Has US been undercounting COVID-19 deaths? A new analysis suggests so

An analysis of federal data for the first time has estimated a greater number of deaths across the United States -- exceeding the reported tally -- as coronavirus spread in its early weeks.

The analysis suggests that the deaths announced in the weeks leading up to April 4 failed to capture the full impact of the pandemic. The data is based on reports from state public health departments -- an analysis of federal data conducted for The Washington Post by a research team led by the Yale School of Public Health.

To be precise, in the early weeks of the coronavirus epidemic, the United States recorded an estimated 15,400 excess deaths, close to double of what was attributed to COVID-19 at the time. During the same time, the US reported 8,000 deaths from COVID-19.

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This was especially true in New York and New Jersey, states hard-hit by the pandemic.

The team, however, could not show whether the increased deaths were due to coronavirus. But there are strong indications that they were. Interviews and 911 call data from other cities also suggest a spike in the numbers of people dying at home, a circumstance that makes them less likely to be tested for the coronavirus or included in the official death counts.

"In New York City, this discrepancy was even more stark, with three to four times as many excess all-cause deaths as pneumonia and influenza deaths," the team wrote. California had 101 reported deaths due to COVID-19 and 399 excess pneumonia and influenza deaths.

The Yale analysis estimates that, excluding New York City, approximately 1,700 more New York state residents than would be expected had died as of April 4 — far more than the 1,022 counted as COVID-19 deaths.

To this end, the report says the new coronavirus causes respiratory disease, and deaths would presumably be listed among the regular reports of deaths and illness from pneumonia and influenza. Also, patients already weakened by pre-existing conditions such as diabetes, cancer and heart disease may have had a death listed as being due to one of those causes, rather than coronavirus.

As of Sunday, more than 54,000 people had been killed by the novel coronavirus in the US, according to numbers reported by state health departments.

Some of Trump's defenders had earlier claimed that COVID-19 death figures are inflated because they may include people who died with the disease but not of it.

The problem of undercounting coronavirus deaths is not unique to the United States. In many countries, insufficient testing has been a major obstacle to understanding the scale of the pandemic.

Some public health experts had earlier also claimed that COVID-19 was almost certainly spreading in the United States in January and perhaps as early as December, long before the US reported the first official death.

Officials in California said last week that a 57-year-old woman who died February 6 had been infected with COVID-19 and was actually the first recorded death in the US from the virus. Before that announcement, the first coronavirus death in the US was thought to be that of a man in Washington on February 29.