Stan, age 65: "I'm not bothering with a shot. I don't believe all those COVID numbers."
My response: "Well, Stan, a whole lot of extra people died in 2020, and most of them had COVID. Something is killing them. I figure it's probably COVID."
One of the persistent characteristics of this pandemic is that many people deny COVID is really killing many people.
Stan is part of a demographic and political group that is ground zero for COVID denial. He is a rural, white, male, Fox-viewing Trump supporter. He thinks efforts by Oregon's governor Kate Brown ordering mask-wearing and social distancing are overdone because they are unnecessary. He says he would be concerned about people getting sick and dying, sure, but he doesn't believe it is really happening to very many people. He thinks news of deaths are exaggerated."Yeah, some people get sick and a few people die, but that happens anyway. Pete, I just don't believe the numbers."
Americans keep track of deaths. A death creates a point in a statistic. A tiny number of people "go missing" and may or not be alive, but the overwhelming number of Americans who die are understood to have died. They leave a dead body to deal with, an irrefutable document of a death. And because a death has social consequences--grieving family, social security payments to end, medical bills to settle up, life insurance to pay, a body to bury--the number and timing of deaths are recorded and are credible.
COVID is now the number three cause of death in America, behind cancer and heart disease. Stan and millions of others can question what really killed those people. People who die under a doctor's care have death certificates filled out with the cause of death ambiguous because there were multiple overlapping causes of death. I have seen this multiple times from the deaths of my former clients. A person with an inoperable leaky heart valve dies. The patient was retaining water because of the heart condition, so it was treated with all the diuretics the patient could bear, which badly stressed the kidneys. The retained water gave the patient labored, increasingly shallow breathing from a torso swollen with water. So what was the cause of death? Heart failure, kidney failure, or asphyxiation?
When president, Trump said doctors had incentives to call ambiguous deaths COVID because they got more money for that diagnosis. Stan repeated that idea to me. "The doctors and hospitals make bank when they say it is COVID." The reality is that legislation does pay hospitals higher Medicare rates for COVID-19 patients and treatment, but fact-check sites say there is no evidence of fraudulent reporting, spokespeople for doctors and hospitals deny they have any real incentive to mis-state the cause of death.
People can argue about whether doctors and hospitals cheat. What is undeniable is that something is killing Americans in extra numbers.
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| 503,976 increase in deaths in 2020 |
The numbers come from JAMA, the Journal of the American Medical Association.
America would have expected some increase in the number of deaths; our population is growing and people eventually die. The first line on the chart shows the increase in total deaths from year to year: An increase of 32,000 from 2015 to 2016, then an increase of 69,000 in 2017, then 26,000 in 2018, then 15,000 in 2019. What happened in 2020 is out of all proportion: 503,976 extra deaths.
COVID skeptics and minimizers in the media make a persuasive case that the shutdowns cause unintended negative consequences in job loss, in family stress, in lost education-time for students. They consider the costs to be greater than the benefit of shutdowns. (Trump: "The cure is worse than the disease.") This is a choice among values--the disruption of the disease versus the disruption caused by attempts to stop it. There isn't evidence from death reports that the disruption from masks and shutdowns caused a spike in deaths from other causes equivalent to the loss from COVID. The number of suicides is essentially steady, down marginally.
There was an increase of 19,000 in the fourth largest category of deaths, "unintentional injuries" an increase of about 12,000 over the trend-line from prior years, an unusually big jump. The break in routines in 2020 may well have given people time and opportunity to do unfamiliar risky things. The number of deaths attributed to influenza and pneumonia were on the predictable trend-line, but there was an increase of 13,000 in the deaths attributed to diabetes, over what had been a nearly steady number. It is plausible that people with both COVID and the well-established co-morbidity of diabetes had their death attributed to diabetes, a death perhaps hastened by COVID.
The occasional ambiguity in the cause of death gives room for Stan to question COVID's real numbers, especially when one starts with a premise of "fake news" and the virus being a Democratic hoax. Cause of death is a judgement call.
But there is one fact that needs explanation: For some reason 503,976 more people died in 2020 than in 2019.
About 30,000 of them can be attributed to a growing population, which leaves approximately 470,000 extra deaths. We are in a COVID epidemic. It makes sense that it is COVID that is causing this, one way or another.
I suggested to Stan that he get the vaccination. He said he probably wouldn't bother.
6 comments:
Those of a particular political viewpoint are not fact driven. Fake news beliefs allow them to dismiss anything contrary to their belief system. Animal Farm warned us of this possibility long ago. COVID will have a better chance to mutate with these deniers. I guess that is the price of humans being so susceptible.
So if "Stan" skips getting vaccinated, acquires the COVID virus, and assumesxroom temperature, am I supposed to feel badly for him ? Hopefully he has enough money to pay whatever VC or the unsuccessful treatments cost, so Insurance rates won't be driven up for those of us who are doing what we can do to help stop the Pandemic.
It’s unfortunate how many folks, even those who may be well educated, discount “facts” which either run counter to their own belief system, or which are not supported by anecdotes they can relate to.
A Fox report of one undocumented El Salvadoran murdering a child will hold much more credence for many, than a statistic showing that the rate of violent crimes committed by undocumented people is dramatically lower than that of citizens. Why? I think part of the problem is the serious deficiencies in Math literacy (also known as numeracy) of many Americans. “I was told there’d be no math!” So many people’s eyes gloss over when numbers are involved. Can one expect folks to believe facts based on numbers when they don’t understand simple arithmetic, let alone statistics? This is not the case for everyone for sure, but the “fact” that the more highly educated one is, the more likely they are to be Democrats sure makes one wonder.
There are corollaries and histories of past pandemics to the current one. Humans appear to operate on automatic in their daily lives. Not much ever interferes with their beliefs and behaviors. Abrupt societal change causes a person to react automatically. Like a car on cruise control we attempt to maintain speed and direction. Brake lights ahead are part of our learned and accustomed behavior too. We go off cruise control. We look at our surroundings. Without news of what is the cause our minds manufacture what happened based on past experiences with a similar situation, there's an accident ahead. We just can't see it yet. We react to same way with health events. Normally healthy and active people have a little flu or colds but it always goes away on its own. We're young and everyone around us is okay but, hey older people are getting sick and dying. This observation still matches my view of health and wellness. We say hey that's common, old people in nursing homes die. That is not news. When our favored way of getting information appears to have the same opinion that it's nothing to worry about we relax. But the government says hey stay home, wear masks, until the case count and infections drop. This is not the normal response to a health and wellness event. We ask ourselves many questions about why the government issued these orders. We are now ripe for a narrative that fits our normal operating mode. News sources we respect add their caveats about federal and state reactions. We tumble to the realization that what is being done is being done to us not for us. We close the door on accepting any other explanation. No I won't get a vaccination you say. I don't believe the numbers and nothing around me says I should.
It's just plain bad luck, though predictable and inevitable, that a pandemic would happen during a period when Republicans had conditioned a significant number of people to disbelieve reality; science, facts, and common sense. I believe that our society already has a vulnerable population who are having trouble adapting to the increased complexity of the information and technology revolution, and Republicans pander to them, telling them their ignorance and prejudices have some kind of patriotic nobility.
Take a step back and just consider the frankly barbarian superstition of being "anti-vax" in 2021, and then marvel at the staggering hypocritical cynicism of Republican politicians who are encouraging it as "reasonable and free choice" while they quietly vaccinate themselves and their loved ones.
We are fortunate COVID isn't as bad as ebola. If it was vaccinations would be mandatory, but since it's less lethal we have to tolerate this ridiculous debate.
Well, Rick; If this Virus were Ebolaa or any of the other Hemorrhagic fevers out there, we would see it's horrific effects in a much shorter period of time, and even the Anti Vaxxers might be persuaded to vaccinate, if such a therapy were even available.
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