction of the increase officially attributed to COVID-19. So what accounts for all those other deaths? Is the ultimate death toll from this pandemic going to be that much higher everywhere than is understood at the time? If we were able to allocate medical resources more effectively, could we reduce that number?

The answer to those questions is a matter of the balance of two factors: How many “excess deaths” are patients who have COVID-19 but haven’t been diagnosed with it, and how many are patients with other illnesses who can’t get proper treatment in overwhelmed hospital systems?

The first number is likely bigger than you think. Italy has tested about 200,000 people and confirmed 111,000 coronavirus cases. But experts say the true number of cases could be as high as 6 million. People who die at home or in nursing homes are not tested for the coronavirus, and their deaths may be classified as resulting from an underlying condition like chronic pulmonary disease or dementia. But the impact of the resource allocation is significant as well. Beds, physicians, and ventilators are finite resources, meaning that hospital systems around the world are scaling up COVID-19 capacity at the cost of ballooning excess deaths. “If you go to the ICU under normal circumstances, there’s ample capacity available,” says Carri Chan, an associate professor at Columbia Business School who studies the consequences of congestion in intensive-care units. “But if there’s congestion, you might get sent to a step-down unit or even a general medical surgical ward.” In Bergamo, a city northeast of Milan, about 20 percent of all family physicians have been infected, according to the The Wall Street Journal, crippling everyday health care for tens of thousands of people....

awc13
awc13

"Every day I hear stories of people trying to get tested but cannot."

I do too but in all cases people do not exhibit the necessary symptoms. It would be a disaster if people could self-prescribe a test. there would be people who would get tested 2, 3 or even 10 times if it was their decision to make

awc13
awc13

under counting? if anything it is more likely corona virus deaths are being over counted. NY is counting deaths with the virus as deaths because of the virus. if you die and test positive for the virus you go into the corona virus death column, no matter what your actual cause of death is

magoomba
magoomba

Using the current numbers, with all counted cases the death ratio is now 5.4% and rising.
With all treated cases the death ratio is now 20.8% and rising.
There are no more numbers from China, but the cremation smoke can be seen from orbit.
So far 80-90 F temps in South America do nothing at all to slow it down.
These are now large enough samples to make further counting moot as the vast majority will do without counting or treatment.
No wonder govs and corporations can't and probably shouldn't admit the truth.
It's simply MUTATE OR DIE at this point.

tokidoki
tokidoki

Here's another reason for the undercounting ... of humans. A tiger at at the Bronx Zoo was able to get a test. No kidding :)

Sechel
Sechel

Until we test more people in a statistical sampling method we'll never know. As you point out we're still not testing sufficiently.

ReadyKilowatt
ReadyKilowatt

What about over reporting? How many insurance companies are going to look to get bailed out for having to pay for covid-19 related treatment costs and death benefits? We already know that uninsured patients are going to be covered by the Federal Government. Seems to me that jacking up the numbers is the way to go if you're a hospital.

bilejones
bilejones

I agree. My neighbor of some 76 years has diabetes, asthma, 4 by-passes. Smoked for 60 years- gave up in November , is on dialysis 8 hours 2 times a week and has just had two toes amputated for gangrene, He and his wife had the Chinese flu symptoms end Feb and I'm sure his upcoming death will be attributed to it.

Jojo
Jojo

Or the deaths could be substantially over-counted, which would be to the determent of many peoples agenda of fanning the flames of fear and hysteria. See:


Covid19 Death Figures “A Substantial Over-Estimate” Bizarre guidelines from health authorities around the world are potentially including thousands of deceased patients who were never even tested
Kit Knightly
April 5, 2020

tz3
tz3

Both the number and the proportion are wildly OVERcounted.

There was a doctor in a livestream that explained it but the static vid won't be up until tomorrow, but I've heard this elsewhere

Death Certificates are often guesswork, but the current guidance is to treat anything - even people who have late state cancer, copd, and chest pains as a "coronavirus death" even if they don't have coronavirus. If you have lots of co-morbiditities (like those in a nursing home waiting to die), coronavirus is likely to push you over the edge, but is only technically the cause of death.

I guess someone who is run over by a truck if he tested positive will be labeled a "coronavirus death".

What people normally would think it means that someone was spewing bloody mucus on a ventilator. Not found dead of a heart attack without any apparent respiratory problems even a few hours before.

The other side is we aren't testing people who aren't showing symptoms or have had contact with those who do. The better, faster tests, and antibody tests are coming, but the current estimate is that 25% are ASYMPTOMATIC. They get the virus, show no signs, their body fights it off, and no one knows they had it.

Many others just get what they think or thought was a bad cold or flu or allergy or something. Unless there is a high (104) fever or loss of the sense of smell or something else to flag it, they probalby didn't get tested and won't.

Could they be missing a few deaths that should be recorded? I doubt any that aren't already half dead from diabetes, heart problems, obesity, copd from smoking for years... etc.

When anyone over 80 who isn't in great health dies, unless there is a detailed autopsy, it could have been anything. Doctors (or Morticians and Next of Kin) guess what to put down on the death certificate. When they are found dead, was it a heart attack? Anneurism? Massive Stroke? Maybe. But now there is incentive to call them "coronavirus".

Death while positive with coronavirus does NOT mean the coronavirus was the cause of death, either direct or secondary.

Augustthegreat
Augustthegreat

You are under-reporting, unless you are testing everybody.
So what counts is the number of deaths, not the mortality rate.

numike
numike

Please explain:
‘Hospitals in New York state have discharged more COVID-19 patients than they have added for four days in a row, according to the latest data from the state hit hardest by the CCP virus pandemic. Hospitals in the state admitted 574 COVID-19 patients on April 4, while discharging 1,709 patients. The number of daily discharges had also surpassed the daily admissions on the three prior days, state data shows.’
“Discharge rate is way up and that’s great news,” New York Gov. Andrew Cuomo said on April 5.’

GeorgeWP
GeorgeWP

The transmission to other animals is a worry. Their was one report from HK of a dog, which could have been a mis-test. But at the zoo they tested several animals. Do we assume it can be passed back and forth with cats and dogs. I am already off cats because of the brain worms, now they might have pox too!

bradw2k
bradw2k

tz3: "If you have lots of co-morbiditities (like those in a nursing home waiting to die), coronavirus is likely to push you over the edge, but is only technically the cause of death."

People have been saying this for weeks about Italy's C19 death counts. Seems entirely plausible. So we are left with both under-counting and over-counting (not a contradiction since those are different cadavers).

Apparently even the CDC's flu death stats are modeled years after the fact, they are not definite counts.

If it is this hard to count deaths, where the binary test is rather simple, imagine estimating population infections from extremely limited testing.

The fog of war of this whole thing is astonishing.

Snow_Dog
Snow_Dog

“How many deaths and hospitalizations would we have were it not for widespread shutdowns?”

How many FLU deaths and FLU hospitalizations would we have were it not for widespread FLU vaccinations?

“We cannot answer either question. But we can say much, much higher to both.”

The average flu season is ALREADY producing higher numbers of both without any draconian lockdowns and White House level task force attention paid to it.

“Most importantly, we can say the numbers clearly indicate this is Far Worse Than the Flu™.

No, we most certainly cannot say this, at least not truthfully.

Even lacking the frontline defense of vaccination and rampant presence of co-morbidity factors this outbreak has yet to approach the mortality rate of even an average US influenza season.

BaronAsh
BaronAsh

Corruption, incompetence, (asymmetric war) propaganda, sabotage... you name it, it's in the mix.

Meanwhile, a little reality check:

BaronAsh
BaronAsh

An entirely opposite view (which doesn't mean I don't think many of Mish's points don't have merit - even though I don't trust anyone's facts or figures on this wartime viral attack):

BaronAsh
BaronAsh

One of the key data points is mortality of CV vs normal mortality, given many of the senior citizens marked down in the CV death column were already critical or chronically ill.

Deaths might actually be down this year due to the quarantining - less flu deaths, less car crashes etc. so a net positive strangely enough (if you don't count economic damage and possible societal breakdown as negatives!).

My feeling is that the virus is real, but the narratives around it are classic psy-op distortions designed to disrupt ordinary society as part of an ongoing asymmetric war long promised by the China-Russia alliance which is a leading edge partner in the globalist networks and long-term strategies, many of whose afficionados are littered throughout the US body politic - including some of the 'scientists' giving briefings every day (traitors from within).

Given that truth is the first casualty of war, I cannot believe anything involving data since there is so much obfuscation, deceit, distortion (and ignorance) in the mix.

All I know is I had a wicked flu, lucked into a package of HCQ, took the 'acute' dose, and within 12 hours felt 1000% better, and as someone with Lyme who is immune-compromised and often gets flus, this is the first time I've taken anything that made any difference, so I believe it is very effective at modulating immune responses somehow, and since they are what overwhelm the body once the virus has reached a certain critical population mass, makes sense that it helps. Also, it's been used for decades - very successfully - as a once-a-week malaria prophylactic, so as many people use it that way now, quite likely that that many fewer will succumb to CV and we can move past this particular horror into whatever next 'they' inflict on 'ordinary decent people.'

JohnB99
JohnB99

With military coroners on site, they will put cause of death based on what they are ordered to do

frozeninthenorth
frozeninthenorth

It gets worse. America has probably nearly 500,000 cases of CV-19 and there are still states that are dicking around with confinement. China confined 40 million when it had 800 cases. Even if the Chinese were lying about the source. America has had months to see what worked (China) and what didn't (Italy) -- so what did America do, well they did less than Italy. To the south you've got Mexico where the President is in deep denial that there is even the risk of a remote problem...

There's half a billion people in NA and that's a very large population basin where people are not taking this whole situation seriously -- there was even one women being interviewed who said because she's a christian she's protected by "the blood of Christ". America is the only country in the world were nearly 20% of the population believes in Angels -- they better hope for divine intervention because its going to get ugly

Sechel
Sechel

If the person dies at home, when if at all does his death get recorded?

KidHorn
KidHorn

Another article trying to determine something that cannot be determined at this point because the data is crap. And an endless stream of armchair data crunchers quoting articles written by journalists who have little understanding of math or statistics. Might as well try to predict the outcome of a football game after the opening kickoff sails through the end zone.

Augustthegreat
Augustthegreat

tz3
tz3

Explanation on why the stats are TOTALLY FAKE

thankyoumrdata
thankyoumrdata

I've mostly stopped reading and sharing in comment threads. I barely have time to read all of the new COVID-19 information that comes out every day to take care of my patients. (Also, when you share honestly in comment threads, random people show up on the Internet to insult you. I can take it, but who has the time for that nonsense. I have a full boat and communities with mutual respect to use up all my communication time every day.)

That being said I owe this group an "I was wrong." Someone estimated 150,000 COVID deaths in the USA and I opined that was too high by a factor of 100. That person was clearly close to correct. I really missed on how spoiled Americans would be; how Americans would prefer misinformation to correct information until things got really bad; how many Americans would make bad decisions for as long as they could (and continue to do so). I failed to predict human nature rather than believe the truth about us.

It is a tragedy. I am taking care of dying patients on ventilators on a daily basis so I will go back to that. I wish you all the best and thank Mish for regularly doing his best to inform us ahead of the curve. Good luck all.

Herkie
Herkie

As you know I just bought a house in Florida last Monday, the Veterans Admin is my healthcare provider, I am still enrolled at the VA clinic back in Jackson County Oregon. All the VA clinics here are closed. Some people are going to work but when I called and said I needed prednisone for a sun rash they told me they are not accepting patients. They will do over the telephone consults with some patients, like people that have well documented ongoing situations such as diabetes and who are about to run out of insuline for example. But, I was told if I suspected I had Covid to contact the local health department. That appears also to be closed and their website has some stale covid information, but no working contact information nor instructions as to what you should do if you suspect you are infected.

The VA here told me to contact the clinic where I am enrolled as the Florida clinics will not be doing enrollment till this is over. I called Oregon and they told me to go to the nearest urgent care clinic as most of them do contract with the VA for care more than 40 miles from the nearest open VA facility. Well guess what? There are three in this county and all three were closed when I checked the web. Even if they were open they would be just slammed with people wanting Covid testing, and I for one do not relish sitting in a waiting room for hours with people that are sick with Covid. Because some that go to demand testing will actually be sick and spreading it. So, I am just going to have to suffer the rash on my arms and face. The itching is indescribable. It happens every spring and 8-10 days treatment with Prednisone is the only effective treatment, if I do not get it the skin will swell and weep clear sticky fluid and eventually split open and bleed. Then again prednisone is hard on the kidneys, so they could justify not giving it to me based on the fact that compromised kidney function should I get Covid would be a death sentence.

We need a better name for all this. Stephen King at least named his civilization ending viruses in his works, something catchy and evil.

awc13
awc13

how much over count is there? NY is now counting deaths of people who have the symptoms but have never been tested.


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