What does a COVID case make?
If you considered the question in the title superficially you may just say it is a COVID diagnosis. And if you were asked, what constitutes a COVID hospital admission you would likely say, that would be an admission of a COVID-diagnosed person with to a hospital. Both answers, even if a bit simplistic, would be accurate in a sane and logical world. But that does not appear to be the world we actually live in.
For example, until recently at most if not all hospitals in the US the standard procedure was that if you went to a hospital and were tested for COVID - which you often were regardless of what had brought you to the hospital - and if your test result came back positive, you were labeled a COVID case. The same was largely the case when registering and classifying COVID deaths: if you tested positive for COVID and died relatively soon thereafter you were registered as a COVID death. For instance, in the Summer of 2020 a Florida man in his 20's who died in a motorcycle crash was listed as a COVID death as he (most likely, his dead body) had tested positive for COVID. A coroner, when caught in the embarrassment that the case represented, tried to argue that COVID may have dulled the unfortunate man's reflexes and thus contributed to the crash. It is unclear if the ruling was eventually changed. Regardless of that, it is a virtual certainty that the general tendency was to pump up the COVID death count, and many on the roster are those who died with, but not in any tangible way from COVID. There are many reasons why that is most likely so - from the ability of various powers to inflate their importance on the back of a higher COVID death counts to, in some cases, financial incentives.
However, in recent weeks the situation seems to be changing as guidelines and methodology for counting both COVID cases and COVID deaths are changing. According to a friend who works at a major hospital in New England hospital's chief epidemiologist reported in the first half of January that the hospital no longer lumps all COVID-positive admissions into one category but rather distinguishes between those admitted for COVID, i.e., those who need treatment because of their COVID infection, and those admitted with COVID, i.e., those who were admitted due to other health issues, for example, a broken arm, but also happened to be COVID-positive. According to that epidemiologist, 52% of COVID-positive patients were at that point being admitted for COVID and 48% were being admitted with COVID. Roughly the same breakdown has been reported across Massachusetts and New York State. It is reasonable to suspect that in other locales one would find a similar situation, in the US and elsewhere.
So let us recap. We have a change in accounting methodology going in effect in many if not all locales in the US that now, all other things being equal, is poised to give us half the official COVID hospitalization count we had a mere month ago. Of course, the lack of that being officially and loudly announced is disturbing. But it basically invalidates what is bound to be final count when all is said and done. Half as many people are now listed as COVID patients in hospitals. Should one of those hospitalized with, not for, COVID, die that death will likely no longer be listed as a COVID death. In short, whatever the motive for this accounting methodology change, the result is utter confusion. And we no longer have a data set worthy of the name, really.
And now it is also time to very seriously consider the possibility that official COVID figures from the very start were more about presentation, i.e., politics as opposed to actual medical and epidemiological data.
How are COVID-19 deaths counted? It’s complicated
Patrick Boyle, AAMC, 18 February 2021
Florida Man Killed in Crash Listed as COVID-19 Death, Raising Doubts Over Health Data
Soo Kim, Newsweek, 20 July 2020
Do Colorado hospitals get extra money for coronavirus cases and deaths? Yes and no.
Jessica Seaman, Denver Post, 20 May 2020
Nearly Half Of COVID Hospitalizations In Massachusetts Are ‘Incidental’
CBSBoston.com Staff, 20 January 2022
Over 40% of NYC’s COVID-infected hospital patients admitted for other reasons
Bruce Golding, New York Post, 7 January 2022
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