Why the Actual Death Toll Far Less Than Reported or Expected

The problem with anything new is that there is typically a lot of unknowns to figure out. This coronavirus pandemic is no different, which makes it hard to estimate pretty much everything about it.

The little data we do have comes from nations like China, who has not honestly reported all cases or deaths, and Italy, where the health and social infrastructure is so vastly different from ours. 

To help the nation understand more about this virus and how it will affect us, several groups of leading US researchers have come up with a few models to predict things like the death rate, the total number of cases, amount of hospital beds needed, and even the amount of ventilators each hospital should have on hand. 

However, each model is different, and some vastly so. Even within one specific group’s data, there is significant play in numbers, causing some to revise their models frequently.

The Institute for Health Metrics and Evaluation at the University of Washington or IHME, for example, had one that predicted anywhere from 38,000 to nearly 180,000 deaths in the United States through August 1, with the best guess of 93,531 deaths.

But now, with new information, IHME’s model was just updated and released on Sunday to note a 14 percent decrease in the number of total number deaths in comparison with the model’s target projection and 30 percent less than their worst-case scenario. They now say that between 49,431 and 136,401 will die, with a forecast of 81,766 deaths. 

However, even this may be significantly high. 

According to their previous model, IHME predicted that on April 4, New York City would need a total of 65,400 hospital beds to handle the incoming cases of coronavirus. However, in reality, only 15,905 beds were actually used, according to local sources and former New York Times reporter Alex Berenson. This means their calculations were four times too high. 

President Trump said at Sunday’s press conference, “It’s turning out that we need less hospital beds. We may have models, but we’ve sort of been saying that. In New York, we were saying we think you’re gonna need less.”

Of course, given the sporadic testing and general nature of the disease, the actual amount of beds used could be somewhat miscalculated. Here and there, I’m sure a few were missed. But 37,000 some? Doubtful. 

And while their new numbers are lower, it’s not four times smaller, as reality says it should be. 

So what does that mean for the death count? 

Is it four times too high? 

According to The Washington Post, who spoke to several experts, we have no idea. Most are in agreement that the White House’s numbers don’t seem accurate but too high, and by how much, they haven’t a clue. 

Columbia University epidemiologist Jeffrey Shaman says, “We don’t have a sense of what’s going on in the here and now, and we don’t know what people will do in the future. We don’t know if the virus is seasonal, as well.”

And it doesn’t help that the CDC has issued new guidance that tells hospitals to list COVID-19 as the cause of death even if it’s “assumed to have caused or contributed to death.” The latest issue literally says that no tests or diagnosis needs to be made. 

The CDC states that the International Statistical Classification of Diseases and Related Health Problems (ICD) has created two new codes to be used for death: one for coronavirus and another for one assumed but not diagnosed COVID-19 cases. But because lab “tests results are not typically reported on death certificates,” this second code won’t really be used. 

Instead, “the rules for coding and selection of the underlying cause of death are expected to result in COVID-19 being the underlying cause more often than not. COVID-19 should be reported on the death certificate for all decedents where the disease caused or is assumed to have caused or contributed to death.”

They even say that “other chronic conditions such as COPD or asthma that may have also contributed” should be listed in “Part II” but not as the primary cause. 

So if someone comes in for anything remotely similar to the flu, which claims between 24,000 and 63,000 a year in America, and that person dies, COVID-19 can be listed as the cause of death. 

As if we don’t already have any clue, let’s just skew the data even more.