Is COVID-19 Why Florida Has About 1300 More Pneumonia Deaths This Season Than Average Over Previous Five?

Earlier today, I saw this tweet that suggests a huge excess of pneumonia deaths in Florida this year compared to previous years. The data in the tweet suggested that Florida has around 4000 more pneumonia deaths this year than the average for the previous five years. That sounded a little high to me, as I have spent a lot of time over the past few months poring through the data at this CDC site on weekly numbers for pneumonia and influenza deaths. Looking deeper into the tweet, it appeared to depend on a reddit post and it had a low number for Florida reported COVID-19 deaths, so it was necessary to go back to original sources.

A couple of weeks ago, I spent several hours downloading data from the CDC national database you can access at the link above and picking out just the Florida data to paste into another spreadsheet. I chose a poor strategy that day, as I only looked at the total pneumonia and influenza deaths even though the data are broken down into both categories. I few days later, I realized that I needed to go back into the data and look only at pneumonia deaths, as it seems likely that there could be quite a few deaths attributed to pneumonia in patients who were never tested for COVID-19. Also, flu deaths vary widely from year to year depending on the severity of the outbreaks and the effectiveness of that year’s vaccine, so that total number has a lot of noise year to year. Seeing the tweet today prompted me to go back and download the data again so that the 2019-2020 data would be more up to date.

As downloaded today, there are data in the spreadsheet through week number 20 for each state. For Florida, the week 20 numbers appear to be only partial totals, so for this analysis, I only went through week 19 of 2020. Each season in the data begins with week 40 of the year (so this year’s data starts at week 40 of 2019). However, since the COVID-19 outbreak is generally considered to have started in earnest in mid- to late November of 2019, I included only the last four weeks of 2019 with the first 19 weeks of 2020. I then found the totals for the same time period in each of the five previous seasons.

The totals for pneumonia deaths are:

2014-2015                 5510

2015-2016                 5214

2016-2017                 5540

2017-2018                 5792

2018-2019                 5374

2019-2020                 6772

One of these things is not like the others. The average total for the previous five years is 5486 pneumonia deaths for weeks 49 through week 19 of each season. That means that 2019-2020 has 1286 more deaths from pneumonia than the average for that period in the previous five seasons. The Florida COVID-19 dashboard right now is showing 2319 deaths from the virus. I would suggest that number is more like 3605 when the excess pneumonia deaths are included. Note also that there may well be other deaths due to the virus in patients who were not tested but died due to the other types of pathology seen by the virus that don’t manifest directly as pneumonia.

Last week, I asked how many COVID-19 deaths Ron DeSantis is hiding. We can now account for about 1300 and it seems likely there may well be more.

 

 

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50 replies
  1. John Paul Jones says:

    Great detective work. It seems clear there are excess pneumonia deaths this year.

    But the reporting issue seems less clear. I mean, I can understand why the politicians want to mis-report and under-report. But what of the doctors? Are the politicos giving instructions to the docs along the lines of – you are not allowed to test for the presence of the virus when you have a pneumonia death and no antecedent test results? I can certainly see this being ordered; but do the doctors have to follow such instructions? How independent are they?

    • readerOfTeaLeaves says:

      From my conversations, it seems that docs are really hampered by a number of factors:
      — what health insurance will cover, often different for each patient they see in a day
      — availability of tests
      — accuracy of tests (the current test in my area appears to be giving about 30% false negatives, so lots of confusion)

      In my area, the public health folks seem to be quite respected. But no doc that I am acquainted with is going to buckle to a politician, and if they did and the State Medical Board caught wind of it, they’d quite likely have their license pulled. Any politician dumb enough to try and tell docs what they can, or can’t, report is… well, probably named Donald Trump. Anyone else is going to be a total laughingstock and the docs are going to be colossally insulted and pissed at the very idea that anyone is going to screw with the data they report. The doctors that I’ve spoken with view data as kind of a life-or-death matter; false reporting would be viewed with such scorn and contempt… it simply wouldn’t make sense.

      People don’t go to the expense and commitment of medical school to lie on behalf of some asshat politician. Given their constraints and pressures, that just doesn’t make sense.

      • Manny says:

        I know in a lot of states, where the person dies has a lot to do with how it’s reported. If you die in a nursing home, or anywhere outside of a hospital the coroner determines cause of death. If you die in a hospital, doctors determine it. Some coroners are elected or appointed and don’t have medical or pathology degrees,

    • tim stephens says:

      Look at the NY numbers for pnuemonia if you really want to be concerned. And Michigan. This is not just a FL issue.

  2. Sonso says:

    Shortages of testing supplies, overworked ICUs, co-morbidities, professional ignorance…any of these are potential explanations why a death certificate would be issued without ordering an autopsy or coronavirus test. DeSantis would just be taking advantage of the general level of ignorance in the Environment of entropy.

  3. Jharp says:

    It’s times like this that I really wish there was a hell.

    Because that is exactly where that miserable lying piece of shit Governor belongs.

  4. Rugger9 says:

    It also undercounts the snowbirds and spring breakers that went home and died there, but the reasoning is sound enough to consider this the floor. Let’s also remember that in order to own the libs the governors of FL and GA deliberately hid their data, sometimes in risible ways, so at least double this is a more likely “true” number.

  5. Ed Walker says:

    I’ve been reading this CDC site: https://www.cdc.gov/nchs/nvss/vsrr/covid19/index.htm which is titled Excess Deaths Associated with COVID-19. Table 1 shows information about all deaths in the US through May 27, but clearly the last two and maybe three weeks are incomplete. Including them gives an understatement of the excess deaths through the end period. Data through May 2 and possibly May 9 might be reasonably complete. Here’s the disclaimer from the CDC:

    It is important to note that it can take several weeks for death records to be submitted to National Center for Health Statistics (NCHS), processed, coded, and tabulated. Therefore, the data shown on this page may be incomplete, and will likely not include all deaths that occurred during a given time period, especially for the more recent time periods.

    If you read down the deaths from pneumonia column, it seems steady at about 3800 or so through the Mid-March, then jumps up to around 11K in mid-April before dropping again. That makes me wonder if there was a change in the way people dealt with pneumonia as a cause of death. Maybe not so much in Florida?

    Personal disclaimer: epidemiological work is way above my pay grade.

  6. Godfree Roberts says:

    Perhaps Florida got off to an early start?

    Coronavirus was in Florida before we knew it: A Miami Herald analysis shows state health officials have documented at least 170 COVID-19 patients reporting symptoms between Dec. 31, 2019, and Feb. 29. https://www.tampabay.com/news/health/2020/05/05/coranavirus-was-in-florida-before-we-knew-it/

    Florida coronavirus: Up to 171 cases detected in Jan. & Feb., health officials say
    TAMPA, Fla. (WFLA) – As many as 171 people in Florida may have been infected with COVID-19 months before officials said the virus was in the state, data shows. Records show that symptoms of coronavirus were reported to the state’s Department of Health as early as Jan. 1 – exactly two months before Gov. Ron DeSantis announced that the first two cases had been confirmed. According to state data, which was changed Monday to remove the date of symptoms reported, 171 people reporting symptoms in 40 counties across the state eventually tested positive for coronavirus.Those reporting early symptoms ranged in age from 4 to 91 years old.https://www.wfla.com/community/health/coronavirus/florida-coronavirus-up-to-171-cases-detected-in-jan-feb-health-officials-say/

  7. JohnH says:

    My daughter’s company is based in Texas but has a condo/office in Florida. The owner’s brother died from Covid-19 two months ago while working in Florida. Shortly after his death, she asked me if he was a resident of Florida or Texas. She stated Florida was demanding to know. We were thinking this is a possible tax question?. I am a CPA but I had no idea why Florida was asking this. Later, I learned that Florida only count residents Covid-19 deaths. No idea if this is how other states report Covid-19 deaths or not. Seems to be a possible reporting black hole.

    PS Bmaz and everyone — thanks for keeping trolls off of here.

    • P J Evans says:

      It’s Florida pretending they have fewer deaths than they really have. Remember, DeSantis didn’t want non-Florida cruise passengers in his state, so they wouldn’t counted.

      • readerOfTeaLeaves says:

        Well, there seem to be some fairly big questions about the role of Vitamin D and immunity. Orlando’s latitude is 28.5. Up here in the Seattle region, I’m at about 47 degrees, and it was a long, wet cold winter here so plenty of time for coronavirus to spread in the gloom of a rainy winter.

        But I think that Jim is very smart to be looking at pneumonia stats — between poor testing and false test results, a lot of cases have been missed, which impacts health policies.

        Sadly, I have a friend with (verrrry early) dementia, and last fall, I was trying to get her moving more. I went to her care facility once each week, hoping to help with balance and muscle tone. Unfortunately the residents on her floor were not capable even of that kind of movement. Consequently, I ended up doing ‘deep breathing’ exercises with several groups of residents — if you don’t go into these facilities often, you don’t realize how many people have very shallow breathing, and extremely limited mobility — they don’t move air through their lungs much, and move minimally though the day. It doesn’t take much to put them at tremendous risk.

        I was shocked at how much of a difference I could make simply getting the residents to do very simple, slow breathing movements with very simple spinal rotations. (Being memory care patients, they needed to be guided through longer breathing activities… which underscores that I think Jim is smart to look at data for pneumonia.)

        Sadly, I simply found it a totally depressing experience, so I begged off further sessions by Thanksgiving. (FWIW, this was in a verrrrry well run facility with plenty of staff, so it was ‘the best of all possible worlds’ in terms of senior care facilities. It’s typical: sign-in, wear a badge, you must be authorized to enter a floor, the building is secure: cameras everywhere.)

        Once the news about coronavirus started as a mumble in late January, it was clear that all the people in those senior facilities are essentially ‘sitting ducks’ for anything respiratory, because they are already so impaired. So for Jim to track pneumonia deaths makes sense. For the state of Florida to fail to include them is baffling.

        In Florida, maybe someone is wheeling the residents out to get sun, but I’m sure the shallow breathing and mobility issues still contribute to poor outcomes. Given those factors, I’d expect quite a few pneumonia cases, particularly this year.

        (And I hope everyone here took a brisk walk today!)

        • Rayne says:

          Please don’t push a therapy if you have no studies to support them. The Chinese did a study and found that infection rates didn’t decline with increase in UV using increasing length of daylight and satellite measurements of UV. Now I have to dig through comments and posts here because I know I shared this. Could we use more studies about UV’s affect? Sure, but let’s see the data before we encourage people to increases their risks like skin cancer.

          We’ve also had community members from warm and sunny locations who’ve told us neither sun nor heat nor humidity are significant deterrents to the spread of SARS-CoV-2.

        • P J Evans says:

          L.A. has been hot this week – 35C – and summer is also high UV most days (10+). But we have the virus around, still.

        • Eureka says:

          I have some literature that may be of interest, but first have to make a general note that, due to a host of factors, vitamin D level does not necessarily correlate with latitude, and can in fact oppose it (in fact, the finding of one of the papers below: Vit D levels correlated with COVID death rates in European countries, but not with latitude — perhaps due in part to variability in fortification policies and other aspects of diet, etc.).

          Latitude is a rough proxy for things like vitamin D levels and solar radiation, with lots of seemingly paradoxical, biological, and cultural effects with the former, and additional ecogeographic variability in the latter, too. You’ll have two countries at similar latitudes with divergent vitamin D levels in their populations, etc.

          So while it might be a quick way to start with a proxy analysis of a group of locations, it’s generally not meaningful to throw down a couple of locales with divergent latitudes (or sames) and get the contrast one might expect, outside of context or a larger analysis (i.e. statistical effects would be borne by entire latitude bands, with corrections for reduced effects in the Southern Hemisphere). And for public health purposes, a local (sub)population’s vitamin D level would be an empirical question, as would be any given individual’s).

          When talking about vitamin D status, UV radiation, latitude, and so forth, it can be very easy to unwittingly bundle several separate hypotheses in a single statement.

          OK, the links. So this has been a hot topic among Irish researchers and public health experts especially over the last couple of months, with some recommending mass supplementation and others arguing for caution, debates over amounts, etc.

          The May issue of the Irish Medical Journal has a ‘Vitamin D Debate’ section with several papers and replies on the topic of Vitamin D and COVID-19 (plus a smattering of other papers outside that section):

          Irish Medical Journal – May 2020 Vol. 113 No. 5 – Irish Medical Journal
          http://imj.ie/irish-medical-journal-may-2020-vol-113-no-5/

          You’ll need to get three April papers that kicked off the above section; this item from the section above will lead to the three from April:

          Covid-19 Cocooning and Vitamin D Intake Requirements – Irish Medical Journal
          http://imj.ie/covid-19-cocooning-and-vitamin-d-intake-requirements/

        • Eureka says:

          This is the paper re correlation between Euro populations’ Vit D status and their COVID death rates. I’ll just add that this type of gross analysis with data pulled from lit review, with a gentle but significant correlation, is pretty typical looking for this type of research. Something like this would fuel more refined study and be considered within the body of findings on vitamin D status and immunity and other aspects of nutritional status generally, besides other data as they relate to COVID-19. i.e. I’m not all excited that it’s not more dramatic, nor that the relationship exists (as I would expect, at least at the poles of blood level):

          Vitamin D and Inflammation – Potential Implications for Severity of Covid-19 – Irish Medical Journal
          http://imj.ie/vitamin-d-and-inflammation-potential-implications-for-severity-of-covid-19/


          Here’s a separate review from a mainly in vitro perspective (US VA-affiliated, IIRC) from March 2020 in J Clin Virol:

          Vitamin D and the anti-viral state
          https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3308600/


          NB: Providing literature, not specific endorsement or advice.

        • BeingThere says:

          That report in the Irish Medical Journal pinged a few observations a week ago (seems like both forever ago and yesterday.)

          Some years ago an older family member in northern British Isles after suffering a fracture was advised by doc to up intake of both calcium and vitamin D intake – vitamin D apparently being essential in the pathway between absorbing calcium and laying down in bones. This was noted by the doc as many older people are less active outdoors, bundled up more from cold too also cutting sunlight (not that there is much/any UV up there), and may be less tolerant to dairy with age (less everyday dietary calcium). Those compound to poorer bone density with risk of osteoporosis. The vitamin-D intake being advised to help retain absorbed calcium and lay down into bone mass. Our sunshine exposure (balanced with family instances of skin cancer) and calcium (milk & cheese) + vitamin D intake has been ongoing discussion since then. Family member in this case I know is out enjoying the sunshine digging & planting veg garden, and not so enjoying the sunshine from constant watering of baby veg plants!

          This Irish Medical journal report noted “strongly correlated” COVID-19 symptoms and vitamin-D levels does beg a question: do long-time residents of care homes lead to an _additional_ susceptibility if spending much time indoors? (this would need data – one would expect vitamin supplements would be taken in good care environment). And those teens/adults who play video-games 24/7 indoors…keep up the herring & cheese pizza!

          It also makes wonder for those working long hours in long rotating shifts indoors in places like meat processing plants – night shift sleeping daytime. Also prisons. Also medical staff working rotations in hospitals right now. The value of being able to look into these corners would be so useful now while we’re all dealing with the virus, than later as a retrospective, which means encouraging data collection and publication wherever possible.

          Edit: link to National Osteoporosis Foundation re vitamin D intake necessity https://www.nof.org/patients/treatment/calciumvitamin-d/

        • Eureka says:

          Just want to keep this straight, because I think we are talking about different papers, when you say:

          This Irish Medical journal report noted “strongly correlated” COVID-19 symptoms and vitamin-D levels…

          That’s NOT noted in the paper I linked above [they don’t even given the Spearman coefficient as far as I can see, just the P value (i.e. that it is a significant relationship with _death rates_ by conventional standards)]. Also, it’s a small sample — so with that shape, it could create a higher correlation coefficient, ‘paradoxically’ than might a larger sample of the same shape. By my eyeballs, it’s fair (if perhaps conservative) to call that scatterplot ‘gentle.’

          Now, there is a separate unpublished preprint out of Northwestern, where the pre-press is calling vit d status “strongly correlated” with (various metrics of) cytokine storm.

          Pre-press e.g.:

          Vitamin D levels appear to play role in COVID-19 mortality rates: Patients with severe deficiency are twice as likely to experience major complications
          https: //www.sciencedaily.com/releases/2020/05/200507121353.htm

          Or a write up like this, which talks about both studies and quotes authors of the IMJ article (again, they measured death rates, even if theoretical basis/supposition relates to COVID-19 symptoms) :

          Coronavirus: Adults should take vitamin D, researchers say
          https://www.irishtimes.com/news/health/coronavirus-adults-should-take-vitamin-d-researchers-say-1.4250588

          That Northwestern US preprint [I see they’ve removed “Possible” from the title]:

          The Role of Vitamin D in Suppressing Cytokine Storm in COVID-19 Patients and Associated Mortality – 2020.04.08.20058578.full.pdf
          https://www.medrxiv.org/content/medrxiv/early/2020/04/10/2020.04.08.20058578.full.pdf?mod=article_inline

          That said, I certainly agree in spirit with your comment about the value of getting on these studies now, their potential benefits, and the likelihood that vit D status would be important at least at some levels and in some part.

          We here are keeping track of our vitamin D; it was one of the first things I suggested people look into with their doctors during the ‘planning ahead’ stage before COVID escalated in the US. No panacea, and certainly no substitute for all of the standard advice, but per these and other studies may shake out benefits at the population level.

        • Eureka says:

          Note, this clarification is mainly for the benefit of anyone walking in and reading this thread; Rayne especially has set a standard of trying to be careful when discussing research like this as it relates to COVID, particularly when it is first introduced in comments here.

        • Rayne says:

          I’m going to insert a caveat here for readers with regard to vitamin D.

          Vitamin D is fat soluble. This means it bio-accumulates in fatty tissues. Because it accumulates in one’s fat cells, excess vitamin D is not flushed out of the body. Excess vitamin D can result in too much calcium in the blood and negatively affect the kidneys.

          People who want their body to be better prepared to fend off COVID-19 or its inflammatory affects may consider a multivitamin with 100% RDA of vitamin D as well as vitamins A and K — and no more than that one dose of 100% RDA per day — to avoid vitamin D toxicity and improve their body’s ability to use D.

          Vitamins A and K are both necessary for D to be converted from its form stored in fat cells. Both are fat soluble. Again, a multivitamin with 100% RDA is the maximum one should ingest as a supplement without a doctor’s instructions.

          Vitamin K also poses problems to persons on blood thinners like warfarin.

          Because of risks like that vitamin K poses to specific groups of people, it’s best to check with your doctor first before taking a supplement in case any pre-existing health condition or medication may pose a risk of negative reaction.

          The safest way to acquire these vitamins is through diet — and again, some persons may have restrictions on intake. While vitamin K can be found in dark, leafy green vegetables, persons on blood thinning agents may not be able to consume them.

          I’m not a health care professional — check with your health care provider about vitamin supplementation.

        • Eureka says:

          Thanks for that addition, Rayne.

          I’d also wanted to elevate from subtlety a couple of points from the thread above, especially if people don’t read the (attached) literature:

          In general, the evidence in these types of studies is strongest at the poles or extremes: it’s fair to say that _deficiency_ (~ and insufficiency) states of Vit D consistently make a(n adverse) difference in various disease outcomes. We know much less about the relationships within the normal ranges.

          That is one reason I raise talking with one’s doctor/hc prof for further opinion/testing as needed.

  8. mgallopavo says:

    I think ‘excess death’ analyses should be placed in close proximity to any Covid-19 death count reports. They provide a nice counterpoint, albeit at lagged times: instances of death eventually show up to be counted, accurate causes are a different matter entirely. Florida is certainly not alone in the Covid-19 versus ‘excess deaths’ discrepancy. I have seen 20% to 50% as a likely range of overall Covid-19 death undercount. I see that CDC is not only putting out the data but even providing analyses. [See https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm which is within the page Ed Walker pointed to above and offers a national graphic with state as a drill down. The Farrington model is decent. Modelers are known to quibble over every structure and parameter because our lives are so….] Note the agency is not making any visible summary assessments of those analyses. Hmmm.

    On a TMI note…
    There are legitimate and long-standing issues in cause-of-death discussions that involve primary, and secondary or contributing causes as well as more theoretical questions of necessity versus sufficiency. These manifest themselves in a Wild West of death certificate data, where personal physician interpretation is very much in play. If you are interested, the link below goes to death certificate reporting instructions provided by CDC.
    [ https://www.cdc.gov/nchs/data/dvs/blue_form.pdf ]
    Let’s just say that the forms are rarely filled out with the attention to detail provided in the examples. In the world of many competing risks=>causes at play among the very old, a convenient pick from within a diverse set is probably the norm. Among the aged, pneumonia is often convenient.

    Apologies if I have not used my original screen name. It has been a couple years since I posted.

    • P J Evans says:

      I could cite my mother’s death cert – officially she died of pneumonia, and it may well be true. But she’d been getting treated for stage-4 colon cancer – earlier scans hadn’t picked up anything – and the side effects were bad enough that she stopped chemo, didn’t pull out of the side-effects, and because she couldn’t get up and move around, she got blood clots that didn’t clear, then organs started to shut down. So, pneumonia. Officially. (I sat with her for an hour or so the night before she died, and she was having trouble breathing.)

      • Diana Demarest says:

        I’m so very sorry PJ. My Mom died in my house of colon cancer. It’s a painful thing to witness.

        I’m in Palm Beach County in South Florida (a scant 22 miles from trumplandia). I’ve been saying from the beginning that DeSantis was cooking the books on the data. I’ve been tracking their numbers since April and they never made any sense to me. Marcy’s post makes the picture a lot clearer.

        DeSantis is nothing more than a trump mini-me. He doesn’t take a piss without the orange menace’s approval. If you saw DeSantis’ campaign ad, it would show you what we’re dealing with down here. It’s nauseating.

    • Ed Walker says:

      I found that part hard to grasp. To see the current estimate of excess mortality you have to use your cursor over the spikes above the blue line, which I think is the threshold level for determining excess mortality. There is no total figure, possibly because the lag time for reporting on this graph is given as 8-10 weeks.

  9. fishmanxxx says:

    You would expect , with the added vigilance and precautions that some of the public will have taken, that “normally occurring” influenza related illnesses or deaths would have actually deceased. So, in my opinion, the truth is likely statistically worse?

    • Jim White says:

      Yes, I’ve spent a lot of time thinking about that and looking to see if flu deaths are down. But as I pointed out in the post, year to year variation in flu cases and flu deaths is so large that it’s not really possible to tell if something like that went on.

      • readerOfTeaLeaves says:

        This might sound completely off-the-wall to you, and I’m reluctant to post it b/c some wackadoodle Uber-conservative might *misread* this, but in Jan-Feb, I filled in quite a bit for a two younger folks who had a horrible congestion that they were unable to shake; they had weeks and weeks of respiratory infection, and one was diagnosed with walking pneumonia.

        Anyway, in my state, pot is legal.
        Draw your own conclusions.
        Including, that rOTL doesn’t smoke weed as a general rule. Alas ;^)

      • Eureka says:

        Happy Atlantic Hurricane Season, by the by (no need to wait for June 1st; the storms don’t anymore lately).

        I see your rationale for dumping flu, making your FL undercount ~cleaner/conservative, but Inquirer reporters made use of it in a different way.

        In their analyses of NJ and PA death undercounts (PA just for April +/-), the Inquirer included space in some for the 2020 Pneumonia/Flu trend remaining down by 15% versus prior years, as it had been through the first week of February (before rising, and doing so ‘out of shape’). Interesting graphics and approach. Since the down-trend even preceded general awareness of COVID/significant social measures, I would anticipate that trend would be additive to what fishmanxx noted — so doubly subtractive from expected death totals, leaving more deaths likely attributable to COVID. Except that second part can’t really be measured, as you note.

        NJ 2020 COVID deaths way undercounted, possibly by 32%; PA remains significantly behind on death certificates (missing tons from January to late March*, plus other missing-data issues), so only 9% April undercount (by their methods) may change, besides whatever comes from an analysis of the whole period when more data are in.

        And these are states that are not trying to be dishonest. I can only imagine what else you’ll find in Florida.

        Pa. and N.J death counts from coronavirus are likely too low
        https://www.inquirer.com/health/coronavirus/pennsylvania-new-jersey-virus-death-undercount-statistics-20200526.html

        *e.g. at CDC page Ed linked, it looks like an oddly-palated Cookie Monster chomped into most of PA’s first quarter deaths; they later required that funeral homes submit death certs electronically, that helped starting in late March.

  10. CFL says:

    Hi Jim, I believe you are misinterpreting the CDC data; it should include confirmed COVID-19 cases if they are coded as having COVID-19 associated pneumonia (or indeed, COVID-19 infections with co-morbid but unassociated pneumonia).

    In its weekly flu surveillance reports, Florida has provided a breakout of pneumonia cases other than those associated with COVID-19. I’ve downloaded the CDC data and played around with it a bit, and it looks identical to Fig. 4 in the most recent weekly flu report, except for the spike that you observed, which first appeared in about mid-March. http://www.floridahealth.gov/diseases-and-conditions/influenza/_documents/2020-w20-flu-review.pdf

    This indicates that the vast majority of the observed spike in CDC data is indeed due to cases coded as confirmed COVID-19 infections. However, these would be included in Florida’s current dashboard totals, and eyeballing the differences, they do not seem to add up to more than the death totals Florida is currently reporting. There is a small uptick in excess pneumonia mortality since mid-march, but it is only in the range of 250 or so cases, which isn’t a huge departure from seasonally expected variation, and well within the plausible range of an increase in people dying from other types of pneumonia because they delayed or avoided seeking medical attention out of fear of catching coronavirus (or not being able to afford treatment, etc.)

    Personally, I think DeSantis has a lot of levers with which to grossly manipulate state data, but this is probably a less viable one. Florida’s infectious disease reporting system is partially automated and collection is decently well dispersed, with data coming in from a whole lot of local health departments, laboratories, etc. It would require a lot of people in the fact- and reality-based community to be forced to lie simultaneously.

  11. skua says:

    From NYC news reports, COVID-19 increased fatal heart attacks a lot.
    Suggesting that some FL COVID-19 deaths will have been mis-counted as non-COVID heart attacks.

  12. Raven Eye says:

    And once again, we find some politicians shrinking from testing, and some making sure that testing resources remained scarce and protocols remain, at best, nascent.

    In a better (not necessarily “perfect”) world anyone who has died since December, 2019 of some medical condition would be tested for COVID-19. And that might not really be needed if testing was done with enough controls to produce statistically significant results.

    Knowledge is power, and there are a bunch of people who are afraid of that.

    • madwand says:

      While I believe knowledge is power just like you, Republicans are demonstrating power is power and rewriting the narratives. Right now we are hoping to win in November, but what if we don’t? What then, who’s thinking beyond November if the worst case scenario, Trump wins or loses and refuses to vacate, happens.

  13. e.a.f. says:

    Interesting read. given the high number of people from Quebec and Ontario who go to Florida each year, wonder how many of them came back and died. I do know they have a higher rate of deaths due to covid than other provinces. Part of that is due to the high death rates in care homes but those figures are out there, so the number who died from other related diseases would be fairly easy to access. Certainly the C.B.C. Canadian Broadcasting Corporation will have a lot of the figures because they have the press conferances each premier and the P.M. give each day.

    • posaune says:

      Feels like we have become the old CCCP when people tried to read Brezhnev tea leaves to guess what was really happening.

  14. Tom says:

    The President’s “Transition to Greatness” is looking more and more like “The Charge of the Trump Brigade”.

    “Forward the Trump Brigade!
    Open the country!” he said:
    Into the Valley of Death
    Rode the states fifty.

    Virus to right of them,
    Virus to left of them,
    Virus in front of them,
    In aerosol droplets sprayed.

    “Forward the Trump Brigade!”
    Was there a man dismay’d?
    Not tho’ the doctors knew
    Some one had blunder’d.

    With apologies to Lord Tennyson

  15. Vicks says:

    It looks like there are number of ways to manipulate the data and I think “we the people” need to demand audits of these counts.
    Colorado is reported to have a case where the country coroner ruled the cause of death “ethanol toxicity” after lab work showed levels substantially over what is lethal. The man also tested positive for Covid-19
    At the time there were 2 Covid deaths in the county so when the state department of health website started showing 3 deaths from the virus it was clear the department of health had disregarded what was written on the man’s death certificate.
    I’m not taking a side on this one, just giving a believable example of a state (more than likely) overriding (A hard to argue with) coroner’s scientific conclusIon on a cause of death.
    This example was easy to spot because of the few cases in that particular county, but in reality getting the numbers will be difficult because even if death certificates are public records they do not disclose cause of death.
    Unlike Colorado’s coroners, Florida’s medical examiners aren’t elected officials; and from what I understand they all are physicians, one would hope that both of those facts would minimize the temptation for these doctors to allow politics to influence what they state is the cause of death on a death certificate.
    I think it will take a whistle-blower or someone following up with enough families of the deceased to get a sense of how the examiners were classifying the deaths, If the state was re-classifying, or if the final entries were simply being manufactured and actual data disregarded.

  16. Summertime Blues says:

    It’s clear that there is an effort underway to understate the prevalence of COVID-19 in both the nationally and selected states through low rates of testing, combining viral and antibody testing, and manipulation of data. While pneumonia is associated with COVID-19 silent hypoxemia is also one of the disease processes. Individuals can be lucid and responsive with profoundly low oxygen levels, and deteriorate quickly. Underlying co-morbidities such as heart disease and renal disease can be exacerbated as a result. There are also reports of blood clotting disorders. Individuals dying at home and untested will result in under-reporting, as happened in New York.

    https://www.cdc.gov/mmwr/volumes/69/wr/mm6919e5.htm?s_cid=mm6919e5_w

    As a result it will be difficult to fully understand the extent of infection and the scope of infection. Sadly, the increase of patients in hospitals, and in ICU’s may be the most reliable marker of an individual states success or failure in mitigating infection rates and the accuracy of reporting.

  17. Pete T says:

    I dunno if the approach Dr John Cooper did for the UK would or could apply here, but essentially he took the prior five year average of all deaths reported versus current year for same time period COVID-19 has been in play. The difference between the prior 5 year average of all deaths and the current year for the same time period total deaths was noted.

    Granted, lock down maybe decreased the number of vehicular deaths, murders, perhaps suicides, drownings, etc.

    So, the difference from above may not be all COVID.

  18. Bevel says:

    Does anyone know why the pneumonia numbers were separated out from the flu numbers on the CDC site for Florida? I had been following the numbers when they spiked at the end of April. Afterwards, I could only find the flu numbers. I also wonder if there are cardiovascular and vascular deaths that were COVID19 related but were reported as the prior two. Is there a way to find these causes of deaths?

  19. chrisb says:

    Interestingly, a friend of mine currently has pneumonia, and just had a CT scan of his lungs last week. His wife tested positive for COVID-19 in Orange county, but he’s tested negative twice. Perhaps he had COVID-19 and cleared that infection but got pneumonia as a direct result, and is still fighting that, one can only speculate. There’s definitely more going on with these numbers than meets the eye.

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