Claim that COVID-19 deaths have been “vastly overcounted” is baseless; the evidence suggests the opposite

On 1 March 2022, The Epoch Times published a piece by Joseph Mercola, the biggest purveyor of anti-vaccine disinformation according to a report by the Center for Countering Digital Hate, where he claimed that COVID-19 “deaths have been vastly overcounted”. Mercola, who has made a career for himself by promoting unproven and unapproved health products, went on to claim that COVID-19 “primarily killed those close to death anyway”, that “most COVID deaths [were] likely due to ventilator malpractice”, and that hospitals were incentivized to drive up COVID deaths. As we’ll show below, all of these claims are inaccurate and were previously fact-checked by Health Feedback and other fact-checking organizations.

Claim 1 (Inaccurate & Flawed Reasoning):

“COVID Deaths Have Been Vastly Overcounted”

Since the beginning of the COVID-19 pandemic, Health Feedback has reviewed multiple false claims that COVID-19 cases, hospitalizations, and deaths were inflated (see here, here, here, here and here). In reality, public health experts believe that COVID-19 numbers are undercounted. In the U.S., for instance, using excess deaths in 2020 and 2021 experts estimate that the true number of COVID-19 deaths may be 20% higher than the official number of over 962 thousand reported COVID-19 deaths as of 10 March 2022. And in India a scientific study published in Science by a team of researchers estimated that the country’s COVID-19 deaths up to September 2021 were six to seven times higher than official reports of 483,178 COVID-19 deaths^[1].

Despite the evidence of undercounting of COVID-19 deaths in multiple countries, in his piece for The Epoch Times, Mercola claimed that “the actual death toll is vastly lower than we were led to believe.” To support his claim, he used a 20 January 2022 YouTube video titled “Freedom of information revelation” by John Campbell, a retired nurse practitioner. In the video, Campbell claimed that the COVID-19 death numbers in the UK “shows the number of deaths actually attributable to COVID may be way lower than anyone thought.” Specifically, Campbell in his video and Mercola in his piece, claimed that only deaths solely caused by COVID-19 should count as COVID-19 deaths, while people with underlying conditions and/or comorbidities shouldn’t be counted as COVID-19 deaths.

Health Feedback previously fact-checked Campbell’s video, as well as similar claims about COVID-19 deaths and underlying conditions and/or comorbidities (see here and here). The claims are based on a misinterpretation of death certificate information. According to these claims, if an individual’s death certificate lists COVID-19 as the cause of death, but also includes a list of one or more other conditions that may have contributed to that death, then this person’s death was actually caused by the other condition(s), not by COVID-19.

However, this line of reasoning is flawed. In such cases, a person with an underlying medical condition and/or comorbidity would most likely still be alive if they hadn’t gotten COVID-19. For example, diabetes is a condition that increases the risk of severe COVID-19 outcomes, including death; a person with diabetes who dies of COVID-19 died because they had COVID-19, not because they had diabetes.

Claims that COVID-19 deaths have been overcounted have been made throughout the pandemic, and are part of a common false narrative about COVID-19, namely that the pandemic is not a serious concern. In reality, COVID-19 has caused over 450 million confirmed cases and over six million confirmed deaths globally as of 10 March 2022. As previously mentioned, in many countries, official COVID-19 numbers are undercounted, meaning the actual toll of COVID-19 globally is much higher. As such, the claim that “COVID deaths have been vastly overcounted” is inaccurate.

Claim 2 (Inaccurate):

“Most COVID Deaths Likely Due to Ventilator Malpractice”

In his piece, Mercola then claimed that “without doubt, most of the early COVID patients were killed from ventilator malpractice.” To back up this claim, Mercola cited an 8 April 2020 article from STAT News and an investigation that found that “80% of COVID-19 patients in New York City who were placed on ventilators died.”

However, the STAT article didn’t state that most COVID-19 deaths were likely due to ventilator malpractice. Instead, the article discussed how, as doctors learned more about COVID-19, they found that it may not always be necessary to put patients on ventilators once their oxygen saturation levels drop below the typical threshold of 93%, but at lower threshold instead. While the article did discuss why ventilators may not be helpful to extremely ill COVID-19 patients and how they may harm some patients, the article doesn’t provide evidence for Mercola’s claim that “most COVID deaths [are] likely due to ventilator malpractice.”

The claim that 80% of COVID-19 patients placed on ventilators died in New York City comes from a 22 April 2020 scientific study that initially reported that 88% of COVID-19 patients in a New York hospital system (Northwell Health) placed on ventilators died^[2]. However, a correction was published two days later clarifying that 24.5% of patients placed on ventilators died, not 88%.

The 24.5% number closely matches data from another study, also from April 2020, which found that less than 17% of COVID-19 patients placed on ventilators had died at Massachusetts General Hospital^[3]. Despite the correction, the JAMA study left some patients and doctors with the incorrect idea that ventilators were the problem, not COVID-19.

Ventilators work by pumping air into people’s lungs when they cannot breathe adequately. This can happen when lung function is impaired, which can occur when a person develops severe COVID-19. Ventilators don’t cure a disease like COVID-19, but they keep people alive as the body fights the infection. As such, ventilators are an important tool in treating severe COVID-19, something Health Feedback explained in more detail in a previous fact-check.

Claim 3 (Misleading):

“Hospital Incentives Are Driving up COVID Deaths”

Mercola then claimed that hospitals are “using treatments known to be ineffective at best and deadly at worst” to protect their bottom line. According to him, this is because “hospitals receive payments for COVID testing all patients, COVID diagnoses, admitting a ‘COVID patient’, administering remdesivir, use of mechanical ventilation, and COVID deaths”.

The claim that hospitals in the U.S. are inflating COVID-19 numbers because they get paid more is an old one, dating back to early 2020. Fact-checks have shown that this claim is misleading. PolitiFact rated this claim a half-truth, explaining that it’s standard for Medicare, the U.S. government’s national health insurance program, to pay roughly three times more for patients who go on ventilators, and due to a federal stimulus law, Medicare was paying 20% more for the treatment of COVID-19 patients.

The U.S. Centers for Medicare and Medicaid Services (CMS), which administers Medicare, provides add-on payment for COVID-19 treatments approved and authorized by the US Food and Drug Administration. This includes remdesivir, which Mercola singled out, but also COVID-19 convalescent plasma, baricitinib, molnupiravir and Paxlovid.

But while it’s true that CMS has add-on payments for COVID-19 treatments—meaning that hospitals do get paid more for COVID-19 patients—PolitiFact pointed out that there was no evidence that hospitals were inflating COVID-19 patient numbers to make more money. There are strict policies for reporting COVID-19 hospitalizations and deaths, and overreporting is unlikely, PolitiFact explained. Instead, COVID-19 cases are actually undercounted due to lack of testing and other factors.

Conclusion

In his Epoch Times piece, Mercola resurrected false claims that were previously fact-checked to support his claim that COVID-19 deaths have been vastly overcounted. As we showed above, there is no support for such a claim. On the contrary, many public health experts agree that COVID-19 deaths have actually been undercounted in many countries.

REFERENCES

• 1 – Jha et al. (2022) COVID mortality in India: National survey data and health facility deaths. Science.
• 2 – Richardson et al. (2020) Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York City area. JAMA.
• 3 – Ziehr et al. (2020) Respiratory pathophysiology of mechanically ventilated patients with COVID-19: A cohort study. American Journal of Respiratory and Critical Care Medicine.