key: cord-0999058-0hzi11o2
authors: Kampf, Günter
title: Call to apply a consistent scale in public COVID-19 reporting
date: 2021-11-04
journal: Lancet Reg Health Eur
DOI: 10.1016/j.lanepe.2021.100264
sha: 6da033b6d7d0c6f51d3ad973af45426277f9db2c
doc_id: 999058
cord_uid: 0hzi11o2

nan

The Robert Koch-Institute in Germany regularly reports about the national COVID-19 situation and population-based vaccination level. But a consistent scale is not used. A person is classified as "COVID-19 case" whenever tested positive for SARS-CoV-2 irrespective of any symptoms. But symptomatic fully vaccinated COVID-19 patients are described as "probable breakthrough infection" [1] . A person with typical symptoms and a positive PCR test, however, is more likely to be a "COVID-19 case" than an asymptomatic person with a positive PCR test. The asymptomatic person would be better described as a "probable COVID-19 case" and the symptomatic fully vaccinated patient as a "breakthrough infection". Although the official definition for a breakthrough infection is fulfilled (a fully vaccinated symptomatic person with positive PCR test), the Robert Koch-Institute considers the majority of them not to be a breakthrough infection despite fulfilling their own criteria because they were 80 years or older and therefore had a higher risk to die anyway [1] . This explanation, however, has never been applied for any COVID-19-associated deaths in nursing homes or hospitals among unvaccinated or partly vaccinated elderly persons. Another example are the numbers of COVID-19 deaths. Both people who died directly from the disease ("died from") and people who were infected with SARS-CoV-2 and died for any reason ("died with") are currently being recorded and classified as "COVID-19 deaths" [1] . At the same time 1254 deaths were reported in Germany after COVID-19 vaccination until 31. July 2021 and correctly described as "suspect report" suggesting that the cause of death is uncertain [2] . This important limitation, however, has never been applied for reporting COVID-19 deaths although it is known that some of them "died with" COVID-19. Taking into account that only 6% (median) of adverse drug reactions are reported it can be assumed that the real number of deaths after vaccination is substantially higher [3] . The Paul-Ehr-lich-Institute considered 48 of the 1254 deaths to be possibly or probably related to the vaccination (3.8%). Recent data from autopsies in Norway, however, suggest that 30% -40% of deaths after vaccination among nursing home residents are possibly or probably related to the vaccination [4] . Official reporting should use consistent scales and wordings so that the population can have more confidence in the data provided by health authorities.

GK as the sole author of this Letter, contributed to all aspects of the text.

The author has no competing interests to declare.

W€ ochentlicher Lagebericht des RKI zur Coronavirus-Krankheit-2019 (COVID-19)

Coronavirus/Situationsberichte/Wochenbericht/Wochenbericht_2021-07-22.pdf? __blob=publicationFile. Accessed

Sicherheitsbericht -Verdachtsf€ alle von Nebenwirkungen und Impfkomplikationen nach Impfung zum Schutz vor COVID-19 seit Beginn der Impfkampagne am 27

Under-reporting of adverse drug reactions: a systematic review

Nursing home deaths after COVID-19 vaccination. Tidsskrift for den Norske laegeforening: tidsskrift for praktisk medicin