Keep in your dead! The true toll of COVID-19 is being undercounted, including in New York

Sky News Australia / YouTube More than 600 COVID 19 deaths 1586278356.jpg...
Sky News Australia / YouTube

When Donald Trump said that the United States had “15 soon to be down close to zero” cases of COVID-19, the actual confirmed count was over 60. Early in the pandemic, on Feb. 12, China suddenly reported over 15,000 new cases as it acknowledged that its testing had fallen behind the actual number of cases. Just five days ago, numbers for France took a sudden lurch as thousands of cases and deaths that had occurred in nursing homes were at last added to official totals that had been until then limited to those who were tested, or died, in hospitals.

From the beginning, there has been an urge to undercount what’s happening with COVID-19. In some cases, that may be trying to paint the official response in a better light. In others, it may be confusion over how to handle an event that’s overwhelming state or local officials. And in the end it may be a simple inability to acknowledge the genuine scale of the disaster.

In any case, there are reasons to believe the actual number of COVID-19 deaths in New York is much higher than the official number.

As The Wall Street Journal reported last week, Italy appears to be drastically, and intentionally, underreporting deaths due to COVID-19. As with France, deaths in nursing homes are largely being ignored, as are deaths that happen at home, and even deaths that happen in the hospital may be left off the tab because no one is taking the time to test someone if they died before being confirmed as a novel coronavirus patient. The Journal indicated that the undercount in Italy was in the thousands of deaths. And it warned that “Italy’s hidden death toll shows what could lie in store for the worst-hit areas of the U.S.”

That one week in the past prophecy is now being confirmed by Gothamist, which reported a staggering 10-fold increase in the number of New Yorkers dying in their own homes since New York City became America’s viral hot spot. Where on an ordinary day 20 to 25 residents might be expected to die in their own homes, that number is now in excess of 200.

Many of those dying at home are dying for the same reason that another 600 New Yorkers died on Monday: COVID-19. They were either unable to reach a hospital, or overtaken by the disease so rapidly that, like in many reported cases, they progressed from flu-like symptoms to acute respiratory distress within hours. But there is another reason that bodies are being removed from New York homes and apartments at an unprecedented clip.

Last week, paramedics in New York were told to stop bringing in heart attack patients who could not be revived at the scene. The results are so striking that on Monday The New York Times asked “Where have all the heart attacks gone?” The decrease in the number of heart patients was so striking that some hospitals were not at capacity despite the influx of COVID-19 patients. Those people with heart attacks, strokes, and other critical events aren’t going to hospitals. They’re not going anywhere.

The same thing has happened in Spain, Italy, France, China … everywhere that nations have become heavily engaged in combating the rapidly spreading COVID-19 infection. It’s not only those infected with the novel coronavirus who suffer. It’s thousands—tens of thousands—of others. And it’s not only that these people wouldn’t have died at home. It’s that they would not have died. Heart attack counts in hospitals have crashed. Heart attack deaths have spiked.

Just as much as those who died intubated in an ICU, those who died from a potentially treatable heart attack, stroke, or accident are also victims of this pandemic. However, they are unlikely to ever appear in the numbers when the ravages of COVID-19 are finally tallied. Even so, thousands of those who have died at home, and are still dying at home, appear to be direct victims of COVID-19. Those numbers should definitely be added—though the 45% positive rate of testing in New York at the moment makes it painfully clear that the test capacity isn’t even there to handle those who are making it to hospitals.

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