Surgo Ventures

The Coronavirus’ Hidden Death Toll in America’s Counties

Our examination of 366 counties across the United States finds that COVID-19 deaths were two to 30 times higher than reported COVID-19 death rates.

Coronavirus has taken a major toll on the US, and we likely don’t yet know the full extent of its damage. At Surgo Foundation, we’ve been concerned that the severity of the epidemic is being obscured by a massive underreporting of “excess deaths” — or the number of deaths above the average recorded for the same period in previous years.

1. Death rates this year are higher than normal across many US counties.

Across the 366 counties we examined, there were on average 51 more deaths per 100,000 people than the average for the same period in 2014–2018. If this rate held against the entire US population of 328 million, this would amount to over 167,000 excess deaths this year to date.

2. The rate of excess deaths is even greater than the rate of reported COVID-19 deaths.

As the graph below shows, counties with more COVID-attributed deaths also had a greater number of overall excess deaths — that is, deaths above the average number for the same period in 2014–2018.

3. The discrepancy between reported COVID-19 deaths and overall excess deaths isn’t the same across the country.

We also observed that a number of counties in the Southern US (in yellow in the graph above) have very low reported COVID-19 death rates, but high excess death rates, even if they’re not as extreme as they are in Lee County. This raises the possibility that deaths resulting directly from COVID-19 are being underreported.

4. We see more COVID-19 attributed deaths where we have done more testing.

The data suggest we could be missing large numbers of COVID-19 deaths in places where testing is low.

  • We calculated excess death rates in each county during this three-month period by comparing current death rates with average rates for the same period in 2014–2018.
  • Because of low mortality reporting, we excluded Connecticut counties from our analysis.
  • CDC death data for 2020 are provisional. It takes anywhere from 2 to 8 weeks (sometimes even longer) for a reported death to be processed and added to the data — meaning that the final numbers will almost certainly be higher still. CDC methodology is available on their website.
  • State-level testing data and COVID death rate data were retrieved on May 13th from the Johns Hopkins University COVID-19 Github repository.
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