What are excess deaths? NYC coronavirus death toll may be off by thousands, CDC says
The coronavirus death count in New York City may be short by thousands, a new report suggests.
The report, released by the Centers for a Disease Control and Prevention on Monday, analyzed excess deaths data in the city and found that more than 5,000 of these deaths were not included in the counts of confirmed or probable coronavirus deaths — suggesting thousands more may have died from the virus than what’s reported.
Excess deaths are the difference between the number of deaths expected in an area, based on historical trends, and the number of deaths observed during a given period, according to the CDC.
The number of excess deaths can determine whether death counts are higher than they normally would be and can be used amid the COVID-19 pandemic to help determine the potential “burden of mortality” associated with it, the CDC says.
In New York City, the CDC report, which used data from the New York City Department of Health and Mental Hygiene, found there were 32,107 deaths of all causes reported between March 11 and May 2.
Under normal circumstances, the city would expect to have about 7,935 deaths during that same period, meaning there were 24,172 excess deaths, the report found at a 95% confidence interval.
Of those excess deaths, 13,831 were laboratory-confirmed coronavirus-related deaths, according to the report. Another 5,048 were counted as probable coronavirus-related deaths.
The CDC defines a probable coronavirus-related death as one that meets “clinical criteria” and “epidemiologic evidence” without lab testing, one that meets these criteria or evidence along with “presumptive laboratory evidence,” or one that meets “vital records criteria” with no lab testing.
The report classified probable coronavirus-related deaths as those with “COVID-19, SARS-CoV-2 or an equivalent term” listed on the death certificate as an “an immediate, underlying, or contributing” factor without lab confirmation of infection.
But the report says there are 5,293 excess deaths that were not accounted for as probable or confirmed coronavirus-related deaths.
These deaths may be attributable to the COVID-19 pandemic, whether directly or indirectly, but more research would be required to get an exact count, the report says.
Nationally, experts agree that the country’s coronavirus death toll likely has been under-reported and some cite a lack of testing, the misclassification of cases and pre-existing conditions as reasons behind it, McClatchy News previously reported.
The CDC says using excess deaths may give a more accurate measure of the coronavirus pandemic’s impact.
Confirmed and probable death counts may not include people who were not tested for the virus, those who tested falsely negative, those who were infected with the virus after being tested, those who didn’t die in a healthcare setting and those whose doctors didn’t suspect them to be infected, the report says.
Additionally, those with underlying conditions have a higher mortality rate associated with COVID-19 and deaths among them may not be recognized as related to the virus, according to the report. Social distancing and public fear may also keep some from seeking “life-saving care.”
“Thus, monitoring of all-cause deaths and estimating excess mortality during the pandemic provides a more sensitive measure of the total number of deaths than would be recorded by counting laboratory-confirmed or probable COVID-19–associated deaths,” the report says.
Excess deaths can also account for other factors that might affect the death rate, such as “other pathogens circulating” during the flu season, which overlapped, the CDC says.
“Tracking excess mortality is important to understanding the contribution to the death rate from both COVID-19 disease and the lack of availability of care for non-COVID conditions,” the report says.
This story was originally published May 11, 2020 at 3:16 PM with the headline "What are excess deaths? NYC coronavirus death toll may be off by thousands, CDC says."
