August 31, 2020


I went to work this morning early and got home 11 hours later and was stunned by some of the news that came up today. I spent my day seeing patients and doing my Inbox of messages and refills. I also completed a death certificate for a patient who just passed away from pancreatic cancer. She was in hospice and thankfully didn’t suffer long. The death certificate is a government form that is collected by each state with specific requirements. Here is an example from the CDC. Link is below. We are asked to complete the form before the body can be released from the funeral home. The family depends on us to complete it as quickly as possible. The state depends on us to fill it out as accurately as possible, so that causes of deaths and diseases can be tracked and trends recognized. We do not get paid to complete it. We do it as part of our care for patients as their primary provider and our duty to public health. The cause of death cannot be just “respiratory arrest” but needs to be the cause of that respiratory arrest: pulmonary embolus, stroke, pneumonia, myocardial infarction, and other underlying conditions that contributed to the death. They want to know how long they had the condition prior to dying, were they pregnant, and if smoking was the cause of the disease. This really is a public health document, a legal document, and we are pledged to be honest and accurate. The data is then collected by the states and sent to the CDC to track epidemiological trends. Sometimes the data trickles in, depending on the state.

The big story that caught my eye was the claim that only 9200 people (or 6%) or so have died from COVID-19 based in CDC statistics. Some people caught that claim and threw it into the cybersphere to spread it around, hoping to change the narrative and diminish the threat of COVID-19. This bombshell was quickly deconstructed in most circles, but many, eager to have the pandemic go away, opted to believe the statistic and claim the other 170,000 people died from the underlying conditions and not COVID. When the data is examined further, the 6% number is the number who only had COVID-19 and no other contributing conditions. The rest had other risk factors and contributing conditions on the their death certificates, along with COVID-19. For instance, perhaps someone had a stroke caused by the blood clotting that COVID-19 causes or they developed kidney failure or severe pneumonia caused by COVID-19. Yes, they have health issues, but they would probably still be alive if they had not caught COVID-19. Politfact checked the claim quickly and calls it “Lying, Pants on Fire”. The Politfact analysis does a very good job of explaining why the claim is so wrong. I recommend reading it. You might be able to explain it to others.

I want to write about herd immunity tomorrow, the other big story of the day; but tonight I felt it is important to remind us all that statistics can be manipulated and/or taken out of context. Numbers can be used to illustrate what you so fervently wish and hope for, but those numbers don’t really make that wish any more true. I wrote about this effect in late April, calling it "Lies, damn lies, and statistics". Once again, I want to remind you to check Infodemic blog and Newsguard to verify reliable sources when you read something that seems to good to be true. We really have to vet our sources and think about the effect the item might have if we share it.

Wash your hands, cover your noses, keep safe six, and vet your sources.