How to Cheat Death (Rates)

Job interviewer to applicant for accountant position: What is 2 plus 2?

Applicant #1: four.

Interviewer: Thank you. You’re dismissed.

Applicant #2, leaning forward and whispering: what do you want it to be?

When I read discussions about COVID-19, it seems like that sometimes. One group wants the number of COVID-19 cases and deaths to be high, another group wants it to be lower. Ditto with the COVID-19 death rates. But, you ask, isn’t the case count and death count something that can’t be faked? It is what it is, right?

Hardly! When power and money is at stake, reality is flexible. And with this pandemic we’re talking about the power to ground everyone in the entire world and spend trillions upon trillions of dollars of other people’s money. This is no game for amateurs. And rest assured that I’m as amateur as anyone. Still, like a committed sports fan, I won’t let ignorance stand in the way of having fun. So here we go!

First let’s start with something simple, a mathematical formula:

$$fatality\ rate= \frac{deaths}{cases}$$

Simple, right? There are X COVID-19 deaths and Y COVID-19 cases. The fatality rate is x divided by y. Hah! You naïve fool. Let’s take a closer look. How can this formula be manipulated?

Strategy #1: lie

This is the Chinese strategy. Using it China, the place where it all began, has among the lowest fatality rates in the world.

Country Pop (Millions) Cases Rate Deaths Rate
China

1390

83,938

60.4

4,637

3.3

USA

327

988,451

3,022.8

56,245

172.0

As tempting as strategy #1 is, it’s also crude. Everyone sees right through it, except perhaps the WHO. But there are other ways to manipulate the formula. These methods fall into two categories: manipulate the numerator and manipulate the denominator.

Strategies for manipulating the numerator aka redefining death

  1. Person who died of COVID-19 in the judgment of a qualified medical professional, but was otherwise healthy.
    Lowest valid death count. I define valid in the strict sense, someone died who would not have died if not for contracting the disease.
  2. Person who died and had COVID-19 plus 1 other ailment (aka co-morbidity), but COVID-19 was the main cause of death in the judgment of a qualified medical professional.
    Higher, but still valid death count because without COVID-19 the person probably would have lived.
  3. Person who died, had COVID-19 and 2+ with comorbidities. COVID-19 the main cause of death in the judgment of a qualified medical professional.
    Moderate but valid death count. The comorbidities were not the main cause of death.
  4. Person who died with COVID-19 and other comorbidities. COVID-19 not the main cause of death in the judgment of a qualified medical professional.
    High death count, validity questionable. Did COVID-19 contribute to the persons demise? Would he or she have survived otherwise. The mere fact that the patient had COVID-19 is not enough to establish it as a cause of death. In my opinion it should not count as a COVID-19 death.
  5. Review historical death records and apply definition #4.
    Highest death count.  Probably invalid, especially if pressured to define a COVID-19 death loosely.

Physicians report that they are often pressured to classify deaths in hospitals, emergency rooms and clinics as COVID-19 if the patient has COVID-19, even if the proximate cause is something else, such as an automobile accident. As I said, there are trillions of dollars there for the taking.

Uncounted deaths

The focus on COVID-19 deaths overlooks the deaths caused by the lockdown. It is well known that economic issues also lead to deaths from unemployment and financial problems. For example suicides, domestic violence, violent crime, homelessness, etc.. As Frederic Bastiat wrote over 150 years ago, we shouldn’t focus only on what is seen, we should also consider what is not seen. We must consider the whole picture.

Strategies for manipulating the denominator

There are some who want to justify the draconian lockdowns and expenditure of trillions of our dollars, so they want the fatality rate to be higher. For them almost anything counts as a COVID-19 death, but the deaths must be large relative to the number of cases. Otherwise we might not be so afraid as to not ask if all of this is justified. How to make the case count low and consist of mainly sick people? We saw it every day in the White House press briefing. As Drs. Fauchi and Birx repeatedly said “Only get tested if you are showing definite symptoms of COVID-19.” Now this request may have been made for the right reason—a shortage of tests. Why waste testing supplies on asymptomatic people? Still, the effect is to do two things: (1) reduce the case count and (2) increase the measured infection rate. Indeed, early estimates of the infection rate, and thus the transmissibility of COVID-19, were 50 to 85 times as high as some subsequent studies. A sceptic might as if this were deliberate.

Redefining a “case” according to what you want to show

  1. Small number of cases. Only count persons who currently has symptoms of COVID-19 and tests positive.
  2. Small number of cases. Only count persons asked to report for testing only if they have symptoms of COVID-19.
  3. Larger number of cases. Only count persons who have no symptoms but tests positive for antibodies to the virus.
  4. Sample nursing homes only. If you want a high rate of infection, sample from groups known to be especially susceptible.
  5. Sample by Facebook invitation. A study by Stanford University employed this method. Self-selected samples are known to show bias. Which direction (more or less COVID-19) is hard to say?

In the absence of my favorite sports of baseball and basketball, following the pandemic games will have to do for now. And since I’m grounded, I might as well write blogs about it!

Comments

  • Larry Dyer May 9, 2020 at 4:57 am Reply

    This is great Tom. Thanks for putting it into words we can all understand. I”m going to share this with all of my Six Sigma friends.
    Larry

Leave a Reply

Your email address will not be published. Required fields are marked *

Take a tour! In this interactive video you will discover what you will learn in our Lean Six Sigma Black Belt training and certification program.

FREE Sample Lesson