In the midst of an unprecedented global coronavirus pandemic that has killed hundreds of thousands of people worldwide, it can be hard to make sense of the destruction COVID-19 has wrought. In this context, the proliferation of conspiracy theories downplaying the dangers of the virus is sadly unsurprising, though disheartening and dangerous nonetheless.
One such theory making the rounds on social media is the idea that death certificates have been knowingly manipulated by medical examiners to inflate the number of COVID-19 deaths, part of a larger right-wing talking point that the government is using the pandemic as an excuse to infringe on American rights.
This theory has been propagated by everyone from conspiracy theorist David Icke (who is most notable for his endorsement of the idea that the world is controlled by a cabal of “reptilian elites,” or lizard people) to far-right figure Candace Owens, who tweeted on April 6th: “Turns out everyone is only dying of Coronavirus now. Gee. I wonder why,” linking to a New York Times op-ed about patients suffering from other ailments, such as heart attacks, appearing at hospitals in smaller numbers than usual. (Owens did not reference, as the New York Times piece does, the very simple explanation that people may simply be too scared of contracting the virus to present at ERs in the first place.)
One video that has been circulating on social media features a Montana physician named Dr. Annie Bukacek questioning the number of COVID-19 deaths in the United States (more than 26,000, as of Wednesday, April 15th).
Brandishing a stethoscope and white lab coat, she argues that the CDC is encouraging medical examiners to erroneously report COVID-19 as a cause of death in many cases, arguing that the actual cause of death in many cases may have been an underlying health condition. “Testing positive for COVID-19 does not mean a person is sick with it or, if the person died, that they died from it,” Bukacek says before concluding with a grand flourish, “based on inaccurate, incomplete data, people are being terrorized by fearmongers into relinquishing … freedoms.”
The video has been reposted on numerous far-right websites, including Zero Hedge and InfoWars. The channel posting this video, which has garnered nearly 800,000 views, is not a purveyor of legitimate medical or scientific information — it’s a religious organization, specifically the Liberty Fellowship, which describes itself as a “non-501(c)3 fellowship of patriot believers” and is run by Chuck Baldwin, a far-right extremist and former presidential candidate for the antigovernment, anti-LGBTQ Constitution Party.
According to Rachel Carroll Rivas, the co-director of the Montana Human Rights Network, the Liberty Fellowship has been regularly congregating at a hotel in direct opposition to Gov. Steve Bullock’s stay-at-home directive, and has been rallying against the government lockdown. (Another video, posted three weeks ago, describes COVID-19 in the title as “a pretext for civil tyranny.”)
Dr. Annie Bukacek is not an unfamiliar figure in the far right. The head of the Montana Pro-Life Coalition, Bukacek is well-known for bringing tiny plastic fetuses to the state legislature; in 2009, she was under investigation for Medicaid fraud following complaints that she had submitted reimbursements for time spent praying with patients. (Bukacek did not return a request for comment.)
Bukacek is also a public official in the state of Montana, having been appointed to the Flathead City-County Department of Health board last winter. Her appointment raised the ire of residents who pointed to her far-right views, including her longstanding anti-vaccination views, as evidence of her unfitness for the position. “For her to be in that position is quite concerning for us and many of the people in the county, even for those who are conservative,” says Carroll Rivas.
Now, Bukacek is using her social media presence to rally against the statewide lockdown in Montana, and to question what she refers to on her Facebook as the “stylish false narrative” of the threat of COVID-19. She is also promoting a rally in Helena on April 19th in opposition to the lockdown (one that would, presumably, be in direct opposition to the edict’s prohibition of mass gatherings).
Regarding Bukacek’s central claim that COVID-19 is being cited as the primary cause of death to inflate the overall death count, this appears to be based on the idea that CDC guidelines indicate that medical examiners should list COVID-19 as the underlying cause of death in instances wherein victims have had other conditions, such as hypertension or COPD (which make them more susceptible to COVID-19 complications to begin with).
Current CDC guidelines are “to list COVID-19 as the underlying cause of death, because it was the disease which initiated the chain of events that directly lead to death,” explains Dr. Sally Aiken, president of the National Association of Medical Examiners (NAME), who says she has received a slew of media requests on the subject over the past week. “[The] idea is that without these conditions, the outcome may have been different.” Other underlying conditions are listed elsewhere on the death certificate, under a section for “other significant conditions contributing to death.”
“This public-health data is beneficial to all of us, eventually giving us a handle on who is most likely to die of COVID-19,” says Aiken. “It is not a conspiracy and not a departure from typical practice.” She also adds that it would be “very difficult” to manipulate data, considering how many “checks and balances [there are] in the U.S. death-investigation system,” with medical examiners’ offices sharing reports of COVID-19 deaths with both the Department of Health and the Bureau of Vital Records. “So there are three groups continuously analyzing, vetting, and refining the reported death information,” she says.
There is, of course, no evidence that COVID-19 death certificates are being manipulated to inflate the death count — and needless to say, having someone with a doctor’s credentials publicly diminish the threat of COVID-19 is dangerous to the public good, to say the least, says Dr. Joan Donovan, research director at Harvard Kennedy Shorenstein Center. “This kind of speculation is driving toward two different outcomes,” she says. “One is very dangerous in the sense that if people think the death rate is being inflated, they may take on risky behaviors. The second would be that, if someone is convinced that the profit motives of the hospital outweigh the drive to keep them well, they may avoid the hospital if they think it won’t provide good care.”
In a country plagued by overburdened hospital systems and a lack of resources and widely available testing, to a degree it makes sense to question the data emerging during a pandemic. But if nothing else, most evidence (including one U.K. study released earlier this week) suggests that COVID-19 deaths are under, not overcounted. That’s, in part, not only because of the lack of widely available testing and hospital resources (which vary widely from state to state), but also due to the fact that many people are dying at home and not at hospitals, says Aiken. “I don’t believe that all deaths caused by COVID-19 are being counted, and I don’t believe that accurate counting will happen in the short-term future,” she says.
This is a bleak reality, one with which many people in this country might not like to grapple. But that certainly won’t stop Bukacek and her ilk from trying to mold it to fit into and promote their own pre-existing worldview, says Donovan. For most of us, this is a tragic pandemic — but for them, “this is a huge opportunity to push forward an agenda.”