## B. Death Rate Calculations

The death rate associated with a particular disease is the prime indicator of its harmfulness.  It is a simple ratio of the number of deaths divided by the number of people infected.  An accurate death number and an accurate infection number are needed.  When a person dies that is easy to assess and count.  It only requires a death certificate from a doctor attributing the death to COVID-19.  However, the presence of concurrent causes makes it difficult to assign a single cause to a death.  Also, during a pandemic doctors are swamped and do not have the time to investigate causes.  This means that the death numbers related to a particular virus or disease are often over stated.

The number of people infected with the virus is almost always unknown.  The only numbers that are reported are number of people who tested positive for the virus.  But, test numbers are not the same as the numbers infected.  Confirmed cases are the same as tested numbers.

With respect to COVID-19, the test numbers are vastly different from the infection numbers.  For example, testing is limited by the availability of testing kits as well as by people choosing not to be tested.

Italy has reported, through blood tests, that 40 percent of the people infected with COVID-19 had no symptoms.  That does not mean they had no temperature, it only means that those individuals did not believe they were sick.  People who did not know they were sick would not know or would not choose to be tested.  In addition, most testing facilities require the patient to have symptoms before they can qualify to be tested.

Hence, the number of confirmed or tested cases is not the same as the number infected.

An antibody test has been developed and approved by the FDA.  Antibody tests indicate if a person had the virus in their system long enough to produce antibodies.  By taking random samples of people in the general public, experts can determine the percentage of people in the population who had the virus.  With this information, they can use algorithms to determine the number of people who were infected.

However, that requires a statistical analysis with a true random sampling in order to be accurate.

The following is a listing of antibody tests that have been done at various locations.  The studies show that the testing numbers are 7 to 85 times lower than the actual infection numbers. This wide variability (7 to 85) indicates that these antibody tests were not done by a statistical random sampling method.

List of Antibody Tests

• Santa Clara County Antibody Test: 50 to 85 times more than reported.  Test size 3300 volunteers, drive-through.  Test date 4/3-4/2020/.

• Los Angeles County Antibody Test: 28 to 55 times more than reported.  Test Size 863.  Test Date -Early April 2020. Large scale tests are underway.

• New York State: 8 times more than reported.  Test Size 7500.  Test Date -Mid April 2020.  Equivalent to 2.7 million in New York State.  The total confirmed cases as of 5/1/2020 was 308,314.

• Gangelt Germany Antibody Test from blood donors: 7 times more than reported.  Test Size 1000 blood donors.  14% had antibodies and only 2% confirmed as infected.  Test Date -April 2020.

• National Blood Bank in Netherlands Antibody Tests: 13 times more than reported.   Test Size Unknown National blood bank samples.  3% had antibodies and only .2% confirmed as infected.  Test Date -April 2020.

Table 1 displays the above tests and illustrates that the average multiplier is approximately 27.  The estimates made here use a multiplier of 25.

Table 1.  This is a summary of the above antibody testing.  the test size, average test size, low multiple, high multiple and average multiple are set forth.

Figure 3 illustrates the adjusted death rate percent (ratio #death/ #infected converted to percent) based a multiplier of 25. The last bar, in orange, is the death rate associated with a normal influenza season as reported by the CDC.

Figure 3 is a bar graph of the Death Rate for COVID-19.  The vertical axis is the death rate, in percent, of total infected.  The horizontal axis are various countries.  The blue bars are adjusted to reflect a 25 times multiple.  The deaths and confirmed infections are as of May 1, 2020.  The data in the blue bars are from www.worldometers.info.  The orange, flu bar is the USA average from the CDC.

Figure 3 indicates that COVID-19 has a death rate of 0.22% and that influenza has a death rate of 0.16%. A death rate of 0.16 means that out of 1000 people that become infected 1.6 will die. With COVID-19, 2.2 out of 1000 people infected will pass away from the infection.

Age Related & Pre-Existing Conditions.  Many believe that COVID-19 attacks the elderly.  That’s not quite true.  It attacks all humans and some animals.  It is true that COVID-19 has a higher morbidity with elderly people, i.e. 90 percent are older than 65, with a majority of those over 80.  A large proportion of the elderly also have preexisting conditions.  However, the following Table 2 shows that influenza does the same thing.

Table 2 is a list of various viruses, the years, and percentage of deaths over 65. Information compiled from the CDC.

The same preexisting conditions that contribute to influenza deaths also contribute to COVID-19 deaths. The underlying conclusion is that both influenza and COVID -19when combined are more deadly to the elderly at approximately the same percentage.

Figure 4 shows the relative number of deaths as organized by the disease.

Figure 4 is a bar graph of the Annual Death Rates in the United States from various causes. The horizontal axis are the years from 2010 to 2017. The vertical axis is the total number of deaths. The bars represent various diseases. Data from the CDC.

On September 1, 2020, the CDC put out an update on the coronavirus and its connection to co-morbidities.  In Table 1, Column 2 it reports that the deaths involving COVID-19 was 169,419.  Column 5 reported pneumonia deaths “that also involve COVID-19” but excludes “pneumonia deaths involving influenza” was 173,669.  Column 6 reported COVID-19 deaths and pneumonia deaths but excluded influenza deaths to be 75,199.  Column 8 reported COVID-19, pneumonia, and influenza deaths to be 273,560.  Subtracting column 8 from column 2 yields the number of pneumonia and influenza deaths to be 104,141.  This means that the number of deaths from COVID-19 is 62% of the total and pneumonia and influenza deaths is 48%.   Column 7 reports that influenza deaths that did not involve pneumonia was 6,657.  This suggests that almost all influenza deaths causes pneumonia.  This is consistent with studies that connect influenza deaths to pneumonia.  [Noymer A, Nguyen AM. Influenza as a proportion of pneumonia mortality: United States, 1959-2009. Biodemography Soc Biol. 2013;59(2):178-190.]

The CDC reported number of pneumonia and influenza deaths in 2018 was 191,680 [CDC National Center for Health Statistics-Data16].  This study suggests that COVID-19 and Influenza are related.  It also supports that COVID-19 and Influenza/pneumonia have essentially the same morbidities (169,419+ = COVID-19 deaths to 191,680 = 2018 influenza/pneumonia deaths).