The number of Americans who died from COVID-19 in March through May was likely significantly higher than the official U.S. count due in part to state-level reporting discrepancies, according to a study published on Wednesday.
The overall number of U.S. deaths for any cause tallied by the National Center for Health Statistics during March, April and May was 781,000, or 122,300 more than the historical average for the period, according to the study funded by the National Institutes of Health and private foundations published in JAMA Internal Medicine.
The number of March through May deaths officially listed as due to COVID-19 was 95,235, or 28% less than that excess number. A Reuters tally for the period that includes "probable" COVID-19 deaths, was higher at 103,649.
Media reports have suggested that many early nursing home deaths or those attributed to pneumonia rather than COVID-19 may have contributed to an undercount.
"Determining the cause of death on a death certificate is not an exact science," said Daniel Weinberger, the study's lead author from the Yale School of Public Health.
"It is possible that someone who had COVID-19 and that triggered pneumonia might have pneumonia listed as the cause of death. Whereas another jurisdiction might have COVID as the cause," he said. "The coding for what a person died from can vary a lot from person to person and jurisdiction to jurisdiction."
In several states, deaths that might later have been attributed to the coronavirus occurred before COVID-19 diagnostic tests were widely available.
"Some states had good concordance between the number of reported coronavirus deaths and the total number. Washington state and Minnesota has almost no gap, but in South Carolina and Texas there is a considerable difference," Weinberger said.
Other studies have found that coronavirus fears kept people with symptoms of heart attack or stroke away from emergency rooms, possibly contributing to increased deaths.
Concerns have also been raised about the increased risk of suicide and drug overdose, triggered by the unemployment caused by the pandemic.
"You can certainly see that things like heart attacks and strokes and people dying with primary cause as Alzheimer's Disease have gone up," Weinberger said. "But when you look at the magnitude it is still smaller than coronavirus deaths."
COVID-19 death reporting discrepancies have decreased considerably in recent weeks as diagnostic testing became more available and awareness of the illness has grown, Weinberger said.
"Things are much better now than they were in March," he said.
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