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2020 MEDICAL YEAR
IN REVIEW

dating more public restrictions.
Another reported positive test is the Anti-
body test. This test looks for antibodies to the
COVID-19. Antibodies are proteins your
immune system produces to fight off a for-
eign invader, such as a virus. A COVID-19
antibody test cannot diagnose active coron-
avirus infection. All it tells you is whether
you have been infected at some point in the
past, even if that occurred months ago. Un-
fortunately, often these tests, when applied
and reported as positive, gives a false impres-
sion that a person is positive today. In fact,
we do not know how long ago a person was
infected. If the person was infected three
months ago yet is reported as an infected case
the day the result was discovered, then we are
inflating the number of "positive" COVID-
19 cases. This might explain why the "spikes"
of reported cases and the number of deaths
are inversely correlated.
Trying to understand the impact of
COVID-19 is further exacerbated by reporting
cases that are not confirmed and cases that are
lumped in a number of deaths related to, but
not the cause of, COVID-19. According to the
CDC, case and death counts include both con- November 7, 2020, includes the flu and derived from the results. Physicians should
firmed and probable cases and deaths. And the pneumonia and not specifically COVID-19. demand that the PCR test include the Cycle
definition for probable cases is: Again, setting public policy decisions to limit Threshold in every PCR test so the results re-
businesses from operating at full capacity ceived can then be appropriately managed.
• Meeting clinical criteria AND epidemi- based on inflated numbers may not be the Overstating the problem is not helpful to pa-
ologic evidence with no confirmatory best course of action. When we analyze who tients, physicians, or policymakers that rely
laboratory testing performed for is vulnerable to COVID-19, it is compelling. upon the data to make policy decisions about
COVID-19 The elderly with co-morbidities are those our livelihood. We need to make sure these

who are likely to die from COVID-19. distinctions are addressed for all involved.
• Meeting presumptive laboratory evi-
Those who are over 60 years old account
dence AND either clinical criteria OR
for 80% of COVID-19 deaths. Those over 50 Dr. Alan Preston works in the
epidemiologic evidence
accounts for over 95% of all COVID-19 area of Population Health Manage-
• Meeting vital records criteria with no deaths. And if testing were conducted on all ment and has a doctorate in Science
confirmatory laboratory testing per- suspected COVID-19 deaths and we differ- in Epidemiology and Biostatistics
formed for COVID19 entiated between those who died FROM from Tulane University and has spent his en-
COVID-19 vs. WITH COVID-19, the tire career in the healthcare space.
Additionally, COVID-19 death counts in- number of FROM COVID-19 deaths would
clude pneumonia and influenza-like illness be substantially less than reported.
(ILI). Collectively, it is reported as one met- COVID-19 tests are important; however,
ric called PIC. (Pneumonia & Influenza & we need to understand the implication of
COVID). Therefore, the 237k deaths as of how we use the test and what conclusions are

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