While there have been accusations that the statistical data from China regarding the infection and mortality rate have been inaccurate, a recently published alert from the Centers for Disease Control and Prevention shows how coronavirus data in the United States is being skewed.
Back in early March 2020, the CDC provided this briefing note from the CDC's National Vital Statistics Service (NVSS) as follows:
Here is a highlighted copy of the guidance:
Basically, according to the CDC, COVID-19 should be reported on the death certificates of all decedents who either died as a result of contracting the novel coronavirus or where the medical professional assumes that novel coronavirus caused or contributed to death. This could result in over-reporting of deaths from COVID-19.
More detailed guidance was released on April 3, 2020. The CDC has provided additional guidance for medical staff on certifying deaths due to COVID-19 as shown on these three pages:
You will notice that I have highlighted two sections on the second page. The key paragraphs state that the underlying cause of death (UCOD) should be reported as COVID-19 if it played a role in the death even if there are underlying or otherwise life-threatening conditions. As well, if a definite diagnosis of COVID-19 cannot be made but is suspected, it is acceptable to report COVID-19 as either "probable" or "presumed" even if testing is not done.
Here are two sample death certificates from the April 3rd guidance showing how the CDC wants COVID-19 recorded as the cause of death. In the first case, the decedent has a history of high blood pressure and chronic obstructive pulmonary disease (COPD and yet COVID-19 is reported as the UCOD:
...and the second patient was not tested for COVID-19 but COVID-19 is again reported as the UCOD:
One has to ask the following question; when we are receiving our daily COVID-19 pandemic updates, are we getting the information in the context in which it was reported? For instance, is the media distinguishing between confirmed COVID-19 deaths and presumed COVID-19 deaths? Thanks to lax reporting by the media, we have no context in which to better understand the massive volume of data about the current pandemic, meaning that we have no idea of whether the number of reported deaths in the United States is false or misleading.
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