Fauci: About those pediatric COVID hospitalizations ...

Repeat after me: Correlation is not causation. This basic axiom in data analysis keeps getting overlooked in the pandemic, especially when such wisdom interferes with preferred narratives. Give at least one short cheer to Anthony Fauci here, who reminds everyone of this point on a cable net that exists to promote preferred narratives.

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Fauci also makes a good point about math, too:

“First of all, quantitatively, you’re having so many more people, including children, who are getting infected. And even though hospitalization among children is much, much lower on a percentage basis than hospitalizations for adults, particularly elderly individuals,” he said, “when you have such a large volume of infections among children, even with a low level of rate of infection, you’re going to still see a lot more children who get hospitalized.”

“But the other important thing is that if you look at the children who are hospitalized, many of them are hospitalized with COVID as opposed to because of COVID,” Fauci continued. “And what we mean by that — if a child goes in the hospital, they automatically get tested for COVID. And they get counted as a COVID-hospitalized individual. When in fact, they may go in for a broken leg or appendicitis or something like that. So it’s overcounting the number of children who are, quote, ‘hospitalized with COVID,’ as opposed to because of COVID.”

An average of 334 children under the age of 17 were admitted per day to a hospital from Dec. 21-27, which was over 50% more than the week before, according to the Associated Press, citing the Centers for Disease Control and Prevention. That approaches the peak of 342 daily average pediatric admissions in late September.

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We have two basic errors in the panic over pediatric hospitalizations. The first is mistaking correlation for causation; these are admissions that correlate to a positive COVID test, not caused by an acute symptomatic case of COVID. That has been a problem in reporting all along, and media outlets and public officials know that well enough. They may be allowing a tacit “noble lie” to swirl about sudden change in COVID susceptibility to further their mission to get parents to have their kids vaccinated, which is unfortunately par for the course from our medical establishment over the last two years. The only real surprise here is that Fauci doesn’t want to play along this time.

The second error here is overlooking that risks are expressed by percentages. Fauci does a good job of explaining that in brief, but misses an opportunity to advance a narrative here too — because this is why full effective vaccinations matter. To use very round numbers, if a virus has a fatality rate of 0.3%, you can expect 300 deaths in a population of 100,000 immunologically naive people, distributed in a relatively predictable manner by age, co-morbidities, etc. If, however, you employ a vaccine with 90% effectiveness against death to that same population first before exposure, the number of expected deaths drops to 30, which means the vaccine would save 270 lives. The same effect would apply to the other range of responses — asymptomatics, mildly acute, seriously acute, and hospitalization rate, etc on a percentage scale.

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But to get to the accurate rates on each of those responses, we need data that relies on causation rather than correlation. The US has not bothered to fine-tune this reporting despite it being a known issue in data ever since the start of the pandemic. It’s been so bad that people have had to rely on secondary measures such as excess mortality to estimate just how deadly COVID-19 actually is in the general population. It’s clearly deadly, much more so than the flu, but our current measures don’t give us an accurate calculation.

And that ends up producing some rather absurd results, such as this in Colorado a year ago (via Katie Pavlich):

The Grand County, Colorado coroner is calling attention to the way the state health department is classifying some deaths.

The coroner, Brenda Bock, says two of their five deaths related to COVID-19 were people who died of gunshot wounds.

“these two people had tested positive for COVID but that’s not what killed them,” she said. “The gunshot wound killed them.”

The state of Colorado classifies COVID deaths in two ways: A death due to COVID, where it was the underlying cause, and a death with COVID, where there was a positive test but it wasn’t listed as the cause of death.

“Today, Colorado’s reporting 4,156 COVID deaths, these are actually deaths among cases. Then they show 3,230 deaths due to COVID, and so they’re differentiating that, but I think it can maybe go a little further and I think the policy could be changed,” said Richard Cimino, Grand County Commissioner for District One.

No matter the classification, it goes toward the county’s COVID death count. For rural communities even two deaths can hurt perception.

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Lately, public officials have finally begun acknowledging that case counts don’t matter much for policy making, especially with a large part of the population already fully vaccinated. They are instead shifting to hospitalizations, which is a better metric for policy response — but only if we’re dealing with COVID-caused hospitalizations rather than COVID-correlated hospitalizations. Clearly, we have not fixed this data stream, and Fauci’s correct in pointing out just how badly it can mislead us, especially when it comes to measuring subpopulation groups whose risk for acute COVID syndrome is far lower than other demos, such as the elderly and obese.

Finally, here are a couple of instructive graphs on hospitalization curves from the CDC. Bookmark these as the media decides which governor to chase over COVID-related public policy.

Update: This is worth bookmarking too. Our friend Glenn Reynolds wants a truth commission to hold Fauci and others accountable for “noble lies” and misinformation:

But lies and political manipulation are different. Those are a betrayal of trust, and they’re especially serious because trust is the public-health community’s greatest asset. The record here has been terrible, and we need investigation and accountability.

Early on, public-health officials minimized COVID’s dangers, with Anthony Fauci telling people that it was safe to go on cruises. Maybe that was just a mistake. But then Fauci told people not to wear masks because they didn’t help, changing his position within a couple of weeks to become stringently pro-mask. The earlier statement, it turned out, wasn’t based on his scientific opinion but on a desire to reserve masks for health-care workers — a worthy goal, but that doesn’t justify the lying.

Public-health officials then pushed lockdowns to the max, telling everyone to stay in their homes and not to gather in even small groups, but after George Floyd’s death they suddenly announced an exception: It was fine to gather in huge groups if you were protesting on behalf of Black Lives Matter.

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