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Yes, COVID-19 must be immediate or contributing cause of all COVID-reported deaths

A viewer questioned whether all COVID deaths reported to data dashboards are ‘actually’ from COVID. We VERIFY the criteria.

WINSTON-SALEM, N.C. — It's our ongoing mission to bring you facts -- to ease fears -- amid this ongoing pandemic, which uprooted life as we knew it and imposed a new reality of masking, social distancing and increasingly-contentious political discord. 

That's why it's critically important to stop the spread of misinformation. To do that, we VERIFY claims as true or false, using only vetted, expert sources of information. 


This question is a heavy one about an important COVID-19 metric. We want to warn you, if you have lost a loved one to COVID-19, this information might be triggering.

Viewer Ken Burrell asked, "Is there a way to VERIFY that all (COVID-reported) deaths are actually from COVID-19?"


We've seen similar questions and a lot of confusion about this metric, ever since the CDC published its COVID-19 morbidity report. It showed 94% of COVID-reported deaths from February to December 2020 had more than one cause. Only 6% of death certificates listed COVID-19 as the only cause.




Yes, it is true COVID-reported deaths are from COVID-19, but in many cases, COVID is the contributing, not the immediate, cause of death.

The physician must determine those factors and record them on the death certificate.


The CDC, NCDHHS and Atrium Health Wake Forest Baptist agree yes, it's true -- COVID-reported deaths are due to COVID-19, but COVID-19 might not be the primary cause of death.

Infectious diseases physician, Dr. Chris Ohl explained, "It has to be listed on the death certificate, as either the primary cause or contributing cause of death. Sometimes, particularly the contributing cause can be a little bit in the gray zone, and then it's up to the doctor who is dictating the death certificate."

NCDHHS communications representative Catie Armstrong noted NC's COVID deaths "include people who have had a positive molecular (PCR) or antigen test for COVID-19, who died without fully recovering from COVID-19, and who had no alternative cause of death identified."

She explained deaths are reported by hospitals and clinicians directly to the local and state health departments.

The CDC's reporting guidance is broader. It explains in most COVID-reported deaths, COVID is likely the underlying cause of death listed below the immediate cause of death on a death certificate. In one of the examples listed, COVID-19 prompted acute respiratory acidosis, or lung failure, which ultimately caused the person to pass away. Instances like this are where the reporting can get tricky.

Dr. Ohl gave another example, saying, "For instance, if a person was in the hospital for 45 days with initial admission for COVID, and the actual death is due to a stroke complicating a long ICU stay, how would you record that data?"

He concluded, "Usually, that would be recorded as a stroke as the primary cause and COVID as the supporting or contributing factor. Those would then be counted (as COVID deaths)."

Dr. Ohl explained that's why, sometimes, there can be some overreporting of deaths in all public health scenarios. However, national infectious diseases expert Dr. Anthony Fauci testified before a Senate committee last year that he thought COVID deaths were actually under reported. Either way, experts note, these counts even out over time and provide an accurate measure of trends.

As we talk about metrics, it's important to remember this -- behind every number is a person -- and family -- who is grieving. The CDC reports more than 643,000 Americans have died from COVID-19 since the pandemic started. Health experts emphasize time and again, the best way to prevent severe cases of COVID is to get the vaccine.

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