A bogus claim circulating social media — one that purports that "only 6%" of the reported COVID-19 deaths in the U.S. are solely attributable to the new coronavirus — is dangerously misleading, infectious disease experts told Live Science.
This claim stems from an Aug. 26 update the Centers for Disease Control (CDC) posted on its website, which provides a detailed breakdown of the accompanying health conditions (known as comorbidities) and contributing causes of death reported in people who have died of the new coronavirus in the United States. The CDC noted that "For 6% of the deaths, COVID-19 was the only cause mentioned."
In other words, 6% of people who died when they had COVID-19 didn't have underlying conditions, such as diabetes, asthma or heart disease, and didn't experience any medical complications, such as kidney failure or sepsis. But the other 94% of deaths were still caused by COVID-19, infectious disease experts said. That's because many chronic, underlying conditions can make diseases that a person might otherwise recover from, such as COVID-19, suddenly deadly.
"When you look at the number of excess deaths this year in comparison with previous years, it's staggering," Dr. William Hanage, a professor of epidemiology at Harvard University’s School of Public Health told Live Science. That's an estimated 228,200 additional deaths in the United States, according to the Weinberger Lab at the University of California, San Francisco. Hanage noted that many of the people who have died so far had nonfatal diseases and would not have perished but for contracting the new coronavirus as well. For instance, someone with diabetes or high-blood pressure might have lived decades longer if they had not contracted COVID-19. Dr. William Schaffner, a professor of preventative medicine and infectious diseases at Vanderbilt University Medical Center in Tennessee, echoed the same reality. "The point is that those people would not have died except that they were carried away by COVID," Schaffner told Live Science.
In addition, deadly medical complications can be the immediate cause of death when in fact a virus is the ultimate culprit, as is evident with HIV/AIDS. More than 32 million people worldwide have died so far of HIV/AIDS, for instance, but the disease itself isn't usually the immediate cause of death. Dr. Shahnaz Azad, an infectious disease expert in Olympia Fields, Illinois, told Franciscan Health, "It's not HIV that kills you. HIV kills your immunity, and then you become susceptible to all kinds of infections and cancers."
A death certificate might list a primary cause of death as Kaposi's sarcoma, for instance, but in fact, that patient would never have acquired the otherwise rare type of cancer if they hadn't been infected with HIV. The HIV virus is still what ultimately killed the person.
That hasn't stopped the flood of misleading social media posts about this 6% statistic. These posts have led many people to falsely believe that the number of U.S. coronavirus deaths is far less than previously reported. President Donald Trump, for instance, retweeted a since-removed post on Twitter claiming that "This week the CDC quietly updated the Covid number to admit that only 6% of all the 153,504 deaths recorded actually died from Covid. That’s 9,210 deaths. The other 94% had 2 to 3 other serious illnesses and the overwhelming majority were of very advanced age."
Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, appeared on the TV show "Good Morning America" yesterday to correct the misunderstanding. "The numbers you've been hearing — there are 180,000-plus deaths — are real deaths from COVID-19. Let there not be any confusion about that," he said.
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What's more, the fact that those with comorbidities are likelier to die of COVID-19 is not exactly reassuring. A huge fraction of the U.S. population has conditions that increase COVID-19 severity, such as diabetes, high blood pressure, asthma and even obesity. According to the CDC, nearly 40% of all U.S. adults age 20 and older are obese. "Obviously a lot of people have one of these things, or one of the very large number of other things that would be included in that catch-all term," Hanage said. "And even if you don’t have a comorbidity yourself, someone you love almost certainly does."
The prevalence of comorbidities is seen in the CDC update, which noted that of people who died of COVID-19 but also had other medical complications or underlying medical conditions, "there were 2.6 additional conditions or causes per death."
Schaffner said that "the issue is not whether COVID alone can produce serious illness and death — it can. Of course, those who are older and have underlying chronic conditions (comorbidities) are more likely to suffer more serious disease, often with fatal outcomes. Thus, most people who die of COVID have other contributing causes of death." The cause of death for the 6% who have died without comorbidities, Shaffner explained, is actually a "severe pneumonia, caused by the virus, which is then exacerbated by a person's own immune and inflammatory response."
Moreover, the CDC statistic in question speaks only to overall deaths, the experts told Live Science, and it's important to keep in mind the other disabling and prolonged health problems COVID-19 causes for those who survive the disease.
"Death is not the only outcome that matters." said Dr. Eduardo Franco, the director of the Division of Cancer Epidemiology and the chairman of the Department of Oncology at McGill University in Canada. "There is considerable suffering and risk of long-term sequelae if one is hospitalized because of COVID-19. Being hospitalized is a reflection of the severity of the infection. Being moved to an ICU is an even more ominous indication of severity."
If anything, this episode highlights how public health data shouldn't be misconstrued for political purposes, Franco said.
"The pandemic has become much too politicized when it's really just about dealing with something as basic as public health science," Franco told Live Science. "Some people try to downplay the problem by ostensibly misinterpreting the statistics," he said, adding: "We can prevent so many deaths by taking basic and simple precautions: wash hands frequently, wear a mask, disinfect frequently-touched surfaces, and maintain 6 feet (1.8 meters) of distance from one another. We must keep COVID-19 numbers low while we await a vaccine. Any surges because of the virus will only choke the process and interrupt healthcare for those who need it most."
Originally published on Live Science.