2023
DOI: 10.1101/2023.01.16.23284633
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Differences Between Reported COVID-19 Deaths and Estimated Excess Deaths in Counties Across the United States, March 2020 to February 2022

Abstract: Accurate and timely tracking of COVID-19 deaths is essential to a well-functioning public health surveillance system. The extent to which official COVID-19 death tallies have captured the true toll of the pandemic in the United States is unknown. In the current study, we develop a Bayesian hierarchical model to estimate monthly excess mortality in each county over the first two years of the pandemic and compare these estimates to the number of deaths officially attributed to Covid-19 on death certificates. Ove… Show more

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Cited by 4 publications
(5 citation statements)
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References 39 publications
(57 reference statements)
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“…Eighth, our estimates of COVID-19 mortality may differ from estimates of excess mortality, which include uncounted COVID-19 deaths and deaths indirectly related to the pandemic . Nonmetropolitan areas and some racial and ethnic groups, such as non-Hispanic Black populations, may have a greater number of uncounted deaths . Understanding how undercounting of COVID-19 deaths varied throughout the pandemic is an important area for future research.…”
Section: Discussionmentioning
confidence: 93%
See 1 more Smart Citation
“…Eighth, our estimates of COVID-19 mortality may differ from estimates of excess mortality, which include uncounted COVID-19 deaths and deaths indirectly related to the pandemic . Nonmetropolitan areas and some racial and ethnic groups, such as non-Hispanic Black populations, may have a greater number of uncounted deaths . Understanding how undercounting of COVID-19 deaths varied throughout the pandemic is an important area for future research.…”
Section: Discussionmentioning
confidence: 93%
“… 9 Nonmetropolitan areas and some racial and ethnic groups, such as non-Hispanic Black populations, may have a greater number of uncounted deaths. 9 , 89 Understanding how undercounting of COVID-19 deaths varied throughout the pandemic is an important area for future research.…”
Section: Discussionmentioning
confidence: 99%
“…U.S. national evidence suggests that there has been some undercounting of deaths attributable directly or indirectly to COVID-19 [ 19 , 20 ]. Bias in RMRs could result if COVID-19 deaths are undercounted and the degree of undercounting is associated with vaccination status.…”
Section: Resultsmentioning
confidence: 99%
“…Excess mortality, beyond that directly attributable to acute COVID-19 infection, has been estimated at 24% or a total of 260,000 deaths through February 2022. 4 Emergency care sensitive conditions (ECSCs) are those for which timely access to high-quality emergency care is essential to mitigate morbidity and mortality. A key component of health system readiness to adapt to changes in ECSCs volume now and in future pandemics and other disasters is to optimally manage these conditions, and their risk factors, despite inevitable disruptions in health care delivery.…”
Section: Importancementioning
confidence: 99%
“…The consequences of COVID‐19 disruptions have been considerable. Excess mortality, beyond that directly attributable to acute COVID‐19 infection, has been estimated at 24% or a total of 260,000 deaths through February 2022 4 . Emergency care sensitive conditions (ECSCs) are those for which timely access to high‐quality emergency care is essential to mitigate morbidity and mortality.…”
Section: Introductionmentioning
confidence: 99%