Last week, a Washington Post columnist with whom I am friendly (but have had important disagreements with) wrote that we are overcounting Covid-19 deaths in Massachusetts. The opinion relied upon anecdotal evidence and unrelated hospitalization data. Much of what it said was incorrect, unsupported, or both. Predictably, the column has been co-opted by conspiracy theorists as proof that they’ve been right all along. They could not be more wrong, and I’m saddened to see them emboldened by a column that was so factually inaccurate.
This made my blood boil. At best Dr Wen was lazy in her consideration of data analysis and at worst is incapable or not interested in correcting her initial incorrect position. As you point out there are logical fallacies involved in her analysis. Basically she is free to maintain her beliefs on excess mortality and COVID, but her stated reasons for this are not based on a sound analysis of the best available data. Thank you for taking the time to do this. Keep up the “good fight”.
It's disconcerting to me that the disinformation spread by Drs. Wen and Doron receives large platforms like the Washington Post, CNN (and NBC in Massachusetts), while Jeremy's factual points - based in his own research - are in substack and an 18-minute segment of MSNBC. It's they who are shaping the public narrative, not Jeremy.
I'm very concerned that minimization of the impact of the pandemic is preparing the ground for further neglect of protective measures, like improving ventilation, encouraging indoor masking, and improving access to vaccines and Paxlovid for those that still have massive barriers to both.
On that front - the Biden administration is planning to stop federal funding of vaccines and Paxlovid, and turn them over to the market ("commercialization"). This will have a devastating impact on frontline communities who still have disproportionate access barriers to both, even under the current system. If, as Drs. Wen and Doron claim, people aren't really dying much because of COVID anymore, maybe this is less of a problem? - If, however, COVID is still causing a 9/11 every week, or even every month, it is so clearly morally indefensible.
Dr. Wen may be a wonderful person, but a considerable amount of her opinion columns have been downright dangerous with respect to public health since the earliest days of the pandemic. I don't generally cancel subscriptions to news organizations out of pique, but the fact that the Post continues to feature her "analysis" makes me consider it.
Thank you! I’m incensed as well by the doubling down of Dr. Wen-- as she uses her forums at the Washington Post and CNN. Your factual analysis is greatly appreciated.
PS (and this time I promise to post a short comment!). I also prefer not to scoop myself, as for the past few weeks I've been trying to publish an article on this very topic of Covid deaths (and once again running into the same resistance I mentioned earlier, to any new but potentially "contrarían" ideas on the part of the media; several major outlets seemed interested but the whole idea that perhaps 400 people aren't actually dying every day in the US from Covid was apparently too out there, politically if not so much scientifically, at least until Leana Wen may have calmed the waters a little more recently?..)
In the meantime, in case anyone is interested in reading a bit more about this, beyond what Jeremy and I have already written, FYI here are a couple of thought provoking (and short) pieces on the issue of overcounting of Covid deaths:
Wow! Am I surprised, yes! Am I shocked, no. The Washington Post and Dr. Web, Ugh...! Not cool! This reminds me of the time the CDC put out wrong information and then retracted. Talk about devastation! I just couldn’t believe it! I even called the Dean of the nursing school I graduated from, Loma Linda University to inquire. Due to the fact we were taught the CDC was a “safe” reference. One would think with all the education behind us all, we’d all be in the same page. So very disheartening! I’m with you! #OnTheData #Covid19
Ok, it looks like once again my comment is going to be something of an outlier here. With all due respect (and I do still really mean that, despite the perhaps blunt tone ahead), there is so much in your critique of Wen's article that I question that I'm not really sure where to begin? But this time, I am going to try to keep my remarks shorter, as you (like many people) seem to perhaps have a tendency to only respond to certain issues that are raised while ignoring other ones? (And I take at least partial blame, for writing too much in these comments!)
Alright, for starters there is a certain kind of, to be blunt, arrogant certainty in your comments that I find not only concerning but alas typical of the "dominant paradigm" since the beginning of the pandemic. (While many of your readers seem to feel that voices like Wen's are those that predominate in the mainstream media, I believe that in fact the voices of alarmism have been much much louder all along.) In my own experience, for what it's worth, whereas in the past I have published many op-eds on other infectious diseases, particularly HIV, in venues such as the New York Times, Washington Post,etc, in contrast when it comes to the ultra polarized topic of Covid 19, after a May 2020 article in the Post advocating for reopening of schools (which led to my being accused of being a "baby killer," of being an agent of Donald Trump, and even worse), since then - and other than several peer reviewed articles on the subject - the voices of people like myself have been shunned by the mainstream media and so I've been forced, for the first time in my 4 decades career, to publish popular pieces in much more conservative venues like the Wall Street Journal or even the New York Post...)
Anyway, regarding the rather intense self-certainty I mentioned, right in the second paragraph, for example, you assert that "I KNOW [my emphasis] the column is factually incorrect because I study “excess mortality,” the most relevant field to the question at hand... I have data from as recently as last week showing that the opposite of what the Post column purported is ACTUALLY TRUE; In FACT, we are still undercounting Covid-19 deaths."
Again with all due respect, Doctor Faust, I am sure you must be a fantastic - and I can tell very caring and compassionate - medical doctor to your patients. However, the issue at hand is not clinical care or even medical knowledge, it's EPIDEMIOLOGY. And I have very little doubt that if you were to poll 100 leading epidemiologists and ask them the following question that all (or at least nearly all) would respond with a resounding NO: “Do you believe that the level of excess mortality currently (as opposed to back in 2020) definitely reflects the true number of Covid-19 deaths?"
Rather, I believe that all or nearly all of the epidemiologists would concur with Dr Wen that such a straight line correlation is far too simplistic, for various reasons... Now, just because almost all epidemiologists would disagree with your assertions (stated in a tone of absolute certainty) doesn't mean that there isn't a possibility that you are actually correct and they are all wrong! (When I argued in The Lancet medical journal in 1999 that male circumcision could be important for HIV prevention, almost all the experts said I was crazy or worse. So I've been there...)
However, whereas the tone in Dr Wen's articles tends to be more of a questioning or pondering nature, as I mentioned it seems to me there's a kind of arrogant, I Know The Truth attitude that runs throughout your commentary. You may be right that excess deaths currently automatically equal Covid deaths, but at least to my mind you have yet to make a more compelling case, including that you have yet to explain some basic contradictions, some of which I raised earlier, such as why are so many COVID-19 deaths still happening in places with high levels of vaccination, such as Massachusetts?..
As I intimated, there's much more I could say, but I think I'm going to refrain for now, including because I sense you may just brush off much of what I would bring up? But before concluding, I would like to ask a more fundamental question, one that kept coming up for me as I read your latest response to Wen.
Let's say you're right, and there are still a vast number of people dying out there from Covid, including many cases where someone is in extremely fragile condition and likely to pass away shortly, and then the virus "tips" them into a somewhat earlier death than would have occurred otherwise.
Alright, so let's assume for the sake of argument that such events are a major reason for the currently observed excess deaths. (I myself am not convinced it's still a major factor, but as I said let's just assume so for now.) Alright then, so now we get into some really thorny questions that are not just scientific in nature but also deal fundamentally with ethics and morality, yet in fact also address what I would call a core public health perspective.
It's really a kind of age old (difficult) question , and as a medical doctor you've surely had to wrestle with it even more than myself on a human level?: Is it the same thing when a 90 year old person with end stage cancer dies a little sooner, from something like Covid, then when a 19 year old, with most of their expected lifetime still well ahead of them, dies from something like a drug overdose?
Reducing everything to just a raw tabulation of total death numbers would seem to preclude such an (admittedly difficult) discussion. When we talk about a 747 worth of people dying from Covid (whether that's supposed to be occurring every day or every week), it causes the listener to conjure up a huge airplane full of ALL KINDS of people suddenly getting wiped out: children, families, teenagers, working adults, etc.
Of course, if we turned on the news and heard that a 747 had just crashed with everyone aboard having died, and almost all of them were very elderly and virtually all of them also had serious chronic diseases (and, as you have been arguing, many of them were already very close to death anyway), well I'm sure that none of us would react by cheering and saying that's wonderful. But I also wonder whether this kind of a 747 crash would evoke quite the same intensity of grief and alarm?
Indeed, epidemiologists (and others) have wrestled with such issues for years, and in fact - or at least until Covid 19 - a very important (and rather uncontroversial) principle and metric in public health has been that of "Years of life lost from mortality" (YLL). Thus, if in a given country or population the average lifespan is, say, 70 years, than if a 68 year old person loses their life to some disease or other cause, the resulting YLL would be 2, whereas if a 2 year old baby dies from, say, malaria, the YLL would be 68. Therefore, it would take 34 persons of age 68 dying to result in the same total YLL as one 2 year old dying of malaria...
For this reason, some epidemiologists I know have been essentially crucified (attacked as not caring about the elderly or chronically ill, etc) for pointing out that if we were to use a methodology like YLL to compare the impact of certain other problems, such as the fentanyl epidemic, with that of Covid 19 then clearly the actual impact might look much differently... And of course, this is not about denying that both problems are important, but perhaps about gaining some greater PERSPECTIVE (the title, actually, of one of my past New York Times op-eds 😁...)
Thank you for taking the time to write this article.
This made my blood boil. At best Dr Wen was lazy in her consideration of data analysis and at worst is incapable or not interested in correcting her initial incorrect position. As you point out there are logical fallacies involved in her analysis. Basically she is free to maintain her beliefs on excess mortality and COVID, but her stated reasons for this are not based on a sound analysis of the best available data. Thank you for taking the time to do this. Keep up the “good fight”.
Mic drop! Thanks for writing this!
It's disconcerting to me that the disinformation spread by Drs. Wen and Doron receives large platforms like the Washington Post, CNN (and NBC in Massachusetts), while Jeremy's factual points - based in his own research - are in substack and an 18-minute segment of MSNBC. It's they who are shaping the public narrative, not Jeremy.
I'm very concerned that minimization of the impact of the pandemic is preparing the ground for further neglect of protective measures, like improving ventilation, encouraging indoor masking, and improving access to vaccines and Paxlovid for those that still have massive barriers to both.
On that front - the Biden administration is planning to stop federal funding of vaccines and Paxlovid, and turn them over to the market ("commercialization"). This will have a devastating impact on frontline communities who still have disproportionate access barriers to both, even under the current system. If, as Drs. Wen and Doron claim, people aren't really dying much because of COVID anymore, maybe this is less of a problem? - If, however, COVID is still causing a 9/11 every week, or even every month, it is so clearly morally indefensible.
Thanks for this detailed analysis.
Dr. Wen may be a wonderful person, but a considerable amount of her opinion columns have been downright dangerous with respect to public health since the earliest days of the pandemic. I don't generally cancel subscriptions to news organizations out of pique, but the fact that the Post continues to feature her "analysis" makes me consider it.
Thank you! I’m incensed as well by the doubling down of Dr. Wen-- as she uses her forums at the Washington Post and CNN. Your factual analysis is greatly appreciated.
Bravo! It’s essential to counter fuzzy thinking. Thank you.
PS (and this time I promise to post a short comment!). I also prefer not to scoop myself, as for the past few weeks I've been trying to publish an article on this very topic of Covid deaths (and once again running into the same resistance I mentioned earlier, to any new but potentially "contrarían" ideas on the part of the media; several major outlets seemed interested but the whole idea that perhaps 400 people aren't actually dying every day in the US from Covid was apparently too out there, politically if not so much scientifically, at least until Leana Wen may have calmed the waters a little more recently?..)
In the meantime, in case anyone is interested in reading a bit more about this, beyond what Jeremy and I have already written, FYI here are a couple of thought provoking (and short) pieces on the issue of overcounting of Covid deaths:
https://thehill.com/opinion/healthcare/3622402-mandatory-hospital-screenings-fuel-inaccurate-covid-death-counts/
https://open.substack.com/pub/alexberenson/p/a-veteran-medical-examiner-who-reviewed?utm_source=direct&r=1udzzw&utm_campaign=post&utm_medium=web
https://www.bbc.com/news/health-60000391
Cheers, Daniel
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2800399
Wow! Am I surprised, yes! Am I shocked, no. The Washington Post and Dr. Web, Ugh...! Not cool! This reminds me of the time the CDC put out wrong information and then retracted. Talk about devastation! I just couldn’t believe it! I even called the Dean of the nursing school I graduated from, Loma Linda University to inquire. Due to the fact we were taught the CDC was a “safe” reference. One would think with all the education behind us all, we’d all be in the same page. So very disheartening! I’m with you! #OnTheData #Covid19
Dear Jeremy,
Ok, it looks like once again my comment is going to be something of an outlier here. With all due respect (and I do still really mean that, despite the perhaps blunt tone ahead), there is so much in your critique of Wen's article that I question that I'm not really sure where to begin? But this time, I am going to try to keep my remarks shorter, as you (like many people) seem to perhaps have a tendency to only respond to certain issues that are raised while ignoring other ones? (And I take at least partial blame, for writing too much in these comments!)
Alright, for starters there is a certain kind of, to be blunt, arrogant certainty in your comments that I find not only concerning but alas typical of the "dominant paradigm" since the beginning of the pandemic. (While many of your readers seem to feel that voices like Wen's are those that predominate in the mainstream media, I believe that in fact the voices of alarmism have been much much louder all along.) In my own experience, for what it's worth, whereas in the past I have published many op-eds on other infectious diseases, particularly HIV, in venues such as the New York Times, Washington Post,etc, in contrast when it comes to the ultra polarized topic of Covid 19, after a May 2020 article in the Post advocating for reopening of schools (which led to my being accused of being a "baby killer," of being an agent of Donald Trump, and even worse), since then - and other than several peer reviewed articles on the subject - the voices of people like myself have been shunned by the mainstream media and so I've been forced, for the first time in my 4 decades career, to publish popular pieces in much more conservative venues like the Wall Street Journal or even the New York Post...)
Anyway, regarding the rather intense self-certainty I mentioned, right in the second paragraph, for example, you assert that "I KNOW [my emphasis] the column is factually incorrect because I study “excess mortality,” the most relevant field to the question at hand... I have data from as recently as last week showing that the opposite of what the Post column purported is ACTUALLY TRUE; In FACT, we are still undercounting Covid-19 deaths."
Again with all due respect, Doctor Faust, I am sure you must be a fantastic - and I can tell very caring and compassionate - medical doctor to your patients. However, the issue at hand is not clinical care or even medical knowledge, it's EPIDEMIOLOGY. And I have very little doubt that if you were to poll 100 leading epidemiologists and ask them the following question that all (or at least nearly all) would respond with a resounding NO: “Do you believe that the level of excess mortality currently (as opposed to back in 2020) definitely reflects the true number of Covid-19 deaths?"
Rather, I believe that all or nearly all of the epidemiologists would concur with Dr Wen that such a straight line correlation is far too simplistic, for various reasons... Now, just because almost all epidemiologists would disagree with your assertions (stated in a tone of absolute certainty) doesn't mean that there isn't a possibility that you are actually correct and they are all wrong! (When I argued in The Lancet medical journal in 1999 that male circumcision could be important for HIV prevention, almost all the experts said I was crazy or worse. So I've been there...)
However, whereas the tone in Dr Wen's articles tends to be more of a questioning or pondering nature, as I mentioned it seems to me there's a kind of arrogant, I Know The Truth attitude that runs throughout your commentary. You may be right that excess deaths currently automatically equal Covid deaths, but at least to my mind you have yet to make a more compelling case, including that you have yet to explain some basic contradictions, some of which I raised earlier, such as why are so many COVID-19 deaths still happening in places with high levels of vaccination, such as Massachusetts?..
As I intimated, there's much more I could say, but I think I'm going to refrain for now, including because I sense you may just brush off much of what I would bring up? But before concluding, I would like to ask a more fundamental question, one that kept coming up for me as I read your latest response to Wen.
Let's say you're right, and there are still a vast number of people dying out there from Covid, including many cases where someone is in extremely fragile condition and likely to pass away shortly, and then the virus "tips" them into a somewhat earlier death than would have occurred otherwise.
Alright, so let's assume for the sake of argument that such events are a major reason for the currently observed excess deaths. (I myself am not convinced it's still a major factor, but as I said let's just assume so for now.) Alright then, so now we get into some really thorny questions that are not just scientific in nature but also deal fundamentally with ethics and morality, yet in fact also address what I would call a core public health perspective.
It's really a kind of age old (difficult) question , and as a medical doctor you've surely had to wrestle with it even more than myself on a human level?: Is it the same thing when a 90 year old person with end stage cancer dies a little sooner, from something like Covid, then when a 19 year old, with most of their expected lifetime still well ahead of them, dies from something like a drug overdose?
Reducing everything to just a raw tabulation of total death numbers would seem to preclude such an (admittedly difficult) discussion. When we talk about a 747 worth of people dying from Covid (whether that's supposed to be occurring every day or every week), it causes the listener to conjure up a huge airplane full of ALL KINDS of people suddenly getting wiped out: children, families, teenagers, working adults, etc.
Of course, if we turned on the news and heard that a 747 had just crashed with everyone aboard having died, and almost all of them were very elderly and virtually all of them also had serious chronic diseases (and, as you have been arguing, many of them were already very close to death anyway), well I'm sure that none of us would react by cheering and saying that's wonderful. But I also wonder whether this kind of a 747 crash would evoke quite the same intensity of grief and alarm?
Indeed, epidemiologists (and others) have wrestled with such issues for years, and in fact - or at least until Covid 19 - a very important (and rather uncontroversial) principle and metric in public health has been that of "Years of life lost from mortality" (YLL). Thus, if in a given country or population the average lifespan is, say, 70 years, than if a 68 year old person loses their life to some disease or other cause, the resulting YLL would be 2, whereas if a 2 year old baby dies from, say, malaria, the YLL would be 68. Therefore, it would take 34 persons of age 68 dying to result in the same total YLL as one 2 year old dying of malaria...
For this reason, some epidemiologists I know have been essentially crucified (attacked as not caring about the elderly or chronically ill, etc) for pointing out that if we were to use a methodology like YLL to compare the impact of certain other problems, such as the fentanyl epidemic, with that of Covid 19 then clearly the actual impact might look much differently... And of course, this is not about denying that both problems are important, but perhaps about gaining some greater PERSPECTIVE (the title, actually, of one of my past New York Times op-eds 😁...)
Alright, I better stop here!