The CDC has not introduced a “major rule change” to inflate COVID-19 deaths; there have been more than 490,000 excess deaths in the US so far

FULL CLAIM: “CDC has illegally inflated the COVID mortality rate by at least 1,600 percent”; The NVSS COVID-19 Alert No 2 [issued in 2020 deemphasized] underlying causes of death […] by including it in Part II rather than in Part I of death certificates […] This was an important rule change […] from the CDC’s Handbook for Autopsy of 2003 on the Registration of Deaths and Reporting on Fetal Deaths and the Physician’s Handbook on Medical Certification of Death ”

REVIEW

An article published by the Gateway Pundit in early February 2021 claims that the US Centers for Disease Control and Prevention (CDC) ‘illegally inflated the COVID death rate by at least 1600 percent’. The article received more than 29,000 interactions on Facebook, including more than 14,000 shares on the platform, according to social media analytics tool CrowdTangle. The claim has also been published by other stores, as can be seen in this WND article and this National File article.

The claim that the death toll from COVID-19 has been inflated is not new, as a previous review by Health Feedback shows. The claim is aimed at questioning the severity of the pandemic and the public health measures against the virus, such as lockdown.

The study cited in these articles was published in Science, Public Health Policy and The Law, a journal created by the Institute for Pure And Applied Knowledge (IPAK). IPAK was founded by James Lyons-Weiler, a former biostatistician who published false claims about vaccines, as reported here. Lyons-Weiler was co-author of a dubious study claiming that unvaccinated children are healthier than vaccinated children, despite the lack of evidence for this, as a review by Health Feedback showed. He also wrongly claims that the virus that causes COVID-19 contains a man-made series, as outlined in this review of health feedback.

Despite being called a ‘study’, the term is a misnomer, as it does not contain any of the characteristics that a scientific study would have, such as experimental observations and reporting of new data.

The claim is based on the allegation that the CDC has introduced a ‘significant rule change’ in reporting on death certificates. According to the authors, this method deviated from the Coroners’ Handbook on Death Registration and Fetal Death Reporting and Physicians’ Handbook on Medical Certification of Death, ‘by instructing that COVID-19 be listed in Part I of death certificates as a definite cause . of death regardless of corroborating evidence, rather than being listed in Part II as a contributor to death in the presence of existing conditions, as would be done with the 2003 Guidelines. ”

In support of this claim, the authors referred to the document COVID-19 Alert No. 2, issued by the National Vital Statistics System (NVSS), part of the U.S. National Center for Health Statistics. However, as we can see by reading the actual document, the CDC did not introduce a “major rule change” on the way deaths are reported, as the authors claimed.

The purpose of the document was to inform staff who compiled death data about the creation of a new ICD code assigned to COVID-19 in order to “accurately record death data for COVID-19 on death certificates”. ICD stands for International Statistical Classification of Diseases and Related Health Problems. It is a system maintained by the World Health Organization (WHO), not the US CDC. According to the WHO:

‘ICD is the basis for identifying health trends and statistics worldwide, and the international standard for reporting diseases and health conditions. It is the diagnostic classification standard for all clinical and research purposes. ICD defines the universe of diseases, disorders, injuries and other related health conditions, listed in a comprehensive, hierarchical way that enables the following:

• Easy storage, retrieval and analysis of health information for evidence-based decision making
• Share and compare health information between hospitals, regions, institutions and countries
• Data comparisons in the same place over different periods ”

The document did not state that COVID-19 ‘is listed in Part I of death certificates as a definite cause of death, notwithstanding corroborating evidence’. On the contrary, it stated that ‘COVID-19 should be reported on the death certificate for all deceased persons where the disease has caused or is suspected to have caused or contributed to death’, and that ‘certifiers should contain as much information as possible based on: their knowledge of the case, medical records, laboratory tests, etc. ”

Furthermore, by comparing the information in the 2003 guidelines with the NVSS guidelines issued on 4 April 2020, entitled “Guidance for confirming deaths due to Coronavirus disease 2019 (COVID – 19)”, we can see that the manner in which parts I and II are recorded is recorded. has not changed.

In the NVSS guidance, it reads for Part I:

‘This section on the death certificate is for reporting the sequence of conditions that led directly to death. The immediate cause of death, that is, the disease or condition that preceded it directly and is not necessarily the underlying cause of death (UCOD), must be reported on line a. The conditions that led to the immediate cause of death must be listed in a logical order in terms of time and etiology below.”

And for part II:

‘Other important conditions that contributed to the death but did not form part of the sequence in Part I should be reported in Part II. Not all conditions present at death need to be reported – only the conditions that contributed to it.”

On page 14 of the 2003 revision of the Handbook for Medical Examiners and Autopsy on Death Registration and Fetal Death Reporting (see full document):

‘The cause-death section consists of two parts. Part I is for reporting a series of events leading directly to death, with the immediate cause of death (the final illness, injury or complication directly causing death) on line (a) and the underlying cause of the death. death (the disease or injury that initiated the chain of events that directly and inevitably led to death on the lowest line. Part II is for reporting all other major illnesses, conditions, or injuries that contributed to the death, but which did not lead to the underlying cause of death given in Part I.”

It is clear that in both the 2003 textbook and the 2020 guideline, the way in which the reporting is to be done is identical. In short, the newspaper’s claim that there was a “major rule change” by the CDC in the NVSS COVID-19 Alert is untrue. Furthermore, in another document that explained how cause of death is reported, the CDC was clear that “COVID-19 should not be reported on the death certificate if it does not cause or contribute to death.”

The paper also contains this misleading statement: “underlying causes of death, also called existing conditions or comorbidities”. Existing conditions – such as asthma and diabetes, which put both people at higher risk for severe COVID-19 – can in themselves certainly be a cause of death. For example, a severe asthma attack can lead to suffocation. But due to modern medical interventions, many people with such pre-existing conditions manage to live a normal life.

However, when these pre-existing conditions co-occur with another disease, such as COVID-19, it impairs the patient’s ability to survive the subsequent disease. Although the existing condition contributed to the death, it was not the process that led to the death. Therefore, despite the existing condition, the cause of death is COVID-19.

It is important to understand that patients with pre-existing conditions listed as COVID-19 deaths would not die at that time if they have not developed COVID-19. The merging of ‘underlying causes of death’ with ‘existing conditions or comorbidities’ is inaccurate.

As the fact-checking of PolitiFact on the same allegation noted, experts found it more likely that the number of COVID-19 deaths was under-counted and not over-counted. Roderick Little, a professor of biostatistics at the University of Michigan, told PolitiFact: ‘If anything, I would expect the CDC numbers to be underestimated and not overestimated, citing’ the lack of testing of COVID early in the pandemic ‘contributing factor to counting. Little also added that excess mortality rates ‘on the same date in previous years’ would be a ‘more reliable picture’ of the COVID-19 death toll. Indeed, the number of deaths in the US so far is more than 490,000 more than in previous years New York Times report. As a reference point, the number of Americans killed in World War I and the Vietnam War was reported by National Geographic to be 53,402 and 58,220, respectively.