| | | | | |  | | By Renuka Rayasam | Presented by American Institutes for Research | WHO LIVES, WHO DIES, WHO TELLS YOUR STORY — More than a year and a half after the U.S. recorded its first Covid death in February 2020, there is still no consensus about the exact number of people who have been killed by the disease. The official tally is more than 725,000, according to the CDC, a number the U.S. hit Monday, the same day that Colin Powell died from Covid complications. But did Powell's passing count as a death from Covid? Surprisingly, there is no consensus on that question. "There is no standardized national case definition that I am aware of yet," Michael Phillips, chief hospital epidemiologist at NYU Langone Health, told Nightly today. "There are a lot of opportunities for difference." The phrase "died of Covid complications" means a variety of different things with no definition. States — or even individual hospitals — have their own criteria for how to count deaths from Covid. Death investigations in the U.S. are generally "non-uniform," James Gill, the current president of the National Association of Medical Examiners, said. There are more than 2,000 jurisdictions that report deaths in the U.S.: Coroners, physicians, sheriffs, justices of the peace and others can all fill out death certificates. Those death certificates are what the CDC examines for its official tally.
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Flags fly at the "In America: Remember" public art installation near the Washington Monument in September in Washington. | States' official tallies are climbing as jurisdictions revise their death tolls based on a closer look at death certificates. Oklahoma added more than 1,000 deaths to its count this week after the state health department investigated Covid deaths. New York added nearly 12,000 Covid deaths to its official tally in August after accounting for all death certificate data and not just those from hospitals, adult care facilities and nursing homes. Both states' data now more closely match the CDC numbers. At NYU, every patient who comes into the hospital — regardless of why they are there — gets tested for Covid to trigger infection protocols if necessary, Phillips said. If the patient is still in the infectious period when they die, NYU counts that as a Covid death. For the most part, NYU's Covid death count accurately captures the number of people who died because they contracted Covid, Phillips said. But there are rare cases in which a gunshot victim who tests positive gets thrown into the official count. It's far likelier that there is an undercount of Covid deaths, rather than an overcount. People who don't die in hospitals, say in nursing homes or prisons or in their homes, may never have been tested before dying. The CDC counts only deaths where Covid is listed on a death certificate as a cause or contribution to the patient's passing. It acknowledges that about 20 to 30 percent of death certificates have issues with "completeness," saying "cause-of-death information is not perfect, but it is very useful." These subtleties will be important to historians who study the pandemic and its toll. But they don't matter for most Covid patients. It's clear what they died of, Lisa Maragakis, an infection prevention specialist and epidemiologist at Johns Hopkins Health System, told Nightly. The distinction between dying of Covid and dying from complication of Covid isn't part of the official language. Often a person comes into the hospital because of Covid, but that can lead to a series of other related problems, such as sepsis or organ failure. A family might withdraw care after a patient has been unresponsive on a ventilator for a long time. Or a patient could die from severe lung damage. A death certificate might list the official cause of death as pneumonia, heart attack or stroke, but if Covid is what brought that ailment on, it's listed as a contributing factor. Overwhelmingly, she said, respiratory failure is what is killing the Covid patients she sees. People with compromised immune systems or an underlying health conditions are prone to dying if they get Covid, but Covid is still the reason that patients like Powell died, said Maragakis. Their weakened immune systems couldn't fight off the infection, but had they never gotten Covid, they would still be alive. "People live with cancer for a long time," she said. "It is pretty clinically clear that Covid was the thing that tipped them over." Welcome to POLITICO Nightly. Reach out with news, tips and ideas for us at nightly@politico.com. Or contact tonight's author at rrayasam@politico.com or on Twitter at @RenuRayasam.
| | | | A message from American Institutes for Research: For 75 years, AIR has used evidence to improve lives. Today, we're applying our know-how to address our biggest problem right now—inequity. The AIR Equity Initiative is a $100 million, five-year investment in social science research so institutions can combat injustice and build bridges of opportunity for people and society. Learn More. | | | | | | — DeSantis calls for special legislative session to fight Biden's vaccine mandate: Florida Gov. Ron DeSantis today called for a special legislative session to block the Biden administration's vaccine mandates , taking the most aggressive action yet in his fight with the White House over Covid restrictions. — CDC advisers endorse Moderna, J&J boosters plus mix-and-match strategy: A panel of independent vaccine advisers to the CDC unanimously recommended Moderna and Johnson & Johnson Covid-19 boosters for some adults today , the penultimate step to allowing millions of Americans to receive additional doses. The advisory committee endorsed the FDA's decision to authorize a Moderna booster for people 65 and older and for all adults who either have underlying conditions or work in settings where they're more likely to be exposed to the virus. Those people may obtain the booster, which is half the size of each dose used for initial vaccination, six months after completing the primary vaccine series. — Facebook lobbying surges to $5M during whistleblower uproar: Facebook outspent nearly the entire D.C. influence industry on lobbying during the quarter ending Sept. 30 , putting in its second-most lavish three months ever, according to new filings from the social network, which is embroiled in damaging revelations from whistleblower Frances Haugen. The $5.1 million spree outpaces the company's big tech peers Google, Amazon and Microsoft. The only entities that outspent Facebook on lobbying for the quarter were the U.S. Chamber of Commerce, the National Association of Realtors, Business Roundtable and the drug lobby PhRMA, according to disclosures filed late Wednesday.
| | | | INTRODUCING CONGRESS MINUTES: Need to follow the action on Capitol Hill blow-by-blow? Check out Minutes, POLITICO's new platform that delivers the latest exclusives, twists and much more in real time. Get it on your desktop or download the POLITICO mobile app for iOS or Android. GET A FIRST LOOK AT CONGRESS MINUTES HERE. | | | | | — Battle over creating Space National Guard: The Space Force is here to stay. But a debate over whether the military's newest branch should have its own weekend warriors has turned into the latest space-based political brawl. Lawmakers from Colorado, Florida, Hawaii and other states that are home to space operations are pushing for a dedicated Space National Guard that can provide a talent pool for the technical space branch — while also benefiting from some of the additional spending that would go with it. The House recently passed bipartisan defense policy legislation mandating that a Space Guard be established within 18 months. — Texas asks Supreme Court to let its abortion ban stand: Texas urged the Supreme Court today to turn away a Biden administration effort to halt enforcement of the state's six-week abortion ban but broached the possibility that justices could also opt to use the matter to more broadly consider decades-old precedents affirming abortion rights. The Justice Department this week asked the Supreme Court to take emergency action that would block Texas' novel abortion ban from being enforced while litigation over its constitutionality goes forward. — Fed cracks down on trading by top officials: The Federal Reserve announced today it will ban top officials from trading in individual stocks and bonds as part of a major overhaul of conflict-of-interest rules at the central bank in the wake of recent trading scandals. Under the new rules, Fed policymakers and senior staff will be prohibited from active trading and will be able to purchase only diversified investment vehicles like mutual funds, according to a news release from the central bank.
| | | |   | | | | | | It's October. So Nightly asks you: What's your biggest pandemic fear right now? Share your responses using our form, and we'll include select answers in Friday's newsletter.
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German Federal Minister of Defence Annegret Kramp Karrenbauer and Federal Minister for Foreign Affairs Heiko Maas speak during a weekly government cabinet meeting at the Chancellery in Berlin. | Henning Schacht - Pool/Getty Images | BERLIN TO EUROPE: GET REAL — German Defense Minister Annegret Kramp-Karrenbauer has a blunt message for her European counterparts: Forget your lofty ideas about the Continent defending itself and get real. Kramp-Karrenbauer is doubling down on her dismissal of the idea of European strategic autonomy, which sparked a diplomatic blow-up with French President Emmanuel Macron, and which she sees as further off than ever. While some European leaders have declared the chaotic U.S.-led withdrawal from Afghanistan shows Europe must be able to operate more on its own militarily, Kramp-Karrenbauer has drawn the opposite conclusion: She argues the debacle demonstrates that Europe and the U.S. need to cooperate more closely to be more effective militarily. "There is a lot of talk about European autonomy, or sovereignty, or — as I prefer to call it — more ability to act from the European Union in security and defense. People are asking why we were not in a position to hold the Kabul airport ourselves," Kramp-Karrenbauer told POLITICO in an interview in her Berlin office this week, ahead of a meeting of NATO defense ministers in Brussels today and Friday. "We have to say quite openly: Without the capabilities of the Americans, we, as Europeans, would not have been able to do that," she said.
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| | | | STOP BY ROSSLYN IF YOU HAVE THE TIME — Biden is returning to the trail to campaign for former Virginia Gov. Terry McAuliffe in the closing days of the state's hotly contested governor's race, Zach Montellaro writes. Biden and McAuliffe will rally in Arlington on Tuesday, a week before the election in the commonwealth. It is the second time the president will stump for McAuliffe in the D.C. suburbs, following an event in the area in late July. McAuliffe and his Republican opponent, Glenn Youngkin, a first-time candidate and former private equity executive, are deadlocked in a tight election. A poll from Monmouth University released on Wednesday had the two men tied at 46 percent each among registered voters. Why Northern Virginia: The suburbs of the nation's capital in the state are a voter-rich area where McAuliffe is expected to dominate in the election. In the recent Monmouth poll, McAuliffe led in Northern Virginia, 58 percent to 34 percent, which represented a slight gain for Youngkin from a September poll from the university.
| | | | A message from American Institutes for Research: AIR is applying its know-how to address the biggest problem we face right now—systemic inequity. By investing over $100 million in social science research over the next five years, AIR's Equity Initiative will build and use evidence that can guide policy and improve the lives of people and communities.
But we won't do it alone. The AIR Equity Initiative will work side-by-side with partners and stakeholders, bringing together expertise and diverse viewpoints so we can create sustainable change.
Systemic inequity is a formidable challenge, but we believe in the power of evidence to bridge the gaps that are holding us back. With research and collaboration, we can improve lives across our country—now and into the future.
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