Massive undercounting of deaths caused directly by COVID-19

Here’s a fantastic piece of in-depth reporting from USA TODAY, investigating why the official COVID death count in the USA over the past 22 months is so much lower than the excess mortality in the nation over that same time.

What the journalists found is that, in rural, poor, and heavily Trumpist counties in the southern and western USA, a combination of limited resources to determine actual causes of death and social stigma associated with death from COVID — often reflected in the attitude of local coroners and medical examiners — has led to enormous numbers of people who almost surely died from COVID having their deaths attributed to other causes.

This of course is the precise opposite of the pattern that the right wing noise machine has been fantasizing about for nearly two years now, by which Biased Liberal Doctors attribute lots of deaths with other causes to COVID, because (((Bill Gates))) and (((George Soros))) pay them $50,000 every time they do this.

The moral of the story is: It’s always projection. Always.

Short-staffed, undertrained and overworked coroners and medical examiners took families at their word when they called to report the death of a relative at home. Coroners and medical examiners didn’t review medical histories or order tests to look for COVID-19. They and even some physicians attributed deaths to inaccurate and nonspecific causes that are meaningless to pathologists. In some cases, stringent rules for attributing a death to COVID-19 created obstacles for relatives of the deceased and contradicted CDC guidance.

These trends are clear in small cities and rural areas with less access to healthcare and fewer physicians. They’re especially pronounced in rural areas of the South and Western United States, areas that heavily voted for former President Donald Trump in the 2020 presidential election. . . .

Lafayette Parish’s chief death investigator, Keith Talamo, acknowledged that most people who die at home are pronounced dead over the phone. He said his office lacks the resources to test every death for COVID-19. And, in a significant departure from widely accepted death investigation practices, Talamo said he typically writes down “what the families tell us” and doesn’t push further.

In and around Jackson, Mississippi, deaths from heart attacks at home doubled in 2020 and are on pace to hit a similar level in 2021. The Rankin County coroner said he wrestles with family members who first argue against citing COVID-19 on death certificates, then reverse course when they learn that the federal government pays for burials of people who die from the coronavirus. 

And in Cape Girardeau County, Missouri, coroner Wavis Jordan said his office “doesn’t do COVID deaths.” Jordan does not investigate deaths himself. He requires families to provide proof of a positive COVID-19 test before including it on a death certificate.

So far in 2021, he hasn’t pronounced a single person dead from COVID-19 in the 80,000-person county.

The whole thing is very much worth reading, especially in the context of the CDC’s release yesterday of final national mortality stats for 2020. These recorded 529,000 more deaths in the USA last year than in 2019. (I’ll have more to say about those numbers in another post).

Normal mortality trends would have produced around 15,000 more deaths in 2020 than in 2019, as the typical decrease in mortality rates tends to almost cancel out the effects on mortality of the increase in the size and average age of the population. Yet only 351,000 of these extra 529,000 deaths were officially attributed to COVID in these statistics. (Other CDC statistics record 385,000 COVID deaths in 2020, which testifies to how much inherent looseness there is in these numbers.)

Now it’s no doubt true that some excess mortality in the USA over the past two years has been caused by the pandemic indirectly, but the USA TODAY story suggests strongly that most of the statistical gap between the 800,000 official COVID deaths and the more than one million excess deaths in America in 2020 and 2021 is going to end up being explained by a grim application of Occam’s Razor: that gap, it will turn out, will have been made up largely of COVID deaths that were incorrectly attributed to other causes — often for reasons related to why the national response to the pandemic has been so dysfunctional in the first place.