Tuesday, November 17, 2020

It's Very Possible To Know

      A comment to my post, "Is Seeing Believing?" repeated a couple of canards that have been bouncing around, notions that are plain wrong but which seem plausible at first  sight.

      One was this idea that any death, for any reason, gets classified as a "COVID-19 death" if the decedent tests positive for the virus.  This is untrue; death certificates list all causes and contributing factors.  It's one reason why CDC cause-of-death data for SARS-CoV-2 is much slower coming than the numbers from individual states and counties: CDC evaluates every one and doesn't count deaths where the virus was not the direct cause.*

     His other claim was that "Except for that first peak, it's impossible to say how much of this was actually COVID-19 and how much was a result of the lockdowns...."

      That's nonsense.  It's very possible to tell.  We have charts and graphs for cases, deaths and restrictions, with the shape of the graphs for cases and deaths tracking one another closely, a week or more apart.  At that point, the question becomes, "Do restrictions come before or after increases in cases?" 

      Drum roll, please!  Relaxing restrictions precede an increase in cases; stricter restrictions follow an increase in cases.  COVID-19 is a much greater contributor to 2020's excess mortality than lockdowns, by a huge margin.

      This is not to say restrictions on activities and contacts have no negative effect on mortality; isolation and putting off medical treatment absolutely contribute.  But that is something we can help mitigate.  We have contact-free ways to keep in touch with elderly or ailing friends and relatives: don't put off that phone call or Zoom conversation with them.  And don't put off medical procedures if you don't have to, either -- I suffered for months from an outdated eyeglasses prescription because I was leery of the eye doctor.  Correcting that has helped me a lot. 

      But the virus remains the greater risk.  I don't know if we're going to see a return to the kind of essential-business-only restriction that was put in place early in the pandemic.  We know more about how the virus spreads now, and mask requirements along with limits on the size of gatherings or the percentage of occupancy of a business do a lot to control transmission of the virus without making as damaging an impact on the economy and people's lives.

      This holiday season will be problematic.  We all want things to get back to normal -- and we're very good at making excuses to ourselves for skating around the rules and recommendations.  Please celebrate responsibly.
* This is often tied into the claim that "Hospitals get paid more for COVIOD-19 patients."  Congress did authorize additional payment for Medicare patients only, over the usual coverage for pneumonia-type treatment, but receiving it requires a positive test -- and faking that is Medicare fraud, a very costly thing for a hospital to get caught at. 

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