No, Commissioner Arreola, 20 people haven’t died of COVID in Alachua County in the past 18 days

OPINION

BY JENNIFER CABRERA

In a letter to the University of Florida Board of Trustees, Gainesville City Commissioner David Arreola has asked for a ban on spectators at football games. In the letter, he states that “we have lost 20 lives in the last 18 days, certainly one of the most deadly periods of the COVID-19 pandemic in Alachua County.”

That statement is false and exemplifies our elected politicians’ lack of understanding of COVID data.

First of all, all of the daily death reports you see in the media are those identified by the Florida Department of Health (FDOH) since the last report (which is currently the previous day). Today, for example, the 127 reported deaths for the state are distributed over 70 different days, with changes going back to April 15. Of those deaths, 11 actually happened in July, 54 in August, and 65 in September.

Unfortunately, we don’t get that type of detail by county, but Paul Myers, of the Florida Department of Health, told me that only 3 of the 20 deaths reported in the 18 days before Arreola’s letter actually occurred in those 18 days. It is rare that death reports actually refer to deaths in the previous 24 hours, and reported deaths are often delayed by several weeks or more.

It’s important to understand how COVID deaths are determined. It all starts with the PCR test that is used to identify COVID cases. This article goes into the details, but the bottom line is that, according to the New York Times, the test is so sensitive that up to 90% of the identified “cases” are not infectious. The test was designed for surveillance – to track the spread of COVID in the population – not to diagnose illness in individuals. It is highly unusual in medicine to use a single test result, in the absence of any clinical findings and without any examination from a physician, to declare that someone has an illness.

However, in the interest of making sure patients and long-term care residents aren’t exposed to  COVID, these tests are being given to nearly every hospital patient and repeatedly to every long-term care facility resident. Every person who tests positive and is then hospitalized for any reason, or who is hospitalized for any reason and then tests positive, becomes a COVID hospitalization.

This then cascades into COVID deaths. WCJB had a recent story about a family whose father died after a stage 4 cancer diagnosis and then a stroke. They were told that he tested negative for COVID, but the primary cause of death on the death certificate was COVID-19. The hospital claimed it was a clerical error.

Although hospitals have a valid reason to test to identify infectious patients, they have an incentive to add treatment for COVID to the patient’s chart because Medicare pays an extra 20% as long as the public health emergency lasts. So regardless of whether the patient has any COVID symptoms, hospitals have an incentive to test the patient and put a COVID code on their charts, at which point it is added to the death certificate, whether or not that is the primary cause of death. The overly-sensitive test, which can pick up fragments of the virus for up to 3 months after exposure to COVID, turns non-COVID hospitalizations into COVID hospitalizations and then, if they die, into COVID deaths.

Through the middle of August, we were able to get death certificate information from the local Medical Examiner’s office, but now that information is kept by FDOH, and they say they’re too busy to respond to our public records requests. This article goes through the findings on the death certificates we have access to, and Myers told me the deaths since then follow the same pattern: The people who are being counted as COVID deaths generally have multiple serious health problems; some of them have wound infections, strokes, and falls as contributing causes. Two of the deaths we reviewed listed the Probable Manner of Death as “Accident.” A number of them were already in hospice before testing positive, so they weren’t expected to live long, even if they hadn’t tested positive for COVID.

That doesn’t mean that COVID was not the final cause of death for some of these individuals; what it means is that COVID was not the final cause of death for all of them, and without independent review of the death certificates, we can’t know what that percentage is.

It is a fact, though, that the vast majority of people who have died of COVID were not people who were out and about, going to the grocery store or to football games. In Alachua County, 78% of the COVID deaths listed in the FDOH case line data are over 65 years old; half are over 72 (see the graph below). Even the younger people who died were very unhealthy people; we don’t tend to realize how many very unhealthy people are in our community because we don’t see them. That doesn’t make their lives any less valuable, but it changes the focus of public policies that are intended to protect people against COVID: Myers has told the county commission repeatedly that “No one is protected when everyone is protected”—resources should be devoted to protecting the vulnerable, not to shutting down the parts of society that cater to people who are not at great risk from COVID. Football games and bars are obvious examples of places that the elderly and unhealthy generally avoid, even when there’s not a pandemic.

There is another argument, that people in the community will infect those who don’t go out. It is undeniable that people who are in contact with the vulnerable must take precautions, but that is no reason to limit the activities of students who rarely step off campus or anyone else who has little interaction with people who are very unhealthy.

Misinformation from UF

More misinformation was presented during the September 30 joint Gainesville/Alachua County meeting, when County Commissioner Ken Cornell asked Dr. Michael Lauzardo, of UF, “Based on what you just said, it is UF’s intention to continue to take a follow-the-science approach?… so with regards to the governor’s opening up of Phase 3 throughout the state, do you anticipate anything changing specifically on campus with regards to continuing to follow the science and continuing to require masking as a preventive measure?”

Lauzardo responded, “Absolutely. Right now I think that there’s been no new evidence to show that masks are not effective. In fact, the consensus is, you know, it has grown to the point where it’s universal in terms of the scientific community, the benefit of masks. Again there are issues there in terms of no randomized control trials and things like that used for evidence in other circumstances. but there’s so much evidence to show that is a benefit.”

It is truly disturbing when someone who claims to “follow the science” uses words like “consensus” and “universal.” “Consensus” is not a scientific term; science is a process of discovery, and “truth” is not subject to a vote or even to popular opinion. Even if you believe that there is “so much evidence” that masks are beneficial, it is absolutely false to claim that “it’s universal in terms of the scientific community.” 

A multitude of evidence that our current policies are not universally supported by scientists was presented at Governor DeSantis’ COVID-19 roundtable on September 24, at which two professors from Stanford and one from Harvard pushed back on nearly everything we are doing locally. During the roundtable, Dr. Jayanta Bhattacharya from Stanford said, “I haven’t seen a ton of evidence that suggests that… the kinds of masks people actually use, not the kinds that we prescribe them to use, do they actually work? I don’t think I’ve seen any studies that suggest that the typical mask that people use, that they use and re-use, often without washing them or whatnot, are those effective?”

He continued, “I think people like masks because intuitively you think, ‘I am giving droplets out to you that might have the virus, and so it’s got to provide some protection.’ Intuitively, it might, but as a scientific matter, it’s still an open question whether they do or not. Often in science, we end up with results that are not intuitive; we’re surprised by the experimental results. I think this may be one area where… you can probably hear my reticence to weigh in because I don’t know of a ton of studies that definitely say one way or the other on this, and that’s actually a problem. I think there ought to be more if we’re going to create this into this talisman that we have to wear in order to be a good person.”

There is no question that limiting business activity, closing schools, and isolating college students have consequences that we are only beginning to acknowledge. Anyone who thinks that the local COVID-19 policies have kept our community safe should either read the transcript or watch the video of the roundtable. Many people think Lauzardo’s statement about consensus is true, but that is only because scientists who disagree have been systematically silenced, including journals’ refusal to publish studies by top epidemiologists like Dr. Sunetra Gupta of Oxford. (This article contains links to many studies about the use of face masks to stop viral spread, written before the topic became political.)

The draconian policies that continue to be discussed by our local commissioners are the reason why Governor DeSantis’ order requires them to justify those orders with data. Knowing they can’t do that, their response at yesterday’s meeting was to declare that they will need to “think creatively to get around the governor’s order.”

Commissioners who misunderstand the data are making our policies, academics who engage in groupthink claim to be “following the science,” and it will take years for our community to recover from the damage their policies are causing to our economy, our education system, and our mental and physical health.