Relaxed CDC COVID-19 Probable Case Definition Leads to Widespread Misdiagnosis from Deaths from Extreme UV Index and High Heat Index; US 2020 Reported COVID-19 Mortality Rate 9% of 2019 YTD.

Abstract:

Centers for Disease Control (CDC) rule changes have affected the quality of cause of death certifications and the number of deaths reported.

New COVID-19 US case numbers soared during the 2020 second wave¹ after CDC probable case definition changed² in early April allowing for unconfirmed cases to be counted as COVID-19 cases/deaths³ for symptoms once attributed to heat-related illness⁴ etal. The CDC predicted extreme heat for US states where most cases/deaths have occurred.⁵ The second wave started in US spring/summer as heat index increased from higher UV Index⁶ (UVI, ultraviolet) in the 8 to 11+ range (above the 2006-2019 US average) from less cloudiness due to negative Nino34 anomalies⁷ and positive Central Pacific Outgoing Longwave Radiation⁸.

The daily EPA/CPC UV Index⁹ for 58 US stations for 2020 was directly compared with COVID-19 data¹⁰ and weather data¹¹ to evaluate the coincidence of UVI and heat index on areas with high COVID-19 cases. In southern states with the most cases, the number of cases/deaths per day exhibits a geometric growth pattern with increasing UV severity levels 4-11. Case/death growth followed the duration of UV index extremes when the number of continuous days UVI>=10 exceeded a threshold that was location and population-resilience dependent; short spikes in cases/deaths correlated with UVI 7-day average spikes or long duration high UVI periods.

The COVID-19 death toll in the US is 148K, at 9% of the 2019 US death total YTD. All US state cases are below 2.5% per capita, deaths below 0.18% per capita, the ratio of COVID-19 negative to positive tests is 11.2, with a 1.3% average per capita case rate, and 3.5% rate of death with COVID-19 attribution. 78% of US states reported death peaks/valleys on average every 7 days, often the same day.

Recent Central and South American cases¹² also correlated with high UVI, and could worsen with the SH spring season. Heat-related illnesses in the US should start declining with seasonal UVI towards the NH autumn. Other than actual viral cases, shelter-in-place rules and lockdowns may have contributed to poor weather acclimation to the high heat of 2020 after the US opened again, contributing to the second wave. A new policy is recommended for new public sun & heat advisories with an emphasis on overall healthiness and without mandatory actions like masks and social distancing.