Know What You Don't Know

Trump’s Triumphs: Know What You Don’t Know.
 
Not knowing is difficult. But knowing what you don’t know is important for making decisions about the future. There’s much we don’t know about Coronovirus. Acknowledging what we don’t know can help us plan amidst the onslaught of news, fake or otherwise. 
 
How many Americans have died from COVID-19? We don’t know. The virus mostly affects those with compromised health and the elderly. Though it may sound cold to say so, some Coronavirus suffers would’ve died anyway. A cancer patient, for example, may contract pneumonia in his last days. Should doctors list the cause as cancer or pneumonia or both? The doctor’s choice informs the statistics. Therefore, the only way to tell the virus’ true impact the US death rate is to compare the number of deaths from all causes before and after the presence of the virus. Even if the percentage of deaths associated with COVID-19 goes up, the “excess deaths” reveal the true impact. 
 
According to the CDC, the average number of deaths per day from all causes in 2019 was 7708. This number skews higher during flu season than in the summer when the numbers trend lower. 7708 people per day equals an average of 53,963 per week- approximately 54,000.
 
Attached is a link to the CDC’s US weekly death count from all causes compared to the combined percentage of those who died from flu, pneumonia or COVID-10.  A chart on this page indicates a shocking leap in deaths attributed to COVID-19. Yet, below it lies a chart telling a more benign story - the chart of deaths per week beginning with Week 40 in 2019 and ending with Week 16 of 2020.  At the end of December (week 52, 2019), 58,133 people died in the US or about 4 thousand above average, with 6.4% from respiratory issues. Though the flu season was considered rough, the above average total raised no red flags at the time. Interestingly, the “all causes” total gradually lessens (53,238 by Week 12) while the percentage of those dying of respiratory issues rises  to 9% by Week 12.  Week 14, 2020, spiked to a peak of 60,324 at 19.9%. One might think the chart shows Coronavirus having a devastating impact. But look closely at the numbers…the number of “excess deaths” was literally 0 in the 3 weeks prior to the spike. Then suddenly,  the total drops precipitously to half the average as Week 16 counts only 28,483 deaths.  Yes, in the middle of this crisis, we experienced the anticipated deaths from all causes dropped by half.
 
What does that mean? Who knows? Perhaps people who would’ve died anyway died weeks or months sooner thanks to COVID-19. Or because everyone stayed home fewer people caught the virus or died in car accidents. Or perhaps the count is an aberration.
 
Tracking the percentage of respiratory deaths provokes questions.  The percentage for Week 40, 2020, was 5.2 percent. That number slowly climbs to 9%, jumps to 12.8% in Week 13 and peaks at 23.6% in Week 15, lessening to 18.6% in week 16. 
 
Now think about what that means. Using a death rate of approximately 54,000 as a norm, Week 15 shows only 2000 deaths above average while attributing 12.6% to COVID. That means close to 11, 000 people died from respiratory issues whose deaths might been attributed to other causes in different circumstances.  In Week 16, the “all causes” total suddenly drops by half. Yet, 5304 or 18.6% were attributed to the virus. That means only about 23,000 people died from other causes. 
 
Why have deaths from other causes diminished while the percentage dying of COVID rises? Could the data be skewed by doctors reporting false cases? Or skewed by doctors attributing what might previously been attributed to cancer or other causes to COVID- 19? Since the government pays up to $39,000 per COVID ventilator patient, there’s certainly incentive.  But all we really know is the numbers look odd. 
 
What else don’t we know? We don’t know how many people have had the virus or have developed antibodies without ever showing symptoms. If it turns out, as some now think, that the disease was present in the US in December (part of that difficult flu season), the death toll from the virus may be less than we now think. Currently, CDC figures indicate between 5 to 6% of those who tested for the virus die. But as more Americans get tested, that number might revise down to 1 or 2% - still 10 times worse than a typical flu - but not the catastrophe the current numbers indicate. 
 
President Trump knows what he doesn’t know. When the first US case appeared, he took instant action. Back then, experts knew very little about the virus. He and other world leaders relied on the now famous Oxford University study that projected 2 million Americans dead. But now that the president has seen how the virus functions and how both the medical profession relays information about it, he’s urging the country to take precautions but get back to business.