In a very dialectical media environment, my conspiracy about conspiracy theories is that people make up wild conspiracy theories to discredit any more nuanced arguments. For example, if you raise any specific concerns about mRNA vaccines, someone will not only claim that you’re anti all vaccines but that you also think vaccine jabs implant microchips. Though obviously I’m not “anti” all vaccines, and don’t believe anything regarding implanting microchips which, of course, is very silly. To set the record straight, I also don’t believe that C-19 is a “hoax” or was caused by 5G.

But what’s interesting is that some of the things that were dismissed as conspiracies actually may have some basis after all. For example, human error quite possibly leading to a lab leak of an enhanced virus funded with NIAID money. The virology community continues to try to quash this by saying that so many genetic changes to the virus aren’t possible even after Peter Daszak of EcoHealth Alliance, whose group has funded such research, said quite succinctly that this was easy to do in an interview on Dec. 09, 2019:

“You can manipulate them [coronaviruses] in the lab pretty easily. Spike protein drives a lot of what happens with the coronavirus, zoonotic risk. So, you can get the sequence, you can build the protein, and we work with Ralph Baric at UNC to do this. Insert it into a backbone of another virus, and do some work in the lab.”

Well, at least, this was until he later tried to orchestrate a campaign that the virus had to have a wild source, couldn’t possibly be a lab leak, and that anyone who suggested otherwise is a conspiracy theorist. Daszak is continuing to do this, and was appointed as WHO’s only US investigator investigating the origin of the virus, despite his blatant conflict of interest.

Another thing I heard that I thought was complete bull shit was that hospitals got more money for C-19 patients and thus had an incentive to claim that deaths with C-19 were cases due to C-19. This just seemed to be too crazy to be true. Though when I actually looked into this I found that there were provisions in the CARES ACT that increased Medicare reimbursements. Those most impacted by C-19 are people over 65 on Medicare. Per CDC data that the average age of death was 78.8 years old which is pretty much the average life expectancy in the US. Possibly facilitating the inclusion of deaths with C-19 (as opposed to deaths due to C-19) were subtle changes to the way death certificates were recorded by the CDC in April of 2020.

Seem a bit far fetched? Please continue reading to find out more.

Regarding the CARES ACT, I started with a simple keyword search on Google and found these two “fact check” articles from USA Today and Snopes.

Fact check: Hospitals get paid more if patients listed as COVID-19, on ventilators
Are Doctors and Hospitals Paid More for COVID-19 Patients?


Next I found this bulletin from the American Hospital Association:
Coronavirus Update: CMS Releases Guidance Implementing CARES Act Provisions

And another document from the Center for Medicare & Medicaid Services

Finally I went directly to the CARES ACT, skimmed the table of contents, and found some of the relevant information including Sec. 3710.

Sec. 3710. Medicare hospital inpatient prospective payment system add-on payment for COVID–19 patients during emergency period

(iv)(I)For discharges occurring during the emergency period described in section 1135(g)(1)(B), in the case of a discharge of an individual diagnosed with COVID–19, the Secretary shall increase the weighting factor that would otherwise apply to the diagnosis-related group to which the discharge is assigned by 20 percent

So basically what the CARES ACT did was include reimbursement of Medicare patients by an additional 20% as well as wave some other restrictions. The American Hospital Association link above provides a good summary of all the changes and benefits.

But what about death certificates?

There’s a CDC manual for filling out death certificates that has been used since 2003. https://www.cdc.gov/nchs/data/misc/hb_cod.pdf

A death certificate includes two parts. In Part I, the direct cause of death is listed on the top line, with the events that led up to that cause of death in the below lines of this part. In the 2003 version of the death certificate, Part II included the following language (cap emphasis added):

“Part II All other important diseases or conditions that were PRESENT AT THE TIME OF DEATH and that MAY have contributed to the death, but did NOT lead to the underlying cause of death listed in Part I or were not reported in the chain of events in Part I, should be recorded on these lines. (More than one condition can be reported per line in Part II.)”

Now initially when C-19 began, there were probably C-19 cases in the US that weren’t counted. Maybe that led to the CDC issuing “Report No. 3” in April 2020 as ‘Guidance for Certifying Deaths Due to C-19”

This guidance slightly changed the language in Part II as follows (again caps added for emphasis):

“Other significant conditions that CONTRIBUTED TO THE DEATH, but are not a part of the sequence in Part I, should be reported in Part II. Not all conditions present at the time of death have to be reported—only those conditions that actually contributed to death”

So per the revisions to Part II from 2003 to the new 2020 guidelines anything now listed in Part II now was considered as contributing to death rather than something present at death. So even if C-19 wasn’t a factor in the death, if it was noted anywhere in Part II, it was considered something that contributed to death.

The thing with C-19 is that people don’t die from C-19 directly. They instead die from the immune response and inflammation caused by C-19 particularly from ARDS (acute respiratory distress syndrome) and thrombosis. So it’s the string of events after C-19 occurs (the sequelae) that cause death. Other health conditions, make someone more susceptible to catching C-19, and may lead to death from C-19. But other conditions, especially in older individuals, may cause death where C-19 “present at the time of death” may have NOT been a factor in death.

So for example, if someone was a admitted to a hospital for terminal cancer, and died as a result of cancer, Part I of the death certificate would list cancer or the sequelae of cancer in this part of the death certificate as the reason for death. If that person had been given a PCR test and had a positive PCR test for C-19 (even if DNA had to be amplified as high as 40 cycle thresholds), per the old pre-April 2020, Part II way of writing death certificates, C-19 would have been listed in Part II of the certificate as being present but not contributing to the cause of death. Though per the language change in April 2020, any item listed now in Part II was considered a condition that “contributed to the cause of death”. So again, no longer just something that was also present. And thus the hospital in which this death occurred with C-19 could classify that as a death WITH C-19 as a death DUE to C-19 and get at least a 20% larger Medicare reimbursement.

As noted in this paper just with hospitalized children, even where children were admitted for some other reason besides C-19, if they were PCR positive through routine screening, their admission was reclassified as due to C-19

Given the CARES ACT added reimbursements, why does anyone not think that hospitals would do the same thing with admissions and deaths of elderly Medicare patients? Now this in no way suggests that there weren’t a large number of deaths that resulted from C-19. But there’s really no way to tell if there were also deaths WITH C-19 where C-19 had nothing to do with the death

Just looking at other possible scenarios and you really need to see the case histories to determine if the cause of death was the one of the following:

:• Death as the direct result of C-19,
• Death as the result of the sequelae of C-19,
• Death as the result of comorbidities making someone more susceptible to C-19 (e.g. obese individuals)
• Death where someone had symptomatic C-19 confirmed by PCR, though symptoms were mild and didn’t contribute to the cause of death
• Death where someone had mild symptoms that may have been C-19 that were not confirmed by PCR, and those mild symptoms were mild and didn’t contribute to the cause of death
• Death where someone had asymptomatic C-19 confirmed by PCR (at some CT level), though C-19 didn’t contribute to the cause of death

Unfortunately the way the CDC changed Part 2 of death certificates, this really made it next to impossible to make these distinctions. Plus when you look at CDC data deaths “include” C-19 which technically “includes” both deaths WITH and DUE to C-19.

As shown previously in a prior blog post, cases numbers were inflated by including more cycle thresholds.

In some country like India, death counts due to C-19 are too low. But in the US were number of deaths, like case numbers, possibly inflated? Well, the CARES ACT did provide an incentive to do so. Plus higher case and death numbers obviously added to the fear factor making people more irrational.,,,and thus more compliant. But then how many people in the US died due to C-19 rather than died with C-19? Doubt we’ll ever really know.

One can try to look at excess death maybe for some clues. JAMA posted this article,
The Leading Causes of Death for 2020. .

For 2020 there were 503,976 excess deaths, but nearly 160,000 of those deaths were attributed to other causes including more deaths due to diabetes, heart disease, and unintentional injuries. So overburdened hospital treating C-19 may have led to other deaths. Though, if that was the case, why then were cancer deaths flat? Wouldn’t less access to care increased those deaths? Or, did people admitted to the hospital with stage 4 terminal cancer, who were PCR positive, have their deaths coded as deaths “including” C-19?

More questions, we’ll probably never know the answers to.