{"id":3310,"date":"2023-04-18T15:06:06","date_gmt":"2023-04-18T20:06:06","guid":{"rendered":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/?p=3310"},"modified":"2023-04-18T15:06:09","modified_gmt":"2023-04-18T20:06:09","slug":"covid-is-still-a-leading-cause-of-death-as-the-virus-recedes","status":"publish","type":"post","link":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/2023\/04\/18\/covid-is-still-a-leading-cause-of-death-as-the-virus-recedes\/","title":{"rendered":"Covid is still a leading cause of death as the virus recedes"},"content":{"rendered":"
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Washington Post<\/a> But many Americans dispute the data and the risks \u2014 much as they have throughout the pandemic. <\/p>\n\n\n\n

Millions of Americans gathered maskless in homes and houses of worship this month for Passover, Easter and Ramadan \u2014 the latest evidence that coronavirus<\/a> has retreated from public view as the pandemic winds down.<\/p>\n\n\n\n

But retreat is not the same thing as eradication: Federal health officials say that covid-19 remains one of the leading causes of death<\/a> in the United States, tied to about 250 deaths daily, on average, mostly among the old and immunocompromised.<\/p>\n\n\n\n

Few Americans are treating it as a leading killer, however \u2014 in part because they are not hearing about those numbers, don\u2019t trust them or don\u2019t see them as relevant to their own lives.<\/p>\n\n\n\n

\u201cWe\u2019re not presenting the data in a way that resonates with the American people,\u201d said Deborah Birx, who served as the first White House coronavirus coordinator under President Donald Trump,citing research that finds elevated risks of health\u00a0complications<\/a>\u00a0and\u00a0death<\/a>\u00a0in the months after a covid infection. <\/p>\n\n\n\n

Millions of Americans gathered maskless in homes and houses of worship this month for Passover, Easter and Ramadan \u2014 the latest evidence that coronavirus<\/a> has retreated from public view as the pandemic winds down.<\/p>\n\n\n\n

But retreat is not the same thing as eradication: Federal health officials say that covid-19 remains one of the leading causes of death<\/a> in the United States, tied to about 250 deaths daily, on average, mostly among the old and immunocompromised.<\/p>\n\n\n\n

Few Americans are treating it as a leading killer, however \u2014 in part because they are not hearing about those numbers, don\u2019t trust them or don\u2019t see them as relevant to their own lives.<\/p>\n\n\n\n

\u201cWe\u2019re not presenting the data in a way that resonates with the American people,\u201d said Deborah Birx, who served as the first White House coronavirus coordinator under President Donald Trump,citing research that finds elevated risks of health\u00a0complications<\/a>\u00a0and\u00a0death<\/a>\u00a0in themonths after a covid infection. <\/p>\n\n\n\n

The actual toll exacted by the virus remains a subject of sharp debate. Since the earliest days of the pandemic, skeptics have argued that physicians and families had incentives to overcount virus deaths, and pointed to errors by the Centers for Disease Control and Prevention in how it has reported a wide array of covid data. Those arguments were bolstered earlier this year by a Washington Post op-ed<\/a> by Leana Wen that argued the nation\u2019s recent covid toll is inflated by including people dying with <\/em>covid, as well as from <\/em>covid \u2014 for instance, gunshot victims who also test positive for the virus \u2014 a conclusion echoed<\/a> by critics of the pandemicresponse, and amplified on conservative networks.<\/p>\n\n\n\n

\u201cThere\u2019s so much corruption here, and it\u2019s all driven by those numbers being artificially elevated,\u201d Rep. Ronny Jackson (R-Tex.), a physician who formerly worked in the White House and now serves on the House panel probing the coronavirus response, said on Newsmax in January. Health experts and federal officials reject such criticisms, saying they are confident in the CDC\u2019s data \u2014 figures that are drawn from medical examiners and coroners completing death certificates and concluding that covid was the primary or contributing cause of death. <\/p>\n\n\n\n

\u201cIf anything, [the death toll] could even be an undercount,\u201d said Debra Houry, the CDC\u2019s chief medical officer. For instance, Houry described a scenario where an elderly patient sickened by covid suffered a traumatic fall. \u201cMaybe covid [testing] wasn\u2019t done on the autopsy, so that\u2019s something that\u2019s going to be missed.\u201d<\/p>\n\n\n\n

Front-line physicians said that severe cases of covid have plummeted from the virus\u2019s peakin 2021, when the CDC said more than 3,000 people daily died of covid, but thatinfections remain a threat to vulnerable populations \u2014 and occasionally to otherwise healthy people.<\/p>\n\n\n\n

\u201cThere are still people who are getting wicked sick,\u201d said Libby Hohmann, an infectious-disease physician at Massachusetts General Hospital. She cited two covid patients she\u2019d recently seen in the intensive care unit \u2014 \u201cboth vaccinated and near death,\u201d with one immunocompromised patient in their 60s dealing with infection from another pathogen, too, and a second patient in their 30s who was previously healthy, but suddenly fighting heart failure. \u201cFor most of us, it\u2019s kind of a yawn now, but \u2026 you see these people, covid pushes them over the cliff,\u201d she said. <\/p>\n\n\n\n

Shira Doron, chief infection control officer for the Tufts Medicine Health System, said she had broader concerns about how covid data is compiled, citing local and regional differences in how death certificates are filled out, and how health officials are tracking the long-term effects of covid infections in ways that they don\u2019t with other threats, such as flu viruses. \u201cIf you think about causes of death in this country, we certainly don\u2019t have any other infectious disease where we are counting it that way,\u201d she said.<\/p>\n\n\n\n

But Doron noted that her colleagues reviewed about 85 recent deaths at Tufts that occurred after a covid diagnosis, and found \u201c100 percent accuracy\u201d in those death certificates that listed covid as a cause. Moreover, \u201cthere were quite a few patients who our experts felt had died of covid-19, and it didn\u2019t make it onto the death certificate,\u201d Doron added, saying that many of those overlooked patients had suffered \u201clong, slow declines\u201d after covid infections. <\/p>\n\n\n\n

Doron cautioned against extrapolating nationwide from that data \u2014 but \u201cat one hospital, in one city, in one state, we found that death certificates had underestimated covid-19.\u201d<\/p>\n\n\n\n

Outside researchers also have pointed to a nationwide pattern of excess deaths<\/a>, or the number of deaths exceeding what would have been predicted for that time period, which has surpassed the number of deaths attributed to covid.<\/p>\n\n\n\n

\u201cThe non-covid death rate has not returned to pre-pandemic levels,\u201d said Andrew Stokes, a Boston University researcher who is part of a team investigating the rise in excess deaths. \u201cWe believe that there\u2019s an invisible or hidden burden of covid that has persisted essentially into the present, and those deaths are going unrecorded.\u201d<\/p>\n\n\n\n

Elisa Krcilek, vice president of Mountain View Funeral Home and Cemetery in Mesa, Ariz., said her team had seen a \u201cnew normal\u201d of funerals, with higher call volumes than pre-pandemic but lower than at the 2021 peak of covid infections and deaths. She also estimated that covid may have played a role in about 20 percent of recent funerals, but often as a secondary cause, whereas earlier in the pandemic, about 80 percent of funerals were for people who died of covid, with the virus cited as a primary cause. <\/p>\n\n\n\n

\u201cPeople that have died [directly from] covid right now are few and far between,\u201d she said.<\/p>\n\n\n\n

Americans have struggled throughout the pandemic to understand the risks of covid. In one Axios\/Ipsos poll conducted last August, 35 percent of adults said they believed that more Americans were dying from traffic accidents than from covid<\/a>, compared with 11 percent who thought covid was the bigger killer. A little over half of respondents said they didn\u2019t know which posed the biggest risk of death.<\/p>\n\n\n\n

About 3,850 people died in traffic accidents in August 2022, according to federal data<\/a>\u2014 about one-quarter of those estimated to have died of covid that month. The CDC says that 3,918 people died of covid in the last week of August alone.<\/p>\n\n\n\n

Some advocates have accused the Biden administration of failing to highlight the ongoing covid death toll, saying that the White House has been too eager to turn the page. \u201cThe decision to tolerate preventable deaths in disproportionately vulnerable groups, in exchange for the convenience of more able-bodied, younger, wealthy, and white individuals, is unethical and demonstrates a reckless disregard for the lives of communities disproportionately impacted by COVID,\u201d the People\u2019s CDC, a coalition of public health experts, wrote in a\u00a0report<\/a>\u00a0last week. <\/p>\n\n\n\n

White House officials say they have been focused on boosting access to vaccines and treatments, particularly in settings such as nursing homes, and launching an effort<\/a> to develop more effectivetherapies.<\/p>\n\n\n\n

The virus \u201cis not disrupting our lives in a substantial way,\u201d said Ashish Jha, the White House coronavirus coordinator, whose team is set to wind down<\/a> next month. \u201c[But] is there still more work to do to prevent serious illness and death? The answer to that is yes.\u201d<\/p>\n\n\n\n

Others charge that the covid death toll has been inflated all along, skewed by inducements that were intended to better measure the toll of the pandemic and offer support for affected families. For instance, the Federal Emergency Management Agency has offered up to $9,000 in\u00a0assistance<\/a>\u00a0for the funerals of those whose death certificates show covid as a cause of death. <\/p>\n\n\n\n

\u201cIf your government is telling you, if you have a positive covid test, you can get $9,000 [in funeral assistance] \u2026 families are going to say, \u2018Make sure it\u2019s on there,\u2019 \u201d said Leslie Bienen, a veterinarian who studies zoonotic disease transmission and has questioned the accuracy of covid data<\/a>. \u201cI think we\u2019d be naive to think that doesn\u2019t influence anything.\u201d<\/p>\n\n\n\n

Stokes countered with examples<\/a> of coroners<\/a> in rural and conservative communities who said they had been asked by families to leave off covid as a cause of death. He also said that families seeking to add covid to a death certificate to qualify for FEMA assistance would need to go through a multistep process to get the document amended.<\/p>\n\n\n\n

Others note that the CDC has revised its death data over time, often a function of state recalculations, and health officials have acknowledged other problems in local and national covid data.For instance, Doron played a rolelast year in changing how Massachusetts tracks covid hospitalizations,\u00a0effectively halving the number of reported patients<\/a>, by counting only severe cases. <\/p>\n\n\n\n

Wen, the physician who wrote the Washington Post op-ed that argued covid deaths were overcounted, said she was calling for \u201cuniform standards so that we can put this question to rest once and for all.\u201d<\/p>\n\n\n\n

\u201cI think that this entire conversation around covid has become so polarized and frankly unscientific when what I\u2019m calling for here is an acknowledgment that we need better standardized methodologies,\u201d Wen added.<\/p>\n\n\n\n

Houry, the CDC\u2019s chief medical officer, defended<\/a> the agency\u2019s process to compile its data, saying that states did not have a consistent reporting process.<\/p>\n\n\n\n

\u201cWe\u2019re really trying to put out data in a timely fashion. And we understand there\u2019s going to be limitations to it, and that it\u2019s provisional,\u201d she said. \u201cBut because of that, the data does change.\u201d<\/p>\n<\/div><\/div>","protected":false},"excerpt":{"rendered":"

Washington Post But many Americans dispute the data and the risks \u2014 much as they have throughout the pandemic. Millions of Americans gathered maskless in homes and houses of worship this month for Passover, Easter and Ramadan \u2014 the latest evidence that coronavirus has retreated from public view as the pandemic winds down. But retreat is not […]<\/p>\n","protected":false},"author":11,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":false,"jetpack_social_post_already_shared":false,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[11],"tags":[],"class_list":["post-3310","post","type-post","status-publish","format-standard","hentry","category-covid"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/wp-json\/wp\/v2\/posts\/3310","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/wp-json\/wp\/v2\/users\/11"}],"replies":[{"embeddable":true,"href":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/wp-json\/wp\/v2\/comments?post=3310"}],"version-history":[{"count":1,"href":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/wp-json\/wp\/v2\/posts\/3310\/revisions"}],"predecessor-version":[{"id":3311,"href":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/wp-json\/wp\/v2\/posts\/3310\/revisions\/3311"}],"wp:attachment":[{"href":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/wp-json\/wp\/v2\/media?parent=3310"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/wp-json\/wp\/v2\/categories?post=3310"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/wp-json\/wp\/v2\/tags?post=3310"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}