Special Report

How COVID-19 Is Being Underreported in Most States

The United States is approaching 100,000 confirmed COVID-19 deaths, which is by far the most of any nation and more than one-quarter of all confirmed global deaths from the disease. As steep as the U.S. death toll is, it is likely under reported, and the actual COVID-19 death toll is estimated to be much higher.

To assess the impact the pandemic has had so far on mortality nationwide, The Centers for Disease Control and Prevention released a report on the number of excess deaths nationwide and in each state. The report compares the observed numbers of deaths each week this year to the numbers of expected deaths for that week based on historical trends. Nationwide, 88,400 more Americans than expected died from March 1, 2020, through May 9 — about 12,100 more than the COVID-19 reported death toll during that period.

The medical community has several plausible explanations for this discrepancy, including under testing, the failure to attribute some home deaths to COVID-19, and misdiagnosis of COVID-19 as other respiratory diseases such as pneumonia and the flu. It is also likely that in the hardest-hit states more Americans than expected are dying from other causes. The additional stresses on the population, the medical system, and the economy caused by the pandemic are likely also contributing to higher than expected deaths from non-COVID-19 causes. 

24/7 Wall St. reviewed the number of excess deaths as reported by the CDC that occurred from Mar. 1 to May 9, 2020, in each state (except for Connecticut and North Carolina, where data is more limited) and compared it to the state’s reported number of COVID-19 deaths over the same period. 

In some states there have been no excess deaths once confirmed COVID-19 deaths are accounted for. In many states, however, the number of excess deaths surpasses the reported number of COVID-19 deaths by hundreds, and in some cases, thousands. 

Generally, the states with the most excess deaths since March 1 after accounting for confirmed COVID-19 deaths already have among the highest reported COVID-19 cases and deaths per capita. States like New York, Pennsylvania, and New Jersey, which are among the top 10 states with the highest number of COVID-19 cases, have thousands of unaccounted for excess deaths each. 

However, there are also states with high numbers of excess deaths above the COVID-19 reported deaths that do not rank among the top 10 states for reported COVID-19 deaths, including Texas, Virginia, and South Carolina. All three of those states had among the fewest COVID-19 tests performed per capita as of mid-May.  

“COVID-19 is massively under reported in the country and all around the world,” Mark Siedner, associate professor of infectious diseases at Harvard University told 24/7 Wall St. Siedner attributed this underreporting to the ongoing shortage in testing as well as to the fact that many people are asymptomatic but have the disease. While most of the under reporting occurs among people who recover, Siedner explained, there is also a significant number of unreported cases in patients who die. Those who die without getting tested are generally not counted as COVID-19 related deaths.

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