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Thursday, October 29, 2009

Now About Those Flu Numbers....

I've heard several people call in to radio shows over the past week telling stories about hospitals and MD offices reporting all flu as H1N1. I thought it was just a matter of a failure in communication - until I read the CDC's reports about how they are monitoring influenza activity...

From the CDC's website - Monitoring Influenza Activity, Including 2009 H1N1 - Q & A dated 9/11/09 (emphasis mine)...
"This season, CDC and states will continue surveillance for flu-related hospitalizations and deaths, but the system has been modified to combine all influenza and pneumonia-associated hospitalizations and deaths and not just those due to H1N1. This is a new system in place effective August 30, 2009, that will be used to monitor trends in hospitalizations and deaths. CDC believes this system will provid a fuller picture of the burden of serious flu illness and deaths during this pandemic."

Hmmm - provide a fuller picture? Like maybe having the numbers thrown into one big pot and then reporting them as H1N1 to increase the fear factor?

Thinking that maybe this little blurb was just a "lack of clear communication" I kept reading the report. Here's a synopsis of the reasons for the CDC's change in reporting... (emphasis mine)

"CDC believes that regular seasonal influenza viruses will co-circulae with 2009 H1N1 influenza... There are too many cases of flu to test and confirm so laboratory-confirmed data is a vast underestimate of the true number of cases and this bias would be exacerbated over the course of the pandemic as more and more people become ill...Influenza and pneumonia syndrome is a diagnostic code used by all hospitals."

My summary - too many cases to test individually so let's just lump all flu related symptoms and illnesses together so the numbers justify the administration's claims of a national emergency. How better to attempt to sucker koolaid sippers into supporting Obamacare?

Interesting little tidbit tossed in there about "diagnostic codes". Diagnosis codes are used to bill for medical care. There must be a diagnosis code on every single bill submitted to insurance, Medicare, Medicaid, etc. These codes may or may not be specifically assigned by a MD. Most of the time a MD gives a general description and a certified coder determines the right 3 to 5 digit number to use. How many times have you been to the doctor with fever, aches and sore throat only to be told you have the "flu" without any specific test? The diagnosis code used to bill for the visit would be for Influenza. If you were so ill that you required hospitalization, the MD office would notify the hospital that your reason for admission is "influenza". You would then become one of the CDC's statistics for reporting purposes of hospitalized influenza cases.

Even if you were hospitalized for dehydration due to fever and nausea/vomiting, if the MD said it was because of the "flu", you would still be one of those cases reported to the CDC. There is no testing required to become a statistic for the CDC - only a 3-5 digit diagnosis code.

Here's how the CDC puts it... (emphasis mine)
"The CDC has asked states to report either laboratory confirmed hospitalizations and deaths or syndromic cases, i.e. cases of presumed influenza and/or pneumonia based on ICD-9 coded hospitalizations or death reports."

Multiple times in this same CDC document, you can read this statement...
"Due to CDC's new case definitions, there will be no definitive way to differentiate between hospitalizations and deaths due to seaonal influenza versus those due to 2009 H1N1 influenza from aggregate reporting. And some deaths that are not due to influenza specifically will be included."

Next time you hear a TV anchor claim "Deaths due to H1N1 are rising according to the CDC" take the report with a grain of salt. Better yet, add a little tequila and margarita mix to the salt and re-read the CDC's guidelines for reporting.

But don't worry if those statistics used to scare you into standing in line for 2 hours to get a Swine Flu vaccine seem over the top - the CDC promises that "the numbers generated by this system will be cross-checked periodically against modeling studies to estimate accuracy".

WHEW - I feel better now, don't you?

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