Inadequate support: A more accurate death count from the U.S. National Center for Health Statistics shows that COVID-19 is an important cause of mortality. There is also no evidence supporting the idea that the CDC intentionally inflated the number of COVID-19 deaths to exaggerate the severity of COVID-19 or encourage childhood vaccination.
Misleading: By implying that COVID-19 deaths are the main reason for COVID-19 vaccine recommendations, the claim suggests that the only reason to vaccinate is to prevent deaths. However, there are also other factors to consider, such as the spread of the virus and the risk of potentially persistent medical problems from COVID-19, both of which vaccination can help to reduce.
FULL CLAIM: The CDC “removed tens of thousands of deaths linked to COVID-19, including nearly a quarter of deaths it had listed in those under 18 years old”, it aimed to “overstate the threat posed by COVID-19, particularly for those under 18 years old” prior to the adjustment
REVIEW
The COVID-19 pandemic caused more than 400 million confirmed cases and 6 million deaths worldwide as of 22 March 2022, according to Johns Hopkins University. Mortality is an important metric to guide and assess public policies against COVID-19, such as mask wearing, physical distancing or vaccination[1,2].
Because of its importance in assessing the impact of COVID-19, the COVID-19 death toll has been the target of numerous attempts of disinformation, which usually take the form of claims that downplay the number of COVID-19 deaths and which Health Feedback previously debunked here and here.
In mid-March 2022, many websites and news outlets relayed the claim that the U.S. Centers for Disease Control and Prevention (CDC) updated their COVID-19 Data Tracker and “removed tens of thousands of deaths linked to COVID-19, including nearly a quarter of deaths it had listed in those under 18 years old”. In some instances, it was further suggested that the CDC had inflated the death count, prior to that correction, in order to “overstate the threat posed by COVID-19, particularly for those under 18 years old” and thereby facilitate the expansion of vaccination to children.
In a statement to Health Feedback via email, the CDC confirmed that “an adjustment was made to COVID Data Tracker’s mortality data on March 14 involving the removal of 72,277 – including 416 pediatric deaths – deaths previously reported across 26 states because CDC’s algorithm was accidentally counting deaths that were not COVID-19-related”. The press agency Reuters reported the same confirmation from the CDC.
As of 23 March 2022, the now-corrected numbers from the COVID Data Tracker indicated 785,661 deaths across all ages, including 1,357 among people under 18. Without the correction, the death count would have been around 857,938 deaths for all ages and 1,773 for people under 18. In other words, the correction significantly reduced the total death count by 8% and the pediatric death count by 23%. Therefore, the claim that the CDC revised its COVID Data Tracker death count downward is accurate.
Some suggested that CDC representatives used the overestimated death count to promote childhood vaccination. CDC officials such as CDC director Rachel Walensky indeed referred to statistics from the COVID Data Tracker to encourage vaccination during a press briefing on 22 November 2021 at the White House, Walensky declared, “Data updated and posted today on CDC’s COVID Data Tracker continue to show that unvaccinated people are six times more likely to test positive for COVID-19 than vaccinated individuals. And most tragic are the vaccine-preventable deaths we are still seeing from this disease.” based on the COVID data tracker information.
It should be acknowledged that a 23% reduction in pediatric death count is significant and may mean that COVID-19 is less deadly in children than initially thought. However, we were unable to find an instance where Walensky used the COVID Data Tracker death count specifically to promote childhood vaccination.
Furthermore, there is no evidence that the CDC intentionally inflated the death count to sway public health policy toward mass vaccination. The COVID Data Tracker contains the warning that “Counts from surveillance data are provisional and subject to change”, as the CDC stated in its email to Health Feedback:
“[W]orking with near real-time data in an emergency is critical to guide decision-making, but may also mean we often have incomplete information when data are first reported. Our rigorous quality control measures help us identify when new information changes our understanding of data that has previously been reported.”
In other words, adjustments are bound to happen. The CDC explained that their algorithm mistakenly included deaths not due to COVID-19, leading to the March 2022 correction. A report by The Guardian provided a more detailed explanation of how the error came about. According to the newspaper, the error stemmed from how local authorities filled up the forms when reporting deaths to the CDC:
“One data field asks if a person died ‘from illness/complications of illness,’ and the field next to this asks for the date of death. When the answer is yes, then the date of death should be provided.
But a problem apparently arose if a respondent included the date of death in this field even when the answer was ‘no’ or ‘unknown’. The CDC’s system assumed that if a date was provided, then the ‘no’ or ‘unknown’ answer was an error, and the system switched the answer to ‘yes’.”
The articles which claimed that the CDC intentionally inflated the number of COVID-19 deaths didn’t provide evidence to refute the CDC’s statement.
It’s reasonable to wonder whether childhood vaccination still would have been recommended, if the death count hadn’t been overestimated. However, the decision to vaccinate isn’t based on mortality alone. Vaccination also aims at reducing the spread of the virus in the community and the risk of non-lethal health complications. Epidemiological data from the CDC showed that children aged 5 to 11 can transmit the disease and are at risk of a severe COVID-19 complication called Multiple Inflammatory Syndrome in Children (MISC), which occurs in one out of 3,200 COVID-19 cases.
In fact, the CDC was moved to recommend vaccination for children mainly by the protection it provides against severe but non-lethal conditions. Data from the now-corrected COVID Data Tracker showed a lower risk of hospitalization among vaccinated children. Thus, children benefit from vaccination, even if the disease is generally less lethal to them.
It’s also reasonable to ask whether the corrected, lower death count in the COVID Data Tracker means that COVID-19 isn’t as important a threat to public health as previously thought. But once again, other data don’t support that idea. Indeed, the CDC maintains another more reliable database that tracks COVID-19 deaths. The COVID Data Tracker death count is based on information communicated by U.S. states and jurisdictions on a daily basis. This has the advantage of speed, but reduces the reliability of the data, as explained before.
The other death count is maintained by the CDC’s National Center for Health Statistics (NCHS) and is updated weekly based on death certificates. The process is slower, but provides a more robust estimate of mortality. “Death data on the COVID Data Tracker are real-time and subject to change. NCHS’s National Vital Statistics System is the most complete source of death data, including COVID-19 deaths, as they have a robust and rigorous process for reviewing death certificates in determining the official cause of death,” the CDC explained in its email to Health Feedback.
As of 16 March 2022, the NCHS reported 967,044 deaths involving COVID-19. COVID-19 was listed as the underlying cause of death in 92% of those cases. As Health Feedback previously explained, the underlying cause of death is the event or medical condition that triggered the chain of events leading to the patient’s death. When a death certificate mentions COVID-19 as the underlying cause of death, it is considered a COVID-19 death and added to the COVID-19 death toll. Based on the percentage above, we can conclude that there were 889,680 COVID-19 deaths, according to NCHS.
It’s important to keep in mind that the more reliable mortality data from the NCHS was already publicly available before March 2022, when the COVID Data Tracker was still overestimating COVID-19 deaths. It was thus perfectly possible to use the NCHS when assessing the impact of COVID-19 on mortality. More importantly, the NCHS death count reports a higher COVID mortality than the corrected COVID Data Tracker. Therefore, the reduction of the COVID Data Tracker COVID-19 death count from March 2022 doesn’t imply that COVID-19 is less of a public health threat, since the NCHS data, which better reflects reality, tells us otherwise.
As for pediatric deaths, the NCHS reports 847 deaths, while the COVID Data Tracker reports 1,357 deaths as of 23 March 2022. Prior to the March 2022 correction, the COVID Data Tracker would have reported 1,773 pediatric deaths. Therefore, the COVID Data Tracker did overestimate pediatric mortality. However, given that the NCHS count was already available, there is no evidence that the error in the COVID Data Tracker death count had a significant influence on COVID-19 vaccine recommendations.
In summary, it is true that the CDC removed more than 70,000 deaths from its daily COVID Data Tracker death count, including 416 pediatric deaths on 15 March 2022. However, there is no evidence supporting the suggestion that the death count had been intentionally inflated. The downward revision of the COVID Data Tracker death count doesn’t imply that the public health threat posed by COVID-19 is lower, as the more reliable NCHS mortality data was already available before March 2022 and actually shows a higher number of COVID-19 deaths.
REFERENCES
- 1 – Hale et al. (2021) Government responses and COVID-19 deaths: Global evidence across multiple pandemic waves. PLoS One.
- 2 – Roy and Ghosh (2020) Factors affecting COVID-19 infected and death rates inform lockdown-related policymaking. PLoS One.
