CDC did not decrease US COVID-19 death toll — here’s how the data was misconstrued

WASHINGTON - A report from the Centers for Disease Control and Prevention showing U.S. COVID-19 death numbers recently led to the spread of misinformation online, including Twitter posts shared by President Donald Trump that were later taken down by the platform for violating its rules.

As of Sept. 1, the CDC reported 183,050 total deaths from COVID-19 in the U.S., though the actual death toll is thought to be higher.

Over the weekend, social media users falsely claimed that the public health agency had “quietly” decreased the death toll to just 9,210. The posts were misconstrued from a regularly updated CDC data table, called “Provisional Death Counts for Coronavirus Disease 2019 (COVID-19).”

The table is based on data from death certificates that mention COVID-19. In the report, the CDC notes: “For 6% of the deaths, COVID-19 was the only cause mentioned.”

The other 94% list “conditions contributing to deaths where COVID-19 was listed on the death certificate.” Among those deaths, the CDC said, on average, there were 2.6 additional conditions or causes per death.

The table shows several “health conditions and contributing causes” for deaths involving COVID-19, such as diabetes, high blood pressure and obesity. There are also problems listed that are known to be caused by COVID-19 itself, including pneumonia and respiratory failure.

“The underlying cause of death is the condition that began the chain of events that ultimately led to the person’s death. In 92% of all deaths that mention COVID-19, COVID-19 is listed as the underlying cause of death,” the CDC said in an email. As of Aug. 22, there were 161,392 death certificates that listed COVID-19 as a cause of death.

The agency’s death statistics were misinterpreted by some users on social media over the weekend who falsely claimed that the data indicated that only 6% of patients had died from COVID-19 in the U.S.

“In 6% of the death certificates that list COVID-19, only one cause or condition is listed,” the CDC said. “In 94% of deaths with COVID-19, other conditions are listed in addition to COVID-19. These causes may include chronic conditions like diabetes or hypertension. They may also include acute conditions that occurred as a result of COVID-19, such as pneumonia or respiratory failure.”

The term “Only 6%” trended on Twitter as a user, who has retweeted QAnon conspiracy theories in the past, shared tweets that falsely suggested the CDC had “backpedaled (quietly) and adjusted” its death records. Trump was among those who retweeted the information, which was later removed by Twitter.

QAnon is a conspiracy theory that alleges pedophiles who are running a global child sex-trafficking ring are battling against Trump, who they claim is attempting to take the pedophiles down and expose them.

“CDC just backpedaled (quietly) and adjusted the U.S. COVID deaths from 153,504 to 9,210. Admitting that their numbers are so (expletive) that they are off by a whopping 94%,” one post that was shared on Facebook read.

The posts were also flagged on Facebook as having “false information” by verified fact-checkers, part of the social media giant’s effort to combat the spread of false news. While Facebook has the ability to take down posts like Twitter, the company often adds a warning label rather than removing them.

According to Dr. William Hanage, a professor of epidemiology at Harvard University, it would be “quite unusual” to only record COVID-19 as a cause of death.

Hanage added that the data is “not particularly surprising” as many Americans already have pre-existing medical issues, such as high blood pressure or obesity. And just because a person suffered from diabetes, high blood pressure or obesity doesn’t mean their death would be excluded from the COVID-19 toll. 

Not to mention that someone with pre-existing medical issues can still die from the novel coronavirus, and the death certificate could mention both conditions as contributing factors.

“If you talk about comorbidities, then people are often meaning something like diabetes, hypertension, obesity, asthma — you know, something that even if you don’t have it, somebody you love almost certainly does, and which get more common as people get older,” Hanage said. “And so it would not be at all surprising if quite a lot of people who died with COVID would also have one of these things.”

Hanage echoed the CDC’s statement in that people who contract COVID-19 are also more likely to develop other health conditions — like pneumonia and respiratory failure — which are listed on the CDC table.

“We know already that people who are unwell with one thing are more likely to be vulnerable to other infectious insults. That’s always been the case. And so that’s nothing really to write home about,” Hanage added.

The way hospitals fill out the cause of death on death certificates was also being misinterpreted, Hanage said.

Death certificates list any causes or conditions that contributed to a person’s death. These causes are listed onto the death certificate by a physician, medical examiner, or coroner, according to the CDC. Death certificates may have one or more causes or conditions listed, as determined based on the medical expertise of that professional.

Past studies have shown inconsistencies with what hospitals or medical facilities record as a cause of death. Hanage said this can be a result of different doctors with different kinds of experience or specialties.

“It was actually even more misleading than I thought it was. If a person dies of COVID-19, it would be very unusual to record just COVID-19 as a cause of death because they’d have come in in the first place with probably a viral pneumonia, and that could have progressed to a bacterial infection, and they’d end up with septic shock. So all of these other things would be written down as well, but the thing that precipitated it would be COVID-19,” Hanage explained.

In July, hospitals were instructed to bypass the CDC and send daily information on coronavirus patients directly to a new online system operated by the U.S. Department of Health and Human Services in Washington, D.C.

The move was part of an effort to streamline the reporting system and make more informed decisions at the federal level. But some reports have indicated the new system has been plagued with delays and inaccuracies.

Still, the CDC figures further show that the highest risk of death is among those who are older and those with underlying conditions — which is something medical experts have said since the pandemic began. And CDC data on excess deaths in the U.S. reflects that more people are dying than usual due to COVID-19.

“We cannot avoid the fact that there is a very large number of excess deaths in the United States, over what we would have expected based on our experience over the last few years. And those people didn't die of nothing, and it’s not a coincidence that they are dying this year. That's because there's a pandemic,” Hanage said.

RELATED: Research suggests coronavirus vaccine will likely require 2 shots to be effective

This story was reported from Cincinnati.