It certainly seems like it, based on the statistics for Coronavirus.
As of writing, the US has had a case fatality rate of 1.7% (338k deaths/19,151k cases) compared to Qatar’s 0.17% (0.17k deaths/143k cases).
How is the virus 10 times more deadly in the US than in Qatar when the two countries have a similar number of cases per population?
Sure, Qatar has done nearly twice as many tests per population than the US, but that doesn’t account for a factor of 10.
I wonder… is it a different metric?
What did Warren Buffet say again? Something like “Show me the incentive and I will show you the outcome.” Or maybe it was Charlie Munger.
In the US, hospitals there are claims that doctors are pressured to list COVID-19 on the death certificate so that the hospital can claim a higher rebate from Medicare. These claims were predictably fact checked and debunked by USA Today, which ironically also confirmed that Medicare does indeed pay out 20% more for patients who died from COVID-19.
So the doctors’ claims that doctors would put COVID-19 on a death certificate were false, even though there is a very strong financial incentive for administrators to pressure them to do so. I’m sure doctors would speak out against pressure and fear mongering… unless they wanted to keep their jobs!
Indeed, in my experience, doctors will do the right thing as indicated by the hospital and CDC guidelines. And this may be the problem. According to one doctor,
Under the CDC guidelines, a patient who died after being hit by a bus and tested positive for coronavirus would be listed as having presumed to have died from the virus regardless of whatever damage was caused by the bus.
Source
As absurd as that sounds, that’s precisely what COVID task force member Dr Deborah Birx said back in April 2020:
if someone dies with COVID-19 we are counting that as a COVID-19 death.
Source
That’s assuming the patient had tested for COVID-19. But nobody actually has to test positive. They just have to be “likely” to have COVID-19.
In cases where a definite diagnosis of COVID–19 cannot be made, but it is suspected or likely (e.g., the circumstances are compelling within a reasonable degree of certainty), it is acceptable to report COVID–19 on a death certificate as “probable” or “presumed.”
Source: CDC Reference Guide
It is important to emphasize that Coronavirus Disease 2019 or COVID-19 should be reported on the death certificate for all decedents where the disease caused or is assumed to have caused or contributed to death.
Source: CDC Guidance for certifying COVID-19 deaths
This is a big change from the past. In the 2005 handbook
Among that handbook’s examples is a man suffering from heart disease and diabetes who dies from pneumonia. The book instructs doctors to select either heart disease or diabetes — not the infection — as the underlying cause of death.
Source
So if the above patient gets the flu, it wasn’t the flu that killed him. But there’s a good chance that he had COVID-19, which according to the guidelines, will be listed as a primary cause of death on the death certificate.
Perhaps if it were only up to doctors and coroners, even with the pressure from financially incentivized hospital administrators, the death count may not be so high. But it seems that pretty much anyone can count a death as a COVID-19 death, no matter what the coroner says, even if the man drank himself to death. Or even if he had stage four cancer and suffered a stroke and tested negative for COVID-19.
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This all gets me wondering… is the US health care system really 10 times worse than Qatar’s, or is it possible that about 10 times more deaths are being reported in the US than really should be?
Maybe, if you removed the COVID deaths numbers of people who died that
- Didn’t die of COVID
- Hadn’t tested positive for COVID
- Were going to die whether or not they got COVID
you may get a result 10 times less than 338,000 deaths. Maybe something like 34,000 deaths.
That’s just 50% higher than the 2018 murder rate.
Now that just wouldn’t be a pandemic would it?
