Part 3: COVID-19 Mortality Rate with Context

A 5 part series; Context and Compassion: Covid-19 Analysis. Part 3 looks into the mortality rate with context.
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A 5 part series; Context and Compassion: Covid-19 Analysis. Part 3 looks into the mortality rate with context.

PART 4 – Comorbidities & Treatment Outcomes
PART 5 –   EDITORIAL INN-SIGHT

The reporting on the mortality rates of COVID-19 is hugely varied depending on your location and media source, ranging from less than 1% to over 27% internationally and from 1% to over 4% in Canada. This leads one to question if this discrepancy is due to differences in mortality reporting, in the quality of care or, more broadly, how there can be such differing data on a singular disease outcome. 

COVID-19 Fatality rates are extremely varied. This leads to question how these rates are being calculated and how to legitimately identify these numbers. Read our report on COVID-19 mortality to understand Canadian mortality reporting and to see how policies have inflated mortality rates. 

These statistics were used to justify a mandated extreme lockdown order which has shut down thousands of small-businesses, caused economic devastation unseen since The Great Depression, impeded upon fundamental rights to live freely and assemble as well as spurring a worsening mental health and opioid epidemic 

Given the significant impact of these lockdown measures, which are implemented in response to this statistical reporting, it’s important to conduct a nuanced investigation into these numbers. So, this article investigates the reporting of COVID-related deaths in hospitals and calculating metrics.  

The World Health Organization released an International Classification of Diseases Code for COVID-19 to be used on death certificates in order to track the disease. The recommendations create a climate, where it’s difficult to ascertain the number of patients dying from COVID-19 vis-a-vis those dying with a suspected COVID-19 influence.  

According to these guidelines, COVID-19 is attributed as cause of death when “the disease caused, or is assumed to have caused, or contributed to death.” So suspected COVID-19 infections also count towards the total death rate, even when a test does not confirm this suspicion 

Example of accurate death certificate from the WHO International Guidelines for Certification and Classification of COVID-19 as cause of death. Source: World Health organization, See original PDF document HERE

If a dying individual is swabbed and labelled a suspected COVID-19 death, but dies prior to test confirmation, the death is labelled as COVID-19 but the result of the COVID-19 swab is not reported on the death certificate, removing the possibility of correction. This mortality reporting guideline may validate those who have been sharing experiences mirroring this on social media. These testimonies have been widely shared, before being heavily criticized by fact-checking sites and labelled as misinformation by Facebook. 

Given the wide range of COVID-19 symptoms and the impact of comorbidities on patient outcomes, this policy creates an opportunity to inflate the number of mortalities, although we are not privy to exactly how much.  

The hospital funding model further complicates this issue.  

Ontario hospitals receive renumeration based on the illness and treatment of the patients in hospital, and the payment for the treatment of COVID-19 in Ontario emergency rooms totals $30,264.  

Given the WHO recommendations and the hospital funding model, it appears there is some financial incentive for COVID-19 coding and no oversight on suspected mortality. This standardized structure, lack of revision once tests are returned, combined with the many critical mortality testimonials shared on social media creates problematic optics on this issue. 

In a Wall Street Journal opinion piece, authors Eran Brendavid and Jaya Bhattacharya, criticized the case fatality rate number as being deeply flawed. The Case Fatality Ratio (CFR) is the percentage of confirmed COVID-19 cases that culminated in death. The Government of Canada is currently using this metric to measure the death rate, which is at 3.56%

WHO identifies COVID-19 Infection Fatality Ratio at 0.6%, which only includes data on those tested for the disease.

There are loopholes in this figure, however, because this estimate does not include those who have recovered from the infection without being tested, such as those with mild or no symptoms, and those without access to testing. Also, the low rate of testing at the beginning of the pandemic coupled with asymptomatic carriers, means that these figures should be taken with a grain of salt, especially for epistemological models. Therefore, in order to identify the actual mortality rate, it’s important to know the number of individuals exposed to COVID-19 

Research studies published in American Medical Association Journal, The Lancet, Jamet Internal Medicine, conducted serologic (blood serum) tests to identify incidence of active and past COVID-19 infection. They were able to estimate the prevalence of COVID-19 antibodies in various communities and nationwide. The most recent findings, published this September found that 8% of the sampled population had COVID-19 antibodies, and 9.2% of those with antibodies had tested positive. From this, it can be extrapolated that more than 90% of those who had been exposed to the virus, and developed COVID-19 antibodies did not get tested or receive a diagnosis.  

 

 

The consensus from the scientific community is that COVID-19 reinfection is extremely unlikely, and emerging data shows immunity lasts six months or more.  

These figures illuminate a datapoint which was previously unknown, and means that a significant portion of the population have developed antibodies to the disease, and are now immune.  

Some people that challenge the official numbers claim influenza deaths have been conflated with COVID-19. The available data is limited, with no real time reporting on influenza in Ontario, British Columbia and the Yukon. Given the fact that these provinces account for the largest populations in Canada, it would be erroneous to attempt to include this set of data in a comparative analysis. 

Overall, despite elevated levels of testing for influenza, very low levels of influenza are being reported across Canada. This could indicate a distortion of COVID-19 mortality but without relevant data, it’s impossible to further investigate this point. 

Also, in Quebec, influenza numbers are actually higher than in previous years.  

It serves us to compare the crude mortality rates between COVID-19 and Influenza.  All available data indicates that the crude mortality rate (deaths with respect to total population) for pre-vaccine COVID-19 is 0.007% higher than for the 2018 post vaccine seasonal flu/influenza. 

This virus is deadly and must be taken seriously. So, to adequately address this issue, one must understand the implications of certain statistics and the ways these can be manipulated to produce a greater fear response.  

Every single life lost has immeasurable value. These are the lives of family members and friends whose loss cannot be quantified by a statistic. This analysis does not serve to diminish these lives but rather seeks to provide a greater context for all looking to make informed decisions based on fact and not coercion.

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