More than a year since the outbreak of COVID-19 in the United States, a researcher finds the 2019 death toll was in line with those of recent years and did not reflect an overall increase in mortality. Genevieve Briand, Ph.D., an assistant program director and senior lecturer at Johns Hopkins University, provides this analysis in a not-yet-published paper provided to Health Care News.
According to Briand, the objective of her paper is “to assess whether the total death number the U.S. experienced during the 2020 calendar year (2019-20 seasonal year) was unexpected or alarming.” There has been wide speculation that COVID-19 caused nearly 300,000 excess deaths in 2020.
Briand says the mortality rate shows that is not true. Death Rates vs. Totals The Morbidity and Mortality Weekly Report by the National Center for Health Statistics (NCHS) reports deaths as a rate, or proportion of the population, instead of just the total number of deaths. Using rates accounts for changes in population from one year to the next, which, in the case of the United States, invariably means increases in population. U.S. death rates have been between 0.8 percent and 0.9 percent of the total population each year from 1999 to 2019, Briand notes.
“A difference of 0.1 percent in the death rate of one year over another has been observed and is to be expected,” Briand writes. The U.S. death rate for 2020 was 1.0 percent, up 0.1 percent from 2019.
“The death rates show that the total deaths increase in 2020 was not unexpected or alarming, but rather is explained by the population increase,” Briand writes. “This result, in conjunction with the facts that (1) every recorded death is allocated to one cause, (2) a new cause was specially created for COVID-19, and (3) means to test and record COVID-19 deaths were considerably expanded, points to suspicions that some reclassification between the cause of death and COVID-19 deaths might have occurred.”
CDC-Infected Data
In saying “a new cause was specially created for COVID-19,” Briand is referring to a little-noticed but far-reaching step undertaken by the CDC [Centers for Disease Control and Prevention] in the first weeks of the pandemic.
On March 24, 2020, the CDC issued guidance to all coroners, medical examiners, and physicians that unilaterally altered the 17-year-old process by which it calculated disease-caused deaths, creating a special classification for tabulating COVID-19 deaths.
The CDC’s action was in response to a change in World Health Organization (WHO) Emergency Use ICD (International Classification of Diseases) Codes for the COVID-19 Outbreak. As noted in a recent peer-reviewed study by the Institute for Pure and Applied Knowledge, substantially altering how death is recorded exclusively for COVID-19 means “the CDC compromised the quality, objectivity, and integrity of all COVID-19 data collected to date.”
Although not prepared to go that far with her criticism, Briand does raise questions about the CDC’s reclassification of COVID-19 deaths.
“[I]t is not assumed, or even suggested, that such reclassifications if they occurred, were maliciously intended to inflate COVID-19 numbers,” Briand writes. “Nonetheless, individuals within organizations tend to respond to financial incentives and groupthink to some extent. Similarly, it is not assumed or even suggested that mitigation measures adopted were designed to harm targeted groups in the U.S. population. Nonetheless, the unequal toll those measures have had on individuals across our society cannot be ignored.”
No Excess Deaths
On October 20, 2020, the CDC published estimates from the NCHS showing 299,000 excess deaths from late January to October 3, 2020, with twothirds attributed to COVID-19.
A study by L. M. Rossen et al. suggested the COVID-19 deaths were underestimated, but “the model they used to produce excess deaths did not account for the increase in population,” Briand said.
Similarly, a study of “Excess Deaths from COVID-18 and Other Causes in the US, March 1, 2020 to January 2, 2021,” published by jamanetwork.com (April 2), concluded the United States experienced 22.9 percent more deaths than expected in the period under review.
“The model does not adjust directly for population aging, which could contribute to an overestimate of excess deaths,” jamanetwork.com notes. “Other study limitations include reliance on provisional data and modeling assumptions.”
Briand says the data show the U.S. population did not decrease in the 2020 calendar year. “COVID-19 deaths did not decimate the population,” Briand writes.
One Size for All
Briand suggests the response to COVID-19 was overwrought. “The picture of the U.S. COVID-19 situation was heavily skewed by death numbers from jurisdictions such as New York City and the State of New Jersey,” Briand writes.
“At the state level, many have shown no change in death numbers or pattern of deaths in 2019-20 compared to previous seasons.” Briand asks, “has any consideration ever been given to the relevance to the national picture and national ‘solutions,’ to state, county, local, and individual situations? Or have COVID-19 measures been blindly adopted and applied, top-down, in haste, obsessively, and shortsightedly? What role did groupthink play in this?”
‘Data Manipulation’
“With all the data manipulation, political posturing, and change of definitions, the only reliable statistic is probably all-cause mortality,” says Jane Orient, M.D., the executive director of the American Association of Surgeons and Physicians.
“Despite many painful deaths from COVID-19—at least 100,000 of which might have been prevented with early treatment, the number and pattern of deaths in most jurisdictions outside of downstate New York were not greatly different from previous years.”
Briand says she “put data downloaded from publicly available CDC datasets in graphical and tabular form.”
The data presented in her paper “are not estimates—they are recorded past deaths, maintained and made publicly available by the CDC,” Briand writes. “The data have not been produced, adjusted, nor tampered with, in any way, by the author.”
Briand’s work has touched a nerve. A JHU newspaper publication took down an article describing a presentation she made on the topic.
Bonner R. Cohen, Ph.D., (bcohen@ nationalcenter.org) is a senior fellow at the National Center for Public Policy Research.
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