An Instagram post falsely claims that the Centers for Disease Control and Prevention is reporting all pneumonia and influenza deaths as caused by COVID-19. That’s wrong and is based on a misreading of one type of monitoring the agency conducts.
A prominent anti-vaccine activist’s post on Instagram is misinforming users about the COVID-19 death toll by offering a misinterpretation of one way the Centers for Disease Control and Prevention keeps tabs on the pandemic.
The post, from Robert F. Kennedy Jr., wrongly claims that the “CDC has officially acknowledged that it has quietly created a new mortality category : PIC, which groups Pneumonia and Influenza and Covid together… and reports them all as Covid deaths.”
“It appears that the new classification gives official imprimatur to a gimmick that CDC adopted early in the pandemic of counting Pneumonia and Influenza deaths as COVID in order to inflate mortality numbers,” Kennedy wrote.
Paired with his claim was a screenshot of part of a CDC web page focused on COVID-19 surveillance that does look at pneumonia, influenza and COVID-19 hospitalizations and deaths.
“[N]owhere on the CDC or NCHS sites does it say that CDC is counting all PIC deaths as COVID-19 deaths,” Robert Anderson, chief of the mortality statistics branch at the CDC’s National Center for Health Statistics, told us in an email statement. “This is not true. Only the COVID-19 deaths are counted as COVID-19 deaths.”
He pointed out that the CDC’s provisional death count for COVID-19 distinguishes between deaths attributed to COVID-19 and a category of deaths that includes pneumonia, influenza or COVID-19.
The provisional death data runs on a lag, so the last few weeks’ worth isn’t complete. But, as of an update Dec. 16, the provisional death count reported 276,061 deaths attributed to COVID-19 between Feb. 1 and Dec. 12. That’s compared to 423,212 deaths attributed to either pneumonia, influenza or COVID-19 in that same period.
So Kennedy’s post is wrong that the CDC is simply reporting “them all as Covid deaths.” If that was true, the reported COVID-19 death count would be much higher.
The CDC’s measure at the root of the claim — one that looks at pneumonia, influenza and COVID-19 together — is one that has a public health rationale and that is consistent with past practices, experts told us.
The CDC has for years monitored deaths of pneumonia and influenza together as one measure of the flu’s mortality — as archived CDC pages, such as one from January 2016, show. Influenza can cause pneumonia, and so can the novel coronavirus.
“The PIC category was created as a surveillance indicator to monitor COVID-19 mortality, in the same way that we have used combined pneumonia and influenza deaths, for many years, to monitor influenza mortality,” Anderson said. “Pneumonia tends to fluctuate in response to and along with influenza (and COVID-19). This is particularly useful where influenza (or COVID-19) mortality is underreported.”
Alex Washburne, a researcher who has studied the prevalence of the novel coronavirus by analyzing data on influenza-like illnesses, told us in an email that the “CDC’s mortality surveillance is a kind of ‘syndromic surveillance’ similar to their influenza-like illness surveillance, and it’s a way to obtain very useful glimpses of disease burden from a somewhat clunky US health system.”
It makes sense that public health officials would use this surveillance as one way to monitor the pandemic, since there are several diagnosis codes that a doctor may use for a patient with COVID-19 symptoms — especially if a test result isn’t available — said Washburne, now chief scientist and epidemiological consultant at Selva Analytics. For example, a patient might be recorded as having “pneumonia of unknown cause.”
Washburne also said the PIC category “is a useful dataset for disease burden due to respiratory pathogens, which itself is likely a useful category for understanding disease control & prevention (e.g. social distancing and mask-wearing may affect many respiratory pathogens).”
Dr. Justin Silverman, a Penn State assistant professor in the College of Information Science and Technology and assistant professor of medicine who co-authored the aforementioned study with Washburne, agreed. He told us in a phone interview that the PIC metric could be useful for multiple reasons, including “to get a sense of, are we missing COVID deaths?”
But, Silverman said, “no one’s being misled, it’s incredibly obvious” — noting that the CDC’s references to the PIC count are clearly labeled as such.
Anderson, Robert. Chief, Mortality Statistics Branch, National Center for Health Statistics, U.S. Centers for Disease Control and Prevention. Email statement to FactCheck.org. 14 Dec 2020.
“Causes of Pneumonia.” U.S. Centers for Disease Control and Prevention. Accessed 14 Dec 2020.
“Daily Updates of Totals by Week and State | Provisional Death Counts for Coronavirus Disease 2019 (COVID-19).” U.S. Centers for Disease Control and Prevention. Accessed 16 Dec 2020.
“Overview of Influenza Surveillance in the United States.” U.S. Centers for Disease Control and Prevention. Archived 11 Jan 2016.
Silverman, Justin. Assistant professor, College of Information Science and Technology, Penn State. Phone interview with FactCheck.org. 15 Dec 2020.
Washburne, Alex. Chief scientist and epidemiological consultant, Selva Analytics. Email to FactCheck.org. 15 Dec 2020.
“What Coronavirus Does to the Lungs.” Johns Hopkins Medicine. 13 Apr 2020.