The Bent Curve and The Six Million Dollar Man — Guest Post by John Carver

When the media become filled with talk of heroes, you might want to hide your wallet; It’s probably going to get expensive. But more on that later. First some updates on topics touched on in my May 8th post.

The Johns Hopkins COVID-19 Dashboard Revisited

Johns Hopkins is still mis-labeling the numbers on their COVID-19 Dashboard: “Confirmed cases include presumptive positive cases and probable cases, in accordance with CDC guidelines as of April 14.”

No, the CDC guidelines don’t say that. Johns Hopkins is making things up. Per the CDC, confirmed cases or deaths require confirmatory laboratory evidence. Hanlon wrote “Never attribute to malice that which is adequately explained by stupidity,” but one has to wonder because I emailed John’s Hopkins weeks ago concerning their mislabeling of data, but have not received any reply. I also still do not know which data source they are using for their US figures.

The Numbers Revisited

Here’s an updated plot of the week all-cause mortality data from the CDC’s FluView system. I excluded the two most recent weeks, 19 and 20, because the reporting for those is less than 100%.

Though the numbers for past weeks are still being revised weekly (and will be for two years), all evidence indicates that we are over the peak. Shown indirectly on the graph above by the area under the curves, all-cause deaths year-to-date have finally edged past those the same week of 2018 (but only by about 3% according to May 22nd’s data release).

Over-Reporting Revisited

The CDC’s Coronavirus Disease 2019 (COVID-19) page is reporting 94,150 deaths as of the May 22, 2020 update. The CDC’s second page, Provisional Death Counts for Coronavirus Disease (COVID-19) is reporting 73,639 deaths as of the same date. The numbers are much closer to each other than I reported last and appear to be converging.

Per the method outlined in my previous post, let’s repeat our sanity check on the numbers. Using the table from the second Provisional Death Counts page, but excluding the two most recent MMWR weeks, 19 and 20, for which reporting is not complete yet for yields a sum of 64,960 deaths involving COVID-19 to the week ending 5/2/2020, from the CDC’s numbers. Now the check: Summing the all-causes deaths for each week for 2020 minus the average of all-cause deaths from the years 2014-2019 yields an excess of 85,043 deaths.

Frankly, I was surprised by this result as I was expecting over-reporting to be obvious in the CDC’s numbers, but it’s not at all obvious now. Keep in mind that the number of all-cause deaths are just that (What portion are deaths of despair?), and there is no such thing as excess mortality, only displaced mortality (The average age of victims is near the average life expectancy). But this crude check of the numbers indicates that the CDC’s reported numbers are not implausible (and along the lines of a bad flu season).

Medifraud?

In 2003 and 2004, the US government airlifted 363 tons of cash in the form of pallets loaded with crisp 100 dollar bills to Baghdad, Iraq. In April 2020, US hospitals billed (and were reimbursed by) the US government through Medicare for an amount 20 times that.

The April 2020 figure of $118B from the US Department of the Treasury represents a shocking $91B increase over the Federal Hospital Insurance Trust Fund Benefit Payments average of $27B per month in 2019. Keep in mind that most hospitals are operating at much reduced capacity and have very few patients because non-elective procedures have been suspended during the lock-down. In other words, hours being worked are way down, but the amount being billed to the Medicare system is up dramatically. Ironically, the justification behind the lockdowns were that we needed to “flatten the curve” so that the medical system wouldn’t become overloaded. Well hospitals, in general, are definitely not overloaded. In fact, over 250 hospitals across the US have furloughed workers. Look closely at the sign that the guy on the street corner is holding. It might actually say “Need Work – Experienced Surgeon.”

As of May 16, 2020, the number of laboratory-confirmed COVID-19 hospitalizations reported by the CDC stands at a mere 22,060. Dividing the $91B excess by 22,060 yields a result of over 4 million dollars per laboratory-confirmed COVID-19 hospitalization. Not quite The Six Million Dollar Man, but close! Now there may problems in the reporting system and the number of laboratory-confirmed COVID-19 hospitalizations being reported to and by the CDC may be dramatically less than the actual number. But I would argue that if we are paying $100B to the hospitals in a single month, we should require good reporting.

As pioneering television marketer Ron Popeil exclaimed “But wait, there’s more!” The $91B excess in Medicare reimbursement to hospitals that I just mentioned is not the only federal funds being directed to hospitals. The CARES Act also allocated $175 billion for hospitals and other healthcare providers. But wait, there’s even more! These figures do not include the unemployment benefit payments for the furloughed healthcare workers.

The Nursing Home Question

As soon as the news hit of the outbreak at Life Care Center of Kirkland, every nursing home manager in the US would have been aware of it. Yet virtually none instituted lock-ins of staff that would have actually protected their residents. And in fact, some states such as New York mandated that nursing homes must accept COVID-19 positive patients.

Given that such a large percentage of fatalities have occurred in nursing homes, the big question is, why haven’t we protected them? And why aren’t we protecting them currently? I’ll save this topic for another day.

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