The Dead: Confirmed, Probable, and Still-Ignored

Naomi Klein speaks of a “disaster capitalist Cabinet“; the President announces plans for an “economic task force” to “reopen the economy,” of which his daughter and son-in-law may or may not be members and which – like Federal plans to build “a new fleet of ventilators” – may or may not actually come to pass; the President does have financial ties to a French firm that produces hydroxychloroquine (the unproven “treatment” for COVID-19 that the President has been regularly touting during his nightly propaganda lectures which the corporate media has been dutifully broadcasting live) as do some of his advisors and major donors; meanwhile, the confirmed US COVID-19 death toll has crossed 30,000 and more than 2,000 people have been dying (confirmed deaths) from this disease each day in this country; Mehdi Hasan calls this Administration “kakistocratic,” and it’s hard not to feel that he’s right.

Were this President to win re-election, I believe we’d be looking at a doomsday-like scenario. He must be stopped. I’m happy to see Bernie Sanders and Elizabeth Warren endorse Joe Biden for the simple reason that I don’t see any other option at the moment. It’s not just – as Tara Reade’s accusations against Biden seem credible – and Joe Biden’s manifold weaknesses as a candidate may yet come to haunt us all, but this is the scenario we face, and this puckering anus-lipped incumbent must be stopped.

In New York, the failures of our own elected executives become ever more apparent as they are, increasingly, written in dead bodies. Under pressure from media outlets to actually count the people dying at home in NYC from COVID-19, the City adjusted its official death toll, earlier this week, by a staggering 3,778 deaths (adding more than 50% to the previous official figure). This was an important and necessary step, and it shouldn’t have taken investigative journalism to force the City’s hand. (When I wrote a piece three weeks ago entitled “We’ve Stopped Counting the Dead,” I was quoting an Italian nurse from hard-hit Lombardy, but relative to our own hard-hit New York, the title perhaps should have read, “We Never Really Started…”.)

Unfortunately, there are still more layers to this mortal drama, for – although the City is now counting “Probable deaths” (that is: “People who did not have a positive COVID-19 laboratory test, but their death certificate lists as the cause of death “COVID-19″ or an equivalent.”) a mystery remains unresolved. Vital statistics for the City show that, between 2007 and 2016, the annual number of total reported deaths varied between 52,000 and 55,000. (Incidentally, they also reflect that the City has grown significantly healthier/safer/younger in recent decades.) For simplicity, here, I’ll round up to 60,000 annual deaths.

Now, glancing at this report from NYC Health, we see the following: “Deaths not known to be confirmed or probable COVID-19: 8184” for the period March 11th through April 13th, 2020. I’m going to round this to 8,000 deaths for the ~month-long period in question.

Continuing with some simple arithmetic, we take the 60,000 annual deaths above and divide by the 12 months in the year, which yields 5,000 deaths per month. Obviously, there can be both random and seasonal variations in the number of deaths occurring per month in NYC, and it would be illuminating to better understand, in particular, what the seasonal variations might look like; however, it seems clear to me that the City’s data here are hiding something: If 5,000 people die per month on average in NYC, and ~8,000 people died in the month-long period ended April 13th (a stretch happening to coincide with the swift onset of pandemic in the City), it would seem reasonable to conclude that the majority of that 3,000-mortality difference could be accounted for either by deaths from COVID-19 itself, or deaths caused indirectly by the pandemic (eg, of people who were unable to access necessary care owing to the current state of our hospitals).

Circling back around, through April 15th, the City reports 6,840 “[c]onfirmed deaths” and 4,059 “[p]robable deaths” for a total death toll – strangely not indicated on the City’s own data portal – of 10,899.

Screen Shot 2020-04-16 at 12.38.33 PM.png
This is drawn from NYC’s COVID-19 data portal. I include the details about “Data Collection Differences” both because they give insight into the complexities involved in tracking the toll of the pandemic, and because they shed light on how the acrimony between Governor and mayor, State and City, hamstring our pandemic response and harm us all.

In spite of the the figure shown above for “Deaths in NYC Reported by New York State,” consulting New York State’s own COVID-19 data portal, we conclude by simply adding up the death tolls for each of NYC’s five counties that the current total NYC COVID-19 death toll according to NYS is 8,455.

Screen Shot 2020-04-16 at 12.46.50 PM.png
For simplicity, I’ve underlined in red the COVID-19 fatality numbers for Bronx, Kings, Manhattan [New York], Queens, and Richmond Counties. This image is drawn for the NYS COVID-19 data portal. Total city-wide COVID-19 mortality according to the State is 8,455. (Interestingly, “Manhattan” is probably shown above owing to the fact – which I just learned – that Marble Hill in the Bronx adheres to New York County which is otherwise coextensive with Manhattan Island.)
This starts to get a bit confusing, as the City is reporting 10,899 COVID-19 deaths (including probable deaths) while the State is reporting 8,455 COVID-19 deaths (with no mention of probable deaths). The State’s numbers have consistently been more up-to-date for reasons partially explained above and partially due to the stupid and bitter feud between Governor Cuomo and Mayor de Blasio. By taking the State’s figure of 8,455 and adding the City’s figure for probable deaths of 4,059, we get 12,514. I have no reason to believe that any of the so-called probably deaths have yet been counted by the State, so this seems like as reasonable an approach as any given the limits on our knowledge/publicly-available data.

Okay, so 12,514 deaths is a very large figure – as a raw number; given that the average monthly number of deaths in NYC is approximately (and actually less than) 5,000; and, most of all, because that figure contains within it immense suffering, loss, and human tragedy – but, as explained above, I believe it still reflects a significant undercount.

What explains those ~3,000 additional deaths above baseline over the month-long period ended April 13th? They must be – most of them – COVID-19-related deaths. This figure, divided out, would give an average of an additional ~100 deaths per day on top of the existing totals, though, of course, the rate of death had been spiking until last weekend, and has now leveled off for the time being at a very high rate (of above 500 official recorded deaths per day), so it seems fair to estimate that these 3,000 additional deaths were heavily weighted toward the first two weeks of April. That would suggest to me that on top of the “Confirmed deaths” and the “Probable deaths” to which the City now rightly points, we need a third category, “Still-ignored deaths” to account for this anomaly.

Given the disproportionate concentration of these “Still-ignored deaths” in the first two weeks in April, I think it’s reasonable to guess that an additional 200 people per day are dying of/because of COVID-19 in NYC on top of “Confirmed” and “Probable” deaths; given that the confirmed death rate has been steady around 500 deaths per day, and the probable death rate seems to be be between 200 and 300 deaths per day at the moment (considering, among other things, that, in one day, the probable death toll jumped from 3,778 to 4,059), counting this still-ignored death rate of ~200 additional deaths per day would put the city-wide COVID-19 death rate closer to 1,000 deaths per day.

If we are badly undercounting in NYC with all our resources, our world-leading history of public health, our concentration of media (including excellent investigative journalism), and our pseudo-progressivism, what do you think is going on in other parts of the country, where politicians disincentivized to count the dead and often hostile to the marginalized groups (read: Black, Latinx, and Indigenous peoples; incarcerated and detained people; elders; working people of all types) most at risk from this pandemic are confronted with the rage and despair of their constituents at the same time that medical and public health systems – threadbare from decades of neoliberal austerity – are stretched thin or past the breaking point by the onslaught of disease?

What, exactly? Someone must do this grisly accounting so we can hold the people responsible to account.

Postscript: I have to give credit where credit is due. I’d been meaning to write this piece since the 14th, but in doing some catch-up reading this afternoon, I came across this Politico piece (from the 15th) which quotes the Mayor acknowledging that it’s the “obvious truth” that those ~3,000 additional deaths were “overwhelmingly of folks” who suffered COVID-19-related mortality. Why they’re not being counted as such for the time being is probably at once technical and political, but sooner rather than later, their loss should be added to the collective toll.

4 thoughts on “The Dead: Confirmed, Probable, and Still-Ignored

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