[Article] The US CDC’s Broad Legal Disclaimer for the Fluview Interactive COVID Death Numbers

This is the legal disclaimer that appears when starting the US Centers for Disease Control (CDC’s) Fluview Interactive application which purports to report the percentage of deaths per week “due to” pneumonia and influenza (P&I) prior to March 2020 and pneumonia, influenza, and COVID-19 (PIC) since March 2020. (URL: http://gis.cdc.gov/grasp/fluview/mortality.html )

Emphasis is added to key phrases. The NOTES explain the definition and meaning of several technical terms used in the disclaimer.

The disclaimer essentially says, in plain English, the data — the COVID-19 death counts — which is presented with no estimates of statistical or systematic errors is provisional and could be entirely wrong. Two sentences in one paragraph appear to contradict one another.

The CDC had a budget of just over $12 billion in the Fiscal Year 2019. URL: https://www.cdc.gov/budget/documents/fy2019/fy-2019-detail-table.pdf

Disclaimer (Downloaded December 24, 2021)

National Center for Health Statistics Mortality Surveillance System-

NOTE: The National Center for Health Statistics (NCHS) is a division of the US Centers for Disease Control and Prevention (CDC).

The National Center for Health Statistics (NCHS) collects and disseminates the Nation’s official vital statistics. NCHS collects death certificate data from state vital statistics offices for all deaths occurring in the United States. Pneumonia and/or influenza (P&I) deaths and pneumonia, influenza and/or COVID-19 (PIC) deaths are identified based on ICD-10 multiple cause of death codes.

NOTE: ICD-10 is the International Classification of Diseases 10th Edition, a medical classification list by the World Health Organization (WHO). “ICD-10 multiple cause of death codes” refers to multiple “causes of death” listed on death certificates. Many death certificates have many causes of death such as emphysema, a degenerative eventually terminal condition, and pneumonia. One cause of the death is singled out as the “underlying cause of death” or UCOD. One cause of death is singled out as the “immediate cause of death.” The immediate cause of death is often not the underlying cause of death. For example, emphysema may be the underlying cause of death and pneumonia, the influenza virus, or the “common cold” may be the immediate cause of death.

NCHS Mortality Surveillance System data are presented by the week the death occurred at the national, state, and HHS Region levels, based on the state of residence of the decedent. Data on the percentage of deaths due to P&I or PIC are released one week after the week of death to allow for collection of enough data to produce a stable percentage. States and HHS regions with less than 20% of the expected total deaths (average number of total deaths reported by week during 2008-2012) will be marked as having insufficient data. Not all deaths are reported within a week of death therefore data for earlier weeks are continually revised and the proportion of deaths due to P&I or PIC may increase or decrease as new and updated death certificate data are received by NCHS.

NOTE: Notice the conflict between “to allow for collection of enough data to produce a stable percentage” and “the proportion of deaths due to P&I or PIC may increase or decrease as new and updated death certificate data are received by NCHS.” Percentage is a way of expressing the proportion: for example, fifty percent (a percentage) versus one half (another way of expressing the same percentage). “Stable” usually means “not changing or fluctuating” (Merriam Webster) when used in this way.

The COVID-19 death counts reported by NCHS and presented here are provisional and will not match counts in other sources, such as media reports or numbers from county health departments. COVID-19 deaths may be classified or defined differently in various reporting and surveillance systems. Death counts reported by NCHS include deaths that have COVID-19 listed as a cause of death and may include laboratory confirmed COVID-19 deaths and clinically confirmed COVID-19 deaths. Provisional death counts reported by NCHS track approximately 1-2 weeks behind other published data sources on the number of COVID-19 deaths in the U.S. These reasons may partly account for differences between NCHS reported death counts and death counts reported in other sources.

NOTE: The language “a cause of death” likely means that COVID-19 (or pneumonia or influenza in pre-2020 figures) is one of the causes of death listed on the death certificate, not necessarily the underlying cause of death (UCOD). Remember, many death certificates have multiple causes of death, one of which is identified as the underlying cause of death. (UCOD). Note also that the disclaimer specifically states that NCHS numbers “will not match..numbers from county health departments.” County health departments are presumably official, primary sources of death data with qualified staff — medical examiners and others.

In previous seasons, the NCHS surveillance data were used to calculate the percent of all deaths occurring each week that had pneumonia and/or influenza (P&I) listed as a cause of death. Because of the ongoing COVID-19 pandemic, COVID-19 coded deaths were added to P&I to create the PIC (pneumonia, influenza, and/or COVID-19) classification. PIC includes all deaths with pneumonia, influenza, and/or COVID-19 listed on the death certificate. Because many influenza deaths and many COVID-19 deaths have pneumonia included on the death certificate, P&I no longer measures the impact of influenza in the same way that it has in the past. This is because the proportion of pneumonia deaths associated with influenza is now influenced by COVID-19-related pneumonia. The PIC percentage and the number of influenza and number of COVID-19 deaths will be presented in order to help better understand the impact of these viruses on mortality and the relative contribution of each virus to PIC mortality.

The PIC percentages are compared to a seasonal baseline of P&I deaths that is calculated using a periodic regression model that incorporates a robust regression procedure applied to data from the previous five years. An increase of 1.645 standard deviations above the seasonal baseline of P&I deaths is considered the “epidemic threshold,” i.e., the point at which the observed proportion of deaths is significantly higher than would be expected at that time of the year in the absence of substantial influenza, and now COVID-related mortality. Baselines and thresholds are calculated at the national and regional level and by age groups.

For more information on pneumonia and influenza mortality surveillance please visit: http://www.cdc.gov/flu/weekly/overview.htm#Mortality

* The 10 U.S. Department of Health and Human Services regions include the following jurisdictions. Region 1: Connecticut, Main, Massachusetts, New Hampshire, Rhode Island, and Vermont; Region 2: New Jersey, New York, and New York City; Region 3: Delaware, District of Columbia, Maryland, Pennsylvania, Virginia, and West Virginia; Region 4: Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, and Tennessee; Region 5: Illinois, Indiana, Michigan, Minnesota, Ohio, and Wisconsin; Region 6: Arkansas, Louisiana, New Mexico, Oklahoma, and Texas; Region 7: Iowa, Kansas, Missouri, and Nebraska; Region 8: Colorado, Montana, North Dakota, South Dakota, Utah, and Wyoming; Region 9: Arizona, California, Hawaii, and Nevada; Region 10: Alaska, Idaho, Oregon, and Washington.

About Me

John F. McGowan, Ph.D. solves problems using mathematics and mathematical software, including developing gesture recognition for touch devices, video compression and speech recognition technologies. He has extensive experience developing software in C, C++, MATLAB, Python, Visual Basic and many other programming languages. He has been a Visiting Scholar at HP Labs developing computer vision algorithms and software for mobile devices. He has worked as a contractor at NASA Ames Research Center involved in the research and development of image and video processing algorithms and technology. He has published articles on the origin and evolution of life, the exploration of Mars (anticipating the discovery of methane on Mars), and cheap access to space. He has a Ph.D. in physics from the University of Illinois at Urbana-Champaign and a B.S. in physics from the California Institute of Technology (Caltech).

December 21, 2021December 22, 2021

[Article] Known Problems with US CDC’s Pneumonia, Influenza, and COVID-19 (PIC) Death Numbers

Introduction

This is a summary (below) of our lengthy (about 13,000 word) paper on the many issues with the CDC’s pneumonia, influenza, and COVID-19 (PIC) death numbers. It is about 1,000 words in length (5-10 minute read) and summarizes most of our key findings.

John F. McGowan, Ph.D., Tam Hunt, Josh Mitteldorf, PhD. Improving CDC Data Practices Recommendations for Improving the United States Centers for Disease Control (CDC) Data Practices for Pneumonia, Influenza, and COVID-19 (v 1.1). Authorea. November 29, 2021. DOI:10.22541/au.163822197.79126460/v1
(https://doi.org/10.22541/au.163822197.79126460/v1)

URL:
https://www.authorea.com/users/425106/articles/547336-improving-cdc-data-practices-recommendations-for-improving-the-united-states-centers-for-disease-control-cdc-data-practices-for-pneumonia-influenza-and-covid-19-v-1-1

Key Points/Summary

A number of CDC data presentation and statistical practices since the start of the COVID-19 pandemic in early 2020 have not followed common scientific and engineering practice. Several problems with data presentation and analyses for pneumonia and influenza death numbers – which have been merged with COVID-19 death numbers in the FluView web site ‒ predate the pandemic.

Before the pandemic (March 2020), the non-standard data presentation and statistical practices appear to increase the number of deaths attributed to the influenza virus and imply the death counts are certain whereas substantial uncertainty exists due to uncertainty in the assignment of the cause of death and other reasons. Since the pandemic, these practices appear to do the same for SARS-COV-2 and COVID-19.

Remarkably, the CDC had at least three (3) different numbers for deaths attributed to pneumonia and influenza before 2020: the leading causes of death report count with about two (2) percent of deaths (about 55,000) per year attributed to influenza and pneumonia, the influenza virus deaths model with about 55,000 deaths per year attributed specifically to the influenza virus, and the FluView web site count with about 6-8 percent of deaths (about 188,000) per year attributed to pneumonia and influenza.

The FluView number differs from the other two death numbers by a factor of OVER THREE. The probable reason for this difference is that — according to the FluView technical notes — FluView counts deaths where pneumonia or influenza is listed as “a cause of death” whereas the leading cause of death report — according to the technical notes — counts only deaths where pneumonia or influenza is listed as “the underlying cause of death.” This probably reflects a large uncertainty in the assignment of the cause of death in respiratory illness cases; indeed the underlying cause of death may be ill-defined in many cases.

The CDC’s excess deaths estimates on their excess deaths web site does not report any standard goodness of fit statistics, notably the coefficient of determination often known as “R squared” and the “chi squared” goodness of fit statistic. Our analysis shows that different models with the same goodness of fit statistics give different estimates of the number of excess deaths, varying by up to 200,000 deaths in 2020. The CDC web site does not report this systematic modeling error.

The CDC appears to have chosen a set of parameters for the Noufaily/Farrington algorithm used to estimate excess deaths by the CDC that gives a lower “R Squared” value for goodness of fit than other choices and a HIGHER ESTIMATE of excess deaths — whereas common scientific and engineering practice would be to use the models with the best goodness of fit statistics, the “R Squared” closest to 1.0.

The Noufailly/Farrington algorithm is an empirical trend detection and extrapolation model theoretically incapable of accurately modeling the aging “baby boom” population which would be expected to produce “excess deaths” in recent years — nor is it able to explain the puzzling near stop of the increase in deaths per year reported in the immediate pre-pandemic years 2017-2019 despite the aging population.

The CDC does not publish (as of Dec 2021) years of life lost (YLL) estimates which include increases in suicides, homicides, and other adverse effects of the lockdowns, nor systematic modeling errors on the YLL estimates. YLL can illustrate the difference between a disease that largely kills those nearing death anyway versus a disease that easily kills the healthy.

The CDC issued a COVID death certificate guidance document in April of 2020 that appears to change the standards for assigning the underlying cause of death (UCOD) from the pre-pandemic practice for assigning the underlying cause of death for pneumonia and influenza, making COVID-19 the underlying cause of death in the many cases where the person who died had serious pre-existing conditions such as chronic bronchitis, emphysema, heart failure etc.. — the deaths counted in FluView but not in the leading causes of death report. There does not appear to have been any public comment on this guidance document to date.

In general the CDC does not report statistical errors, systematic errors, or estimates of biases in pneumonia, influenza, and COVID-19 death numbers. They do not report any monitoring of the effect of their guidance documents or other directives on the assignment of the cause of death by doctors, medical examiners, and others.

These issues are sometimes shared with other government agencies such as the US Social Security Administration (SSA) and US Census Bureau that work closely with the CDC.

Death counts for both individual causes and “all cause” deaths are frequently reported as precise to the last digit without any statistical or systematic errors, despite both known and unknown uncertainties in counting deaths, such as missing persons, unreported deaths due to deceased payee fraud, the ~1,000 living Americans incorrectly added to the government Deaths Master File (DMF), each month, for unknown reasons, and considerable uncertainties in assigning the underlying cause of death (UCOD) by coroners and doctors.

Similarly, raw counts, adjusted counts, and estimates – often based on incompletely documented computer mathematical models – are often not clearly identified as such. The Deaths Master File, with names and dates of death of deceased persons is exempt from the Freedom of Information Act (FOIA) and unavailable to the general public, independent researchers, and even other government agencies such as the IRS. This confidentiality of data makes independent verification of many CDC numbers, such as the excess deaths numbers tracked during the COVID-19 pandemic, all but impossible.

This omission of common scientific and engineering practices raises questions about the accuracy of the CDC’s data, conclusions, and public health policies in a number of important areas, including the COVID-19 pandemic.

The non-standard data presentation and statistical practices appear to increase the number of deaths attributed to the influenza virus and imply the death counts are certain whereas substantial uncertainty exists due to uncertainty in the assignment of the cause of death and other causes. Since the pandemic, these practices appear to do the same for SARS-COV-2 and COVID-19.

END OF SUMMARY

About Me

December 5, 2021December 5, 2021

[Video] Explaining YouTube Comedian Jimmy Dore’s Confusion over COVID-19 Fatality Rates

Explaining Jimmy Dore’s Confusion over COVID-19 Fatality Rates (Odysee)

Video explaining YouTuber comedian Jimmy Dore’s confusion about COVID-19 fatality rates, due to the significant distinction between the case fatality rate (CFR) and the infection fatality rate (IFR).

Video Links: BitChute NewTube ARCHIVE

References:

Do Lockdowns Work: The Jimmy Dore Show Rumble: https://rumble.com/vq8zzu-how-lockdowns-devastate-you-while-boosting-billionaires.html

http://wordpress.jmcgowan.com/wp/the-distinction-between-the-case-fatality-rate-cfr-and-the-infection-fatality-rate-ifr/ (My May 2020 Blog Post on the difference between the CFR and IFR)

https://coronavirus.jhu.edu/data/mortality (Johns Hopkins Site Showing Case Fatality Rates)

https://www.who.int/bulletin/volumes/99/1/20-265892.pdf (Stanford Epidemiologist John Ioannidis’s Meta Analysis of Infection Fatality Rates referenced by Jimmy’s guest Max Blumenthal). Bull World Health Organ 2021;99:19–33F DOI: http://dx.doi.org/10.2471/BLT.20.26589

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