Without widespread testing, officials must sort through presumed COVID-19 deaths and those who died with infections rather than from them. Then there are the indirect deaths of people who died from circumstances created by the pandemic.
Yet experts are certain that a lack of widespread testing, variations in how cause of death is recorded, and the virus’ economic and social disruption are hiding the full extent of the pandemic’s death toll.In the U.S., COVID-19 is a “notifiable disease”—doctors, coroners, hospitals and nursing homes must report when encountering someone who tests positive for the infection, and when a person who is known to have the virus dies.
For that reason, she says, the numbers don’t always align with death certificate data, which takes much more time to review and classify. And even those can be subjective. Death certificates are usually completed by a doctor who was treating that person at the time of death or, by medical examiners or coroners when patients die outside of a health care facility.
That’s why the two methods of counting deaths can yield different tallies, leading some to conclude that officials are fouling up the numbers. And neither approach would capture the number of people who died because they didn’t seek care—and certainly will miss indirect deaths like Wittner’s where care was disrupted by the pandemic.
For example, from March 11 to May 2, New York City recorded 32,107 deaths. Laboratories confirmed 13,831 of those were COVID-19 deaths and doctors categorized another 5,048 of them as probable COVID-19 cases. That’s far more deaths that what historically occurred in the city. From 2014 through 2019, the city averaged just 7,935 deaths during that time of year.
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