The CDC counts suspected flu deaths too

I have often heard the following three arguments from those who are downplaying the seriousness of COVID-19:

1. We can’t trust models to make these big decisions; we need to use facts instead.

2. We shouldn’t trust the numbers of COVID-19 deaths that are being reported because they are counting suspected cases in addition to those that tested positive.

3. The flu kills 12000-61000 every year, and we don’t lockdown for the flu.

If you buy these arguments (and you shouldn’t), consider this: The 12000-61000 deaths that are attributed to influenza each year are NOT the number of confirmed cases! Here is a quote from the CDC’s website:

“We first look at how many in-hospital deaths were observed in FluSurv-NET. The in-hospital deaths are adjusted for under-detection of influenza using methods similar to those described above for hospitalizations using data on the frequency and sensitivity of influenza testing. Second, because not all deaths related to influenza occur in the hospital, we use death certificate data to estimate how likely deaths are to occur outside the hospital. We look at death certificates that have pneumonia or influenza causes (P&I), other respiratory and circulatory causes (R&C), or other non-respiratory, non-circulatory causes of death, because deaths related to influenza may not have influenza listed as a cause of death. We use information on the causes of death from FluSurv-NET to determine the mixture of P&I, R&C, and other coded deaths to include in our investigation of death certificate data. Finally, once we estimate the proportion of influenza-associated deaths that occurred outside of the hospital, we can estimate the deaths-to-hospitalization ratio.” https://www.cdc.gov/flu/about/burden/how-cdc-estimates.htm

In other words, the CDC includes cases that do not even have influenza listed on the death certificate when counting flu deaths, and they use mathematical models to determine how many of these are likely to be due to influenza.

The takeaway message is that you can’t have it both ways. You can’t say that we shouldn’t trust mathematical models and trust the numbers of flu deaths, because mathematical models are used to count flu deaths.

You also can’t cite the CDC estimates for the number of flu deaths and then complain that we are overcounting COVID-19 deaths. The criteria for reporting COVID-19 deaths is actually more restrictive than the criteria used to count flu deaths. If you were to limit the estimates for flu deaths to just confirmed cases, the largest number of deaths in any flu season since 2013 would be 15620 which is about 25% of the estimated number.

And you can’t claim that COVID-19 is no worse than the flu when it has taken less than 4 months for us to surpass the number of deaths from the worst flu season (which is an entire year!) in the last decade. Sadly that total is still climbing by around 2000 people per day

Or maybe you can have it both ways, but only if you don’t care about things like facts or logic.

PS. You can find the flu mortality surveillance data here: https://gis.cdc.gov/grasp/fluview/mortality.html