Last week, data from the Centers for Disease Control and Prevention (CDC) revealed that only 6% of people who died of COVID-19 actually have COVID-19 on their death certificate. This has led to accusations that the agency has “back-pedalled” on the number of deaths caused by COVID-19.
The conspiracy theory spread over the weekend, with “Only 6%” trending widely on Twitter. Even President Trump jumped on board, retweeting the suggestion that the CDC had updated its records to show that only 6% of US deaths linked to COVID-19 were genuine.
The original post from "Mel Q” was copied from someone else's Facebook post, which claimed that the CDC had "quietly" updated its numbers "to admit that only 6%" of people listed as coronavirus deaths "actually died from Covid," since "the other 94% had 2-3 other serious illnesses." It was later taken down by Twitter for violating rules of the platform.
The truth is, the data was part of the CDC’s latest regular update to a public statistics page on the pandemic—and it wasn’t published any “quieter” than normal.
The so-called “back-pedaling” is also easily explained. “Death certificates list any causes or conditions that contributed to the death,” the CDC/NCHS Mortality Statistics Branch tells Health in a statement. These causes are entered into the death certificate by a physician, medical examiner, or coroner, and there may be more than one cause or condition listed.
“Any clinician who has had experience deciding on what to list as cause of death on a death certificate, as I have had to do for the past 15-plus years, understands that the diagnoses chosen involve a great deal of discretion and judgement,” Scott Braunstein, MD, medical director of Sollis Health LA, a concierge medicine provider, tells Health. “In most cases, there are multiple contributing diagnoses, and it is common practice to list more than one factor.”
This isn’t just an issue when COVID-19 is a factor. “Underlying diabetes or coronary artery disease are common diseases that contribute to mortality, even when the immediate trigger for death was pneumonia, influenza, or some other infectious process,” says Dr. Braunstein.
While it’s true that in 6% of COVID-19-related deaths, COVID-19 was the only diagnosis listed on the death certificate, that’s only part of the picture.
“Many clinicians will list the physiologic process which caused death,” says Dr. Braunstein. “For example, 55,000 of the death certificates had ‘respiratory failure’ listed as cause of death—we know that this is one of the most common mechanisms by which COVID-19 leads to death. We also know that in over 160,000 of the 180,000-plus deaths caused by COVID-19 in the US, COVID-19 was one of the diagnoses that was listed on the death certificate, and was felt to be the trigger for mortality.”
The CDC has never hidden the fact that pre-existing health conditions can cause people to experience serious complications from COVID-19.
If you look beyond the 6%, you’ll learn that as of August 22, there were 161,392 death certificates that listed COVID-19 as a cause of death. And if you do the math, you’ll see that in 94% of deaths with COVID-19, other conditions are listed in addition to COVID-19, including chronic conditions like diabetes or hypertension as well as acute conditions that occurred as a result of COVID-19, such as pneumonia or respiratory failure.
“The reality is that COVID-19 likely has led to even a larger number of deaths than what is being reported, due to secondary effects of patients being isolated, unable to see their primary care physician or cardiologist in person, or being fearful to present to the ER for evaluation of their chest pain, dyspnea (shortness of breath), or even stroke symptoms,” says Dr. Braunstein. “It’s critical that we don’t allow misinformation to diminish the perception of the toll taken by the pandemic, most prominently the 180,000-plus lives lost in the US due to COVID-19.”
Whatever is shared on social media, the advice from the CDC remains crystal clear. The best way to protect yourself and help reduce the spread of the coronavirus that causes COVID-19 is to limit your interactions with other people as much as possible, wear a face mask and practice physical distancing when you do interact with others, wash your hands frequently, and seek medical attention if you start feeling sick and think you may have COVID-19. These precautions are even more important if you’re at increased risk of severe illness from COVID-19.
The information in this story is accurate as of press time. However, as the situation surrounding COVID-19 continues to evolve, it's possible that some data have changed since publication. While Health is trying to keep our stories as up-to-date as possible, we also encourage readers to stay informed on news and recommendations for their own communities by using the CDC, WHO, and their local public health department as resources.
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