Since the COVID-19 pandemic was declared in March 2020, a recurring topic of debate has been whether official COVID-19 death statistics in the U.S. accurately capture the fatalities associated with SARS-CoV-2, the virus that causes COVID-19.
Some politicians and a few public health practitioners have argued that COVID-19 deaths are overcounted. For instance, a January 2023 opinion piece in The Washington Post claims that COVID-19 death tallies include not only those who died from COVID-19 but those who died from other causes but happened to have COVID-19.
Most scientists, however, have suggested that COVID-19 death tallies represent underestimates because they fail to capture COVID-19 deaths that were misclassified to other causes of death.
We are part of a team of researchers at Boston University, University of Minnesota, University of California San Francisco and other institutions who have been tracking COVID-19 deaths since the beginning of the pandemic. A major goal for our team has been to assess whether the undercounting of COVID-19 deaths has occurred, and if so in which parts of the country.
Examining excess deaths
One way to examine the issue is to look at what population health researchers call excess mortality. It’s a measure which, in this case, compares the number of deaths that occurred during the pandemic to the number of deaths that would have been expected based on pre-pandemic trends.
Excess mortality captures deaths that arose from COVID-19 directly or through indirect pathways such as patients avoiding hospitals during COVID-19 surges. While determining a cause of death can be a complex process, recording whether or not someone died is more straightforward. For this reason, calculations of excess deaths are viewed as the least biased estimate of the pandemic’s death toll.
As a general rule of thumb – with …