With all of the discussion and comparison around Influenza and COVID-19, I have been meaning to find some data to publish something worthwhile. As we approach the end of the 2019-2020 *Influenza season, I have decided now is as good a time as ever to look objectively at some data and see if there are any conclusions we can draw. The data I have compiled is specific to Nova Scotia, so for the purpose of this post, we will keep the discussion confined to the situation in Nova Scotia alone. Canada wide data isn't great. I may see if I can dig up some good information from the CDC for the US and write a separate post about that in the near future.

*Note, Influenza season runs annually from week 35 to week 34 (roughly mid August to mid August)

Methodology:

  • Cases, ICU Admissions & Deaths up until March signify the percentage of activity in these 3 categories that occurred from the beginning of each Influenza season (Week 35, August) through Week 9 (around the first of March).
  • For example, in the 2016-2017 Influenza season, there were 442 lab confirmed cases in NS, of which 59.5% (244) had been confirmed by Week 9.
  • Week 9 was chosen as March of 2020 was when COVID-19 began, so I have made the assumption that all Influenza data prior to March should be accurate, insofar as it will not be impacted in any way by COVID-19.
  • The "Projected" row was created by analyzing the current season activity to week 9, and projecting what we would expect it to be by the end of the season (week 34, August), based on the previous 3 seasons activity to week 9 and after week 9.

Some Relevant Points:

  • 2017-2018: Even though 90-95% of seniors living in long-term care and 65.5% of people over 65 living in the community were vaccinated, all 63 people who died were over the age of 65.
  • 2018-2019: 6 (8%) of the ICU admissions were under the age of 19. Canada wide, 10 pediatric patients died (8 aged 2-4).
  • 2019-2020: Data includes weeks through July 18. 4 (21%) of the ICU admissions were under the age of 19. All deaths have been adults.

Cases

The 2019-2020 Influenza season appears to be a particularly mild one. Up to Week 9 (March) there were just 244 lab confirmed cases compared to 393 the previous season and 485 two years ago. Case wise, it was on par with the 2016-2017 season. Looking at the percentage of total cases to week 9, I have no reason to think that COVID-19 has tainted the data with regards to lab confirmed cases of Influenza. Current cases compared to cases by Week 9 for this season are on par with the previous 3 seasons.

ICU Admissions

Actual ICU admissions related to Influenza in 2019-2020 are down compared to projections. Based on the previous 3 seasons, and the current season to week 9, ICU admissions related to Influenza are down 20-37%. During the previous 3 seasons, the ICU admissions rate (ratio of ICU admissions to total lab confirmed cases) was as low as 5.43% and as high as 9.28%. This season, the rate is just 4.31%. Is it possible that people who should have went to the ICU simply didn't seek out help as a result of COVID-19 fears and restrictions? This seems less likely as being admitted to the ICU is not typically voluntary so if you were that ill, you would go to the hospital no matter what. Is it possible some people who were in fact admitted to ICU had both COVID-19 and Influenza but priority of diagnosis was given to COVID-19, and that was labelled as the reason for being in ICU when in fact Influenza is really why they are there? Given the case data for Influenza appears accurate, this suggests people are being tested for Influenza as expected, but if they also have COVID-19 then all the data beyond diagnosis is being associated with COVID-19. Whatever the reason, without a doubt the number of ICU admissions related to Influenza in the current season are well down from what we would have expected based on historical results.

Deaths

Actual deaths related to Influenza in 2019-2020 are down compared to projections. Based on the previous 3 seasons, and the current season to week 9, deaths related to Influenza are down 18-61%. During the previous 3 seasons, the death rate (ratio of deaths to total lab confirmed cases) was as low as 6.11% and as high as 8.53%. This season, the death rate is just 2.04%, meaning far fewer Influenza deaths have been reported since March 2020 versus what we would have projected based on historical data. That said, to add some context, the current season and the 2016-2017 season have essentially the same number of Influenza cases, yet the current season saw half the number of deaths through Week 9. Even so, the numbers suggest that anywhere from 2-14 Influenza deaths are effectively missing from the current season. Is it possible that a handful of cases of Influenza, perhaps in Northwood, that would have resulted in the deaths of those individuals, were labelled as a COVID-19 death because they also had a positive COVID-19 test? We already know directly from Northwood's CEO that if a Northwood patient with a positive COVID-19 diagnosis died, that death is labelled as a COVID-19 death regardless of whether it was a contributing factor or not.

Summary

I want to be clear that this short analysis is not meant to be any kind of indicator or accusation of manipulation of numbers by the Government to make COVID-19 look worse. I don't believe that to be the case, but I do find it concerning that there has been zero discussion around these objective facts. It tends to feel as though the Government is trying to protect us from ourselves by omitting key information that might lend itself to a better understanding of where the numbers come from, and the reality of the danger presented by COVID-19. As in, if we knew everything and weren't as scared or cautious as a result, then we might engage in behaviours that would cause a resurgence of COVID-19, so it's better to just keep the details quiet and keep everyone on high alert. I don't mean for that to come across as sounding conspiratorial, but if you think about it, it does make some sense. Some of you will agree with that approach if it means keeping people safer, others will not agree and demand the truth and allow people to act based on facts. Whatever you believe, one objective fact is undeniable, and that is that we are not being given all the information, which is precisely why I started this page, so that those who wanted more information than was being provided in the mainstream, had that access.

The biggest half truth (or lie by omission) I find most compelling that still isn't something widely discussed, if at all in the mainstream, is the difference between dying WITH COVID-19 vs dying FROM COVID-19. We know as an objective fact that if someone has an active case of COVID-19 (or even a recovered case in Britain) and subsequently dies, their death is labelled as a COVID-19 death, even if it wasn't the contributing factor. I understand this, to a degree. The WHO has previously stated this policy was to ensure they capture as much data about the virus as possible whilst managing a pandemic. I can appreciate that, but the issue is this concept has been muddied and not made clear, resulting in the masses being under the belief that the various COVID-19 death tolls around the world are deaths FROM COVID-19, as in, each of these people would still be alive today if it weren't for COVID-19. This is a patently false belief that is supported in the mainstream media and Government's the world over through the choice of words used during updates.

In Nova Scotia, 64 deaths have been attributed to COVID-19 but I will say, with the utmost confidence, that if COVID-19 did not exist, not all of those 64 people would be alive. 53 of those deaths were in Northwood, where we know that the bulk of cases were in the wing where the sickest, most frail patients lived. Many of them were already on end of life care, meaning a death at any moment was to be expected. Why have we not yet seen a simple report from Northwood that shows how many deaths have occurred there each month over the last 5 years? Was the 6 week period from April 18 (1st reported COVID-19 death at Northwood) to May 30, 2020 (date of last COVID-19 death at Northwood) particularly bad like the 53 COVID-19 deaths would suggest, or was it more or less on par? Or maybe June through August of 2020 have seen significantly fewer deaths, suggesting COVID-19 had an impact, but simply pushed things ahead by a month or 2 for some sick patients? I don't mean to write that off as irrelevant by any means, and I certainly understand that every day of life is important, but all of these questions and all of this data is crucial to fully understand the actual danger and the actual toll caused by COVID-19. If it wasn't for COVID-19, would all 64 people still be alive? Certainly not but it makes a big difference if 60 would have vs if, say, 0 would still be. With this data just in NS, we could likely extrapolate that reasonably well Canada wide given well over 80% of Canada's COVID-19 deaths occurred in long term care homes, just like in NS. It may be years, if we ever actually know the true toll of COVID-19. Everything from total excess deaths to deaths by leading causes will have to be analysed to determine the true toll.

Have you noticed that there hasn't been a single person admitted to the hospital in any of the Atlantic Provinces in, well, I'm actually not sure how long but it's been many weeks, if not months. Of course the number of cases are way down but if this virus were so dangerous that our entire way of like is to be altered, with no end in sight, it seems odd that not one single person in weeks has even had to to be hospitalized? Of course the answer is simple, and that's because nearly all recent cases have been people under 60. Even Influenza kills about 10 children annually, yet not one single person under 20 has died from COVID-19 in Canada (out of nearly 9000 reported deaths). It seems we have gotten a lot better at keeping COVID-19 out of long term care homes, and as a result the outcomes have been 100% successful with 0 deaths and 0 hospitalizations in Atlantic Canada for weeks on end. If people are going to be scared, or agree to wear masks and continue to physical distance indefinitely and be ok with not seeing family who live in other parts of the country or even the world, then we should be able to agree on that based on facts on the ground. If the truth is being obfuscated to bring our fears in line so we accept restrictions in the name of public safety, then one has to wonder what that truth is? Because you can be certain that if the objective truth was terrifying, we would be inundated with nothing but the truth. Yet here we are, having to wade through the data ourselves, which each and every time seems to offer a simple conclusion that things are just not as bad as they are made out to be. Time to turn off the TV for a while.

Sources:

Saltwire

NS Gov