How many Angelenos are really dying, at this point?
On Monday, the Los Angeles County Department of Public Health sent out a news release announcing that there were “41 new deaths due to COVID-19 in Los Angeles County since Saturday.”
However, two weeks earlier, speaking at an internal town hall meeting for employees of LAC+USC Medical Center, epidemiologist Dr. Paul Holtom stated emphatically that there was “nobody” in the hospital with severe COVID-19 disease.
“If the experience of our hospital is reflective of [hospitals] across the county as I believe it is,” Dr. Holtom said, “we're just seeing nobody with severe COVID disease. As of this morning, we had no one in the hospital who had pulmonary disease due to COVID. Nobody in the hospital. We have 24 people who tested positive for (coronaviurs) but nobody, nobody who had COVID-19 disease as we would see in the past.”
How is it possible that there were 41 deaths “due to COVID-19” in L.A. County reported from Saturday to Monday when “nobody” was in the hospital with severe COVID-19 disease two weeks ago?
The Southern California News Group editorial board reached out to the L.A. County Public Health Department to get answers to these questions: What original source material substantiates the statement that there have been “41 new deaths due to COVID-19” in the last three days, how are you defining “due to,” and how does this information square with the recent statements by LAC+USC Medical Center CMO Dr. Brad Spellberg and epidemiologist Dr. Paul Holtom that there was “nobody” in the hospital with severe COVID-19 disease?
Here is the answer we received:
“First, just to clarify, the 41 deaths refer to deaths that had been reported over the past 3 days, not deaths that had occurred over the past 3 days. Although most deaths are reported to our Department within a week of the death, some have longer report delays of weeks to months. For this reason, we report out the most current death numbers by date of report, not date of death. However, if you are interested in the death numbers by date of death, this information is available on our COVID data dashboard. Please note, though, that the daily death numbers on this site for recent days will be falsely low because some of the recent deaths have not yet been reported to us.
“Regarding how we define `due to', it is based on guidelines established by the Council of State and Territorial Epidemiologists (CSTE) and information collected from multiple sources, including death report forms from health care providers, death certificates, coroner reports, medical record reviews, case interviews, and outbreak records.
“The recent statements by Drs. Spellberg and Holtom may reflect the experience at their hospital but do not represent the experiences at all hospitals across the county.”
Thank you to the L.A. County Public Health Department for responding, but this answer is not credible. If dozens of close-to-death-from-COVID-19 patients were arriving at area hospitals, Dr. Holtom, an epidemiologist, would certainly have known about it. Where is the evidence that the 41 reported deaths were “due to” COVID-19 if the now-deceased were not diagnosed or hospitalized with it?
That brings us to the definition of “due to,” which in plain English means “caused by.” To use that phrase in a news release misleads the public, perhaps intentionally, if the meaning of “due to” is anything other than “caused by.”
In fact, “due to” is not a phrase that appears in the cited guidelines established by the Council of State and Territorial Epidemiologists, which is a non-governmental, nonprofit organization. The guidelines document, dated Dec. 22, 2021, is titled “Interim Guidance for Public Health Surveillance Programs for Classification of COVID-19-associated Deaths among COVID-19 Cases.”
“Associated” deaths, according to the CSTE, include deaths from any cause as long as there is some connection to COVID, even if it's just a positive PCR test or “epidemiologic linkage” with “clinical criteria,” such as fatigue and a runny nose.
Public Health Director Barbara Ferrer should explain specifically what “information collected from multiple sources” justifies describing each of the deaths she announces as “due to” COVID-19 in her department's near-daily news releases.
Better yet, the Board of Supervisors should start planning her retirement party. I'll buy the cake.