The COVID-19 case counts, hospitalization numbers, and death counts are meaningless in their current form of fluid morphability. The malleability serves mainly those who seek to manipulate reality. The numbers are reported then manipulated by federal, state, county, city, and hospital authorities and agencies to name a few. The manipulation is driven by power and money and fueled by fear mongering, panic stoking, and promise of monetary and political gain. All this is bought and paid for under the guise of trying to save the world from the COVID-19 pandemic. We must ask the appropriate questions and demand answers, which must then be verified. We must answer the question, what happened June 14-16, because something did when you look at the stats. (Did redefining what constitutes a COVID-19 case, hospitalization, or death change the numbers? Did federal financial aid to hospitals change admitting thresholds and practices? Did the FDA withdrawing its Emergency Use Authorization (EUA) for Hydroxychloroquine (HCQ) alter outpatient treatment resulting in COVID-surging? Was it the Riots? Or what?
Let’s look at the numbers.
The Council of State and Territorial Epidemiologists. (CSTE) adopted new definitions of COVID-19 cases and COVID-related deaths in April that were adopted by the Centers for Disease Control and Prevention (CDC) in May. The states were then encouraged to adopt the new definitions. The Texas Department of State Health Services (DSHS) adopted the new definitions on May 11. When were they put into effect? Which states adopted the new definitions? This makes a huge difference in the counting of New COVID-19 Cases and deaths. The May 18, 2020 Collin County Commisioners meeting is one of the best discussions of the definitions of counting I have encountered. Listen from the 15:27 to the 59 minute mark for yourself. Collin County Judge, Chris Hill, and commissioners beautifully analyzed what was about to go down and even discussed the necessity of warning Collin County residents. My city and county, San Antonio in Bexar County, adopted the new definitions and states: “COVID-19 cases include both confirmed and probable cases” on the COVID-19 San Antonio Dashboards and Data of which I screen shot a photo on July 12. The CDC/CSTE New Definition of COVID-19 cases can result in 17 probable cases from just one PCR-positive patient. COVID-related deaths can include anyone who has COVID-19 listed on their death certificate as one of the causes of death- it doesn’t have to be the first or second cause, and no COVID-19 testing is required. In the exact time frame that these new definitions would have been adopted and implemented, the new COVID cases and COVID deaths started going up in Bexar County. What is going on in your state and your county? Someone must check each of the 254 counties in Texas as well as each of the 50 states and our territories to see what definitions each is using and how their case and death counts are looking in response.
Why would someone want to inflate case counts, and what are the risks and benefits of doing so? As reported in Modern Healthcare, July 17, 2020, “HHS to send $10 billion in round two of relief grants to COVID-19 hot spots.” Modern Healthcare reports, “Hospitals that had more than 161 COVID-19 admissions between January 1 and June 10 will be paid $50,000 for each COVID-19 admission. HHS asked hospitals to start submitting COVID-19 admission data on June 8.”
Hospitals that use the new CDC definition stand to make millions of dollars. The first round of HHS grants was $12 billion and paid $76,975 per admission to hospitals that had more than 100 COVID-19 admissions from January 1 through April 1. Clearly, states hit early got tons of money- Illinois got $740 M, New York got $684 M, and Pennsylvania got $655 M alone. Additionally, Medicaid will pay out $15 billion in relief funds- hospitals must apply by August, so the more cases the better the return. Remember, this is on top of the extra money commercial insurers and the extra 20% Medicare pay the hospitals for patients hospitalized “with COVID-19.” The hospitals reporting the most cases get the most money. In addition to expanding the definition of a New COVID-19 case to include exposure to a COVID-19 positive patient and a self-reported fever, lowering admission thresholds, and requiring testing on every admission, the ability to code a hospital admission as “with-COVID” is easy and becomes a very lucrative business model. My OB-gyn colleague told me about her scheduled C-section patient who was asymptomatic but tested positive on the required admission COVID test, so she too became a hospitalization “with COVID.” The army of hospital billers and coders is no doubt hard at work scouring EMRs and community contact tracing data to find any links that could up their bounty. This may also explain why the average hospital stay for COVID-19 was now around 1.4 days last time I checked- just long enough to go beyond a 24 hour ER observation status to count as an actual hospital admission.
Now, let me be clear, the doctors, nurses, and healthcare workers do not get this money. In fact, many of my fellow physicians received up to 20% pay cuts while being asked to step up and care for the increasing number of admissions, and many nurses and other members of our healthcare teams were in fact fired or furloughed because of financial devastation resulting from the initial premature and prolonged shut downs. Hospital beds and ORs sat empty as a consequence of Governors’ Executive Orders banning all nonurgent care. The premise was to reserve bed capacity for the anticipated COVID-19 surge. The result was near financial ruin for hospitals at the very time they were charged with preparing for a pandemic. The state governments’ bans on non-urgent care for –non-urgent cases, backfired and shot us in the foot twice. Rather than increasing capacity, Texas lost staffed hospital beds. Thus, when our COVID-19 wave came (3 months after the Governor’s EO declaring a disaster), we were less prepared, now with less staffed beds, more financial stress. Now we have less doctors (who are over worked and under paid) and fewer nurses, teams, and staffed beds left to care for more patients. This is compounded by the new public health problem created by the bans and shutdown; all the non-COVID patients who delayed or were denied care during the near 2 month ban on treating them are all now in desperate need of care, and they are sicker. The hospitals now have more COVID patients, more non-COVID patients and less staffed beds.
So , yes, thank and pray for our ICU/ critical care doctors, nurses, teams, and especially patients. They are doing more with less under great stress, but they are doing phenomenally. Death rates in Texas, for example, are remarkably low in spite of the new definition of COVID-related death. As discussed earlier, being coded and a COVID-related death does not require a COVID test but does come with a big payout for the hospitals.
Clearly, hospitals are financially incentivized to code more COVID cases and deaths. Definitions matter. Another sad consequence is that we are losing freedoms and destroying our state and country based on the inflated numbers. Our reopenings are based on these numbers –we have lost our our ability to congregate in groups of 10 or more, go to church, school, weddings, funerals, sporting events, concerts, or go anywhere without a mask, or hug our parents, grandparents, children, grandchildren, and the lonely. In Texas, there are Hospital Trauma Service Areas where larger counties with state and county hospitals take transfers from counties and rural hospitals less equipped. Bexar County covers for 22 counties. Our case reports did not separate out who was a Bexar County resident and who was from another county or country (and we are a 2.5 hour drive from Mexico). Ironically, while Bexar County is taking care of all the sickest patients transferred in, we are penalized because of increasing COVID-19 hospitalizations and deaths; simultaneously, the counties that sent the patients to us, record fewer COVID-19 admissions and deaths and remain open with greater freedom and liberty. San Antonio is not allowing us to gather in groups of more than 10. Meetings and events are being cancelled. Some are being rescheduled to other counties that we cover. This inflicts severe economic and psychological damage on our community.
This is not just a result of perverse financial incentives, but this is clearly also a political fight. San Antonio has a liberal democrat Mayor and Bexar County has a liberal democrat county judge. Their approach is totalitarian. Their goal is for democrats to win on November 3rd. Perhaps they are willing to do whatever it takes to draw this siege out to achieve their personal political goals. Already school openings have been delayed based on their manipulated numbers. Other counties punished also have county hospitals and democrat local leaders- think Harris County and Dallas County. Look at their numbers, definitions, and counting and reporting methods- and their loss of liberty.
We have done this all wrong. We must stop repeating our mistakes and instead learn from them. Imagine if the $37 billion dollars HHS is sending to hospitals now, had been spent instead hiring and training doctors, nurses, and healthcare teams, building out COVID hospitals and rehabilitation units for post-COVID care, and preparing out-patient facilities and ORs to care for non-COVID patients. And this money would have been better spent helping urgent care clinics, outpatient clinics, and rural clinics get their patients tuned up on vitamin D3, vitamin C, zinc, exercise, weight loss, control of their blood pressure, diabetes, and asthma and preparing our nursing homes and long term care facilities- including offering residents the choice of participation in outpatient studies of low dose HCQ and zinc that have proven effective when administered early in safe doses around the world, or small doses of convalescent plasma, or other ingenious available, affordable forms of repurposed treatment and drugs like ivermectin and nebulized budesonide. Frontline healthcare workers and high risk patients could have been offered the same not-risky, potentially life-saving choices. This is inexpensive and safe. Imagine having 84% less hospital admissions to deal with now as a result. Imagine having more doctors and more staffed beds to boot. But shoulda, woulda, coulda doesn’t matter now. Let’s learn from our mistakes. Let’s demand that our numbers be meaningful not means of manipulation.
Finally, I haven’t even touched on the pathetic intellectual dishonesty, scientific fraud and falsification of data that has gone on to sabotage outpatient use of hydroxychloroqine and zinc in order to profit large drug and vaccine makers like Gilead that makes Remdesivir and countleothers. The trillions of dollars, billions of lives, and immeasurable conflicts of interest tying the CDC, FDA, NIH, and Fauci’s NIAID into one giant tangled web are beyond the scope of this discussion. You must research this on your own. In answer to the question, what happened June 14-16, does the rise in COVID-19 cases in any way tie back to the FDA removing the EUA for HCQ from the national stockpile for COVID-19 on June 15? False data from fake company, Surgisphere, was exposed by brave, citizen scientists and investigators resulting in retractions of articles sabotaging the use of HCQ for COVID-19. Lancet and the New England Journal of Medicine retracted two articles based on this falsified data, but not before WHO halted major studies of HCQ based on the fake science. Mathematical studies seem to suggest this has indeed contributed to increased COVID cases and death. Who bears responsibility for such evil? Needless to say, in spite of 35 years at NIAID and over 20 billion dollars in the last 4 years alone, Fauci failed us. We were not prepared, and that was his charge. He can no longer be trusted. Former President Ronald Reagan famously said, “Trust but Verify.” I’m sorry to say, the only thing we can trust is that most of those in charge of this pandemic from Fauci on down cannot be trusted, and the critical questions must be asked by us and their answers must be pursued and verified by us. Definitions, semantics, and statistics matter. There are a few good men and women out there. It is up to We the People to identify them and help them help us. It is we who must save the world or die trying.