U.S. Hospitals May ‘Recalculate’ How They Report COVID Cases
Perhaps influenced by the lifting of COVID-19-related restrictions by several European countries—starting with Denmark—during the past two weeks, the United States seems to be on the verge of following Europe’s lead in declaring the pandemic over. In a recent interview with the Financial Times, White House chief medical advisor and director of the National Institute of Allergy and Infectious Diseases (NIAID) Anthony Fauci, MD said the “full blown” pandemic is almost over and he expressed confidence that COVID restrictions could “soon” be lifted in the U.S.1 2 3 4 5 6 7 8 9 10 11 Dr. Fauci said:
As we get out of the full-blown pandemic phase of COVID-19, which we are certainly heading out of, these decisions will increasingly be made on a local level rather than centrally decided or mandated. There will also be more people making their own decisions on how they want to deal with the virus.10 11
Dr. Fauci added:
There is no way we are going to eradicate this virus. But I hope we are looking at a time when we have enough people vaccinated and enough people with protection from previous infection that the COVID restrictions will soon be a thing of the past.10 12
U.S. Government Feeling Pressure to Move Past the Pandemic
Besides growing peer pressure from European governments to adopt an attitude of learning to live with COVID, a key reason the Biden administration may now be more open to ending COVID restrictions is that public opinion polls in the U.S. are showing that many Americans have grown disillusioned with government COVID control policies that they feel have largely failed.
A recent poll done by Monmouth University Polling Institute found 70 percent of those surveyed agree with the view that “it’s time we accept that COVID is here to say and we just need to get on with our lives.”9 According to the institute’s director, Patrick Murray:
Americans’ worries about COVID haven’t gone away. It seems more to be a realization that we are not going to get this virus under control in a way that we thought was possible just last year.9
Another poll by Yahoo!/YouGov found that 46 percent of those surveyed think that Americans should “learn to live with” the pandemic “and get back to normal.” In that same poll, only 43 percent think “we need to do more to vaccinate, wear masks and test.”9
There has been speculation that the Biden administration may be ready to move past the pandemic, sooner rather than later. The midterm national elections in the U.S. are scheduled for later this year and some Democrats who are up for re-election do not want the lack of progress in eradicating COVID to be an issue of contention. An article in the Daily Mail cited the example of Democratic Congressman Sean Patrick Maloney of New York, who was asked if it was important for Democrats to be “seen as moving on from the pandemic ahead of the midterms.”9
Rep. Maloney responded:
You better believe it. People are sick to death of this pandemic. We will be in a position to communicate a clear off-ramp and to make sure people understand that they will be in a position to care for themselves and their families, that we trust parents to know best for their child and their schools.9
Planning for Relaxation or Elimination of COVID Restrictions May Be Underway
Last week, the Associated Press (AP) reported that the Biden administration is “making plans for a less-disruptive phase of the national virus response” and that the White House “for the first time acknowledged movement in its planning, saying conversations have been under way privately to develop plans for guiding the country away from the emergency phase of the pandemic.”13
According to the AP:
Federal COVID-19 coordinator Jeff Zients said officials are consulting with state and local leaders and public health officials on potential next steps. But as governors and local officials press for clearer federal guidelines for easing or ending restrictions, states, cities and school boards are adopting an awkward patchwork of policies that differ widely from one place to the next.13
It’s probably naïve to assume that U.S. government decisions with regard to COVID and the imminent elimination of associated federal restrictions that have been strictly enforced so far would be based solely on a scientific rationale and in totally unrelated political factors.
U.S. Government Looking for Ways to Declare Victory Over COVID
So the question is: “How does the government make a rational case for dropping all or most COVID restrictions, declaring victory over the pandemic and moving on?”
One way to build a case is to show that the number of SARS-CoV-2 infections are on a consistently steep decline. During the first week in February, the number of infections reportedly dropped by 47 percent across the country—from 453,141 cases to 239,757. The problem is that the number of people who test positive for SARS-CoV-2 has tended to be cyclical over the past two years, depending on the season of the year and the number of people who choose to get tested.9
To declare victory over COVID based on a downward trend in SARS-CoV-2 infections might risk a repetition of what happened after President Biden declared “independence from the virus” in his 2021 Fourth of July speech to the nation. The Delta variant arrived soon after and the number of infections went back up. Then Omicron hit and the number of infections went up again. How often can someone declare victory, be proven wrong and still maintain some semblance of credibility?14
One solution to that dilemma would be to do what the government of Sweden did earlier this month—simply stop testing for SARS-CoV-2. The AP reported:
Sweden has halted wide-scale testing for COVID-19 even among people showing symptoms of an infection, putting an end to the mobile city-square tent sites, drive-in swab centers and home-delivered tests that became ubiquitous during the pandemic and provided essential data for tracking its spread.2
“We have reached a point where the cost and relevance of the testing is no longer justifiable,” said the head of Sweden’s Public Health Agency, Karin Tegmark Wisell, MD, PhD.2
Another solution would be to show a consistent, marked decrease in the number of Americans being hospitalized for COVID and dying of the illness. During the past week, COVID hospitalizations have been declining through the U.S., but that has happened before over the last two years. Hospitalizations for COVID have also gone up and down, depending on the season of the year. So there is no guarantee that hospitalizations would not take an embarrassing upward turn.
Government officials need some assurance that, if they move toward closing the book on the pandemic, COVID hospitalizations will continue to decline and get the point where they are barely noticeable. This could be why the administration is working on “recalculating the number of COVID-19 hospitalizations” in the U.S.15
Federal Task Force Wants U.S. Hospitals to Be More Accurate in How They Report COVID Cases
A recent article by Politico cited the existence of a “task force” of “scientists and data specialists” from the Department of Health and Human Services (HHS) and Centers for Disease Control and Prevention (CDC) who are “working with hospitals nationwide to improve COVID-19 reporting.”15
The Politico article confirmed that two senior administration officials said the task force is asking hospitals around the country to report the number of patients who are hospitalized because they have COVID and separate those from the patients who are hospitalized for other reasons but test positive for the SARS-CoV-2 virus after being admitted.15
“You need a panel of experts to review the cases to adjudicate if a hospitalization is for a person who came in for COVID or with COVID,” said Eric Topol, MD, a former advisory board member of The COVID Tracking Project.15 16
What this suggests is that, in the past, U.S. hospitals have been counting people hospitalized for reasons other than COVID as COVID patients if they happened to test positive for SARS-CoV-2 after admission. This would have the effect of increasing hospital COVID case counts, making the effects of COVID on U.S. hospitals appear worse than they actually were. Remember all those media reports about how overwhelmed hospitals were with COVID patients? It now appears that at least some of that reporting may have been inaccurate, even grossly inaccurate.
If implemented, this strategy of recalculating COVID hospitalizations will surely have the effect of lowering COVID hospitalization cases counts. It will help pave the way for a declaration that COVID, although not vanquished, is something we can learn to live with. There is an element of smoke and mirrors at play here, but it is unlikely that most Americans will ever notice.
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