U.S. struggles with incomplete COVID-19 death data

Five years after the onset of the COVID-19 pandemic, accurate data on death counts in the U.S. remains elusive. Many deaths linked to the virus were not officially recorded, which has made it difficult for researchers and policymakers to understand the full impact of the pandemic. A study examining data from over 3,000 counties found nearly 163,000 excess deaths from natural causes that were not included in official mortality records. These "excess deaths" help reveal the number of unreported fatalities during health crises. Many of these deaths were connected to COVID-19 after reviewing medical records and death certificates. The pandemic highlighted the need for real-time data to track mortality better. This includes details like cause of death, demographics, and medical history. However, the U.S. system for gathering and reporting this data has been characterized by fragmentation and inefficiency. In 2022, more than 3.2 million deaths were recorded, but experts believe this is a significant undercount. Government health reporting systems have struggled to keep pace with the need for timely data. Old practices, such as using paper death certificates, complicate efforts to gather accurate information swiftly. Delays in reporting and poor coordination among hospitals, state, and federal agencies hinder the ability to provide comprehensive data. Efforts to modernize the U.S. mortality data system have been ongoing for over a century. The establishment of standardized death records helped, but issues remain, including varied timelines for states to submit data. While electronic systems have improved some processes, challenges such as high fees and inconsistencies persist. Experts express concern that current public health policies may not address these data challenges effectively. As new health threats, like bird flu, emerge, the incomplete U.S. mortality tracking system may hinder timely responses to such crises. Without improvements, the ability to manage public health emergencies in the future could be at risk.