Study: COVID Death Toll Likely Higher Than Reported

The COVID-19 death toll in the U.S. likely is at least 16% higher than the official tally, and the second year of the pandemic also had nearly as many uncounted excess deaths as the first, according to a PNAS study.

More than 1.1 million Americans have died from the virus, according to the Centers for Disease Control and Prevention.

According to the Guardian, the actual number is likely higher, and researchers looked at data at the county level to discover patterns in geography and time.

Researchers estimated there were 1.2 million excess deaths from natural causes – excluding deaths from accidents, firearms, suicide and overdoses – from March 2020 to August 2022. They estimated about 163,000 of those deaths were not attributed to COVID-19, and most should have been.

"Everyone has wanted to know: why did all these extra deaths happen?" Elizabeth Wrigley-Field, associate professor in the department of sociology and the Minnesota Population Center at the University of Minnesota and one of the study's authors, told the Guardian.

The researchers first examined when and where excess deaths occurred, finding that they began ticking up in the month before major surges.

"The mortality that's not considered COVID starts a little bit before the COVID surges officially start and crests a little bit sooner," Wrigley-Field told the Guardian, indicating  that people didn't realize their illness was COVID.

There was also a rise in out-of-hospital deaths – in homes and nursing homes, for instance – which makes figuring out the cause of death more difficult, the Guardian reported.

The researchers also thought, wrongly, they would see underreporting of COVID deaths mainly in the early months of the pandemic, according to the report.

"Quite the contrary, we find over the first 30 months of the pandemic that serious gaps remained in surveillance," Andrew Stokes, associate professor of global health and sociology at Boston University and one of the study's authors, told the Guardian.

The phenomenon "underscores how badly the U.S. fared as the pandemic continued," Wrigley-Field said. "It does profoundly reflect failures in the public health system."

"There was marked regional variation" in where the deaths occurred, Stokes said, with the hardest-hit in non-metropolitan counties, especially in the West and the South.

"Every jurisdiction is doing this differently, and that's why this is such a mess," Stokes said.

Researchers said that understanding COVID's true death toll — and elucidating the reasons for undercounting — is important for the current responses to infectious diseases as well as preparing for the next pandemic.