'There are still people who are getting wicked sick'

The inconvenient truth of covid, three years in

As my paternity leave wound down, my editors welcomed me back to the newsroom with these questions:

• How bad is the pandemic right now, really?

• How many people are still dying from covid?

One reason they asked: it wasn’t clear the experts agreed on the answers.

The White House in January said it would end the covid public health emergency, even as its own public health leaders stressed that covid was far from gone. The CDC was warning that hundreds of Americans were still dying every day — but the agency’s faced questions about its data accuracy throughout the pandemic.

And Dr. Leana Wen (who works for The Washington Post’s opinion desk, a different side of the organization from me) had written an influential column arguing that covid deaths and hospitalizations were being overcounted. GOP politicians like Reps. Ronny Jackson and Chip Roy had trumpeted Dr. Wen’s findings as Republicans ramped up probes into the pandemic, even as other doctors rebutted the column.

So where did our news team end up landing? With this story:

Covid is still a leading cause of death as the virus recede

(no paywall)

To put it another way: covid was the no. 3 killer in America between 2020 and 2022. At its current pace, covid would likely be a top. 7 killer this year.¹

In trying to answer my editors’ first question about the state of the pandemic, I talked to CDC and state officials for their perspectives — but also to frontline health workers, funeral-home staff and public health experts about what they’re actually seeing right now.

And it quickly became clear: severe covid cases have plunged, and deaths are far from their peak of 3,000-plus per day two years ago, frontline staff told me. On balance, things are a lot better across America.

But as I heard …

“There are still people who are getting wicked sick,” said Libby Hohmann, an infectious-disease physician at Massachusetts General Hospital. She cited two covid patients she’d recently seen in the intensive care unit — “both vaccinated and near death,” with one immunocompromised patient in their 60s dealing with infection from another pathogen, too, and a second patient in their 30s who was previously healthy, but suddenly fighting heart failure.

And in pursuing the second question, about how many people are still dying, I spoke with skeptics who said that covid deaths had been overcounted — but ultimately found more experts who insisted that, if anything, we’ve undercounted the death toll.

For instance, Dr. Wen’s original column had cited Dr. Shira Doron, chief infection control officer for the Tufts Medicine Health System, who argued that covid hospitalizations had been overcounted. (Dr. Doron was so successful at making this argument, she helped convince Massachusetts to update its methodology and eventually halve the number of covid hospitalizations in the state.)

When I reached out to Dr. Doron for an interview, I expected her to make a similar case about covid deaths being overcounted too.

But…

Doron noted that her colleagues reviewed about 85 recent deaths at Tufts that occurred after a covid diagnosis, and found “100 percent accuracy” in those death certificates that listed covid as a cause. Moreover, “there were quite a few patients who our experts felt had died of covid-19, and it didn’t make it onto the death certificate,” Doron added, saying that many of those overlooked patients had suffered “long, slow declines” after covid infections.

Doron cautioned against extrapolating nationwide from that data — but “at one hospital, in one city, in one state, we found that death certificates had underestimated covid-19.”

Other experts pointed to excess death calculations that signal the United States may have undercounted hundreds of thousands of covid-related deaths over the past three years.

You can read the piece here — again, no paywall! — and judge for yourself. I welcome questions and reactions.

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One more note: in year three of the pandemic, these sorts of stories tend to satisfy few people.

There are folks who are unhappy that the piece “platformed” Dr. Wen or Rep. Jackson, arguing that including their quotes spread misinformation.² Others don't like Dr. Deborah Birx, the former Trump White House covid coordinator, and say it was a mistake to cite her warnings. Still more are parsing the headline, photos and timing of the story — factors beyond a lowly reporter's control! — for meaning that isn't there.³

And broadly, many Americans are just done with covid and not interested in being reminded that the virus is still circulating.⁴

But apathy isn’t a reason to ignore a story. If anything, that’s usually more reason to pursue it.

1. We’re clearly past the pandemic peak. The virus was linked to about 1,300 deaths per day in 2021, with covid often the primary cause of death. It’s now linked to about 250 deaths per day, with covid mostly a contributing cause of death, experts acknowledge.

2. I’m often confused by accusations of the media “platforming” certain people by quoting them, and this story was a good example of why that criticism can be mystifying. Dr. Wen has a regular Washington Post column, a gig as a CNN analyst, and a bigger social media following than me. Who’s platforming whom? Beyond that, my reported article directly dealt with her column; it was only fair to ask Dr. Wen to answer questions about it. Meanwhile, I cited Rep. Jackson because he was among the politicians who used Dr. Wen’s column to make his own critiques of the pandemic response.

3. One surprise about this story was seeing conservatives claim that the story was supposedly relying on old data. Their evidence: we hyperlinked this Peterson-KFF tracker on U.S. causes of death between Jan. 2020-Sept. 2022. The only intent for that link, which we added right before publishing, was to offer more context about top causes of death in America in recent years. (And we didn’t expect anyone who clicked on the link to read that as current data; the Peterson-KFF tracker is clearly labeled as offering historic death data.) What’s relevant to the story is this: we calculated that there have been about 250 daily covid deaths in recent weeks in 2023. And at that pace, covid would unfortunately remain one of the 10 leading causes of death again this year.

4. I can identify; having authored several hundred covid articles and newsletters, I’ve got a laundry list of non-covid stories I’m itching to write!