Questions That Need To Be Answered

For the past several months I have called for an out brief by State Officials of the Covid Response in Idaho. I respectfully asked for what has traditionally for the past 130 years in medicine been referred to as a Morbidity and Mortality (M&M) review of the State and local health districts response to the Covid pandemic. I would also respectfully request that the local hospital systems carry out a similar review of their responses administratively and medically and that the public be able to have input and that the reports be made available to the public. Because Covid funds and other government transfer payments were used—many of the funds were allocated and matched without ever being appropriated where the money went and how it was used are important questions that should be answered. At the Federal level this is already happening at the Centers for Disease Control (CDC) and at the National Institute for Health (NIH). Such reviews are needed not only in the health care sector but also in Education.

All case fatality rates went up during the Covid years and life expectancy went down. Data from the CDC 2020 is now complete: I invite the readers to review the following link:

https://usafacts.org/articles/preliminary-us-death-statistics-more-deaths-in-2020-than-2019-coronavirus-age-flu/

From 1980 to 2019, between eight and nine people per 1,000 have died each year in the United States. In 2019, the most recent year with official death estimates, 2,854,838 Americans died, and 3,747,540 were born. That means that 8.7 people died per 1,000 that year — up from a low of 7.9 deaths per 1,000 people in 2009.

More than 350,000 Americans died of COVID-19 in 2020. According to preliminary weekly data from the Centers for Disease Control and Prevention (CDC) (as of April 26, 2021), 3,427,321 people died from all causes in 2020.

Looking at the graph at the end of the article it is interesting to note that the death rate in the USA started going up prior to the Covid pandemic. I would also like everyone to compare 1918 the Spanish flu had a death rate 18/1000 people compared to 10/1000 in 2020. Both pandemics were devasting, but the Spanish flew after WWI more so. Also of interest is the fact that 70% of the deaths in the USA occurred in patients over 70yrs of age and 70% of the rest of the deaths from Covid occurred in people with at least two Comorbid conditions. Most interesting to me is the fact that more people were included in all case fatality numbers than died in from Covid. Heart disease and cancer remained the leading causes of death during the entire pandemic so what caused the even high numbers of deaths?

One final thought. The insurance actuarial data is not being published. Total life years lost is a very important number. If a person dies at 20 and they are expected to live until 80, that one death would count for 60 lost years of life. If 60 people aged 79 died that would count for 60 lost years. I am sure the insurance industry has these numbers, and it would be interesting to see what they look like for our country and our State. We know because of a pause in cancer surveillance and detection programs—mammography for example, cancer deaths increased during the pandemic. We know that suicides and homicides increased during the pandemic. We know that drug overdoses increased over the pandemic and drug use increased even more. Just looking at absolute value numbers and death rates doesn’t tell the whole story. We also know that losses weren’t distributed evenly across all demographics.

How many people refused to go to hospitals for care when they knew that access to therapies not included in protocols or because of Centers for Medicare and Medicaid (CMS) had to be followed or Covid reimbursement rates to institutions would not be available? How many people refused to go to the hospital because family members were not allowed to be in attendance with them at the bedside? How many doctors wanted to go off protocols but because of their relationship to hospitals via employment contracts or threats of DE credentialing by the medical staff were held over their heads they acquiesced to practicality instead of following their professional oath? How many nurses and doctors have left their professions because of the tensions created by Federal directives and implemented by hospital administrators?

The single biggest question that needs to be asked is how many people died from non-Covid causes and why after 20 years of being warned wasn’t the health care system better able to absorb the onslaught of Covid patients without hurting the care of other sick patients?

Public education presents a similar problem. We just had a special legislative session where “education” received almost $500 million. Where did all the Covid monies go that were earmarked for education? As with health care the groups most hurt by shutdowns and lockdowns and at home learning were the groups living in the bottom two quintiles of income for families. Learning at home was almost impossible if your family couldn’t afford a computer—or if there are 5 kids in the family and you only have one computer.

I served two years on the USS Virginia CGN38—a Nuclear Cruiser. Our “Nuke” inspections were difficult and everyone one in the crew—especially the engineers and the medical department dreaded them. But our Captain loved them. He welcomed the scrutiny because it proved to him, the Navy and most of all the crew that was being inspected how good a job they were doing. It validated their competence.

Our legislators and our Governor should welcome an inspection of the Idaho Covid response. Just like at the Federal level legislation should be introduced to establish a bipartisan Covid Commission to examine the Idaho Covid response and make recommendations about how we could have done better. Audits of the Department of Health and Welfare (DHW) and the Department of Education (DE) should be done on a yearly basis and organizations receiving more than $100million of transfer payments should be required to undergo independent signed partners audits to be made available to the people of Idaho via their legislature on an annual basis. Audits of the government agencies should also be done by outside auditors—just like publicly traded companies are required to do. The relationships between government agencies and private sector health care systems need to be reviewed and Sarbanes-Oaxley rules defining relationships between the private and public sector need to be considered

There is a lot that needs to be done between now and when the next legislative session begins. It will be interesting to see how our Governor and leadership in the legislature responds to this plea for accountability.

I have my thoughts about that.