What the CDC Means By Describing COVID As the ‘Only Cause’ of 6 Percent of Patient Deaths

It doesn't mean that only 9,200 Americans have died from coronavirus infections.

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A retweet by President Trump last weekend set off a storm of misinformation about coronavirus deaths and takes advantage of confusion about the concept of “comorbidity” and how death certificates are filled out. 

Trump retweeted a post from a QAnon supporter that claimed, “This week the CDC quietly updated the Covid number to admit that only 6% of all the 153, 504 deaths actually died from Covid, that’s 9210 deaths. The other 94% had 2-3 other serious illnesses and the overwhelming majority were of very advanced age.”

Twitter eventually deleted the Tweet for violating its rules. But the message had already gone viral. Trump and his campaign legal adviser, Jenna Ellis, both retweeted a Gateway Pundit article on the same claim, and Grace Community Church pastor John McArthur declared, “There is no pandemic.”

So, what’s actually going on? First, the CDC’s website, as updated on August 26, does indeed say “For 6% of the deaths, COVID-19 was the only cause mentioned.” The text is an introduction to a table on comormidities, and explains that for the other deaths, there was an average of “2.6 additional conditions or causes per death.”

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  1. Avatar photo
    Earl King

    I just don't get this...I re-read it again. He contradicts himself. Apparently there are 9200 Death Certificates that state only Covid-19. Maning the other 175k deaths had co-morbidities. What is so freaking hard to understand. It means if your are healthy you have a low chance of dying.

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  2. David B.

    Two questions that I had hoped would be answered by this article but weren't:
    1. What is required on a death certificate for it to be included in the official COVID death count?
    2. Is a positive COVID test required to list COVID anywhere on the death certificate?

    For #1, I presume that it has to be listed anywhere in Part 1? Which presumably would be almost always as the underlying cause of death (UCOD) since AFAIK, there aren't other conditions that "cause" COVID. If that is the case, then for the proverbial "got killed in a car crash but had COVID and is included in the COVID death count" would be refuted *for correctly filled out death certificates* because in that instance, COVID would be listed in Part 2: other health problems or not at all. (I think it has to contribute to even be listed in Part 2.)

    Hoping for clarification.

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    John Konya

    I am not a political partisan (the Republican Party left me over four years ago), nor am I an adherent to political conspiracies, and I’m definitely not some sort of nut job QAnon proselyte. That said, this article still has the appearance of chicken-and-egg circular logic. Which cause of death came first, the COVID or the comorbidity? As the spouse of a doctor I can say with some confidence that there is not nearly as much accord within the medical community as the author seems to indicate.

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    David Renken

    Dispatch and or Dr. Yamashita, I've a simple question. Do the other countries, most who reported many less deaths per population than us, have a different standard of tallying their COVID-19 deaths which led to much less numbers?

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    Cole

    Very grateful for this -- so much confusion around this and I had no idea how to process it. Great stuff.

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  6. Raincheck

    Excellent article. I look at a lot of death certificates for family history purposes and this is exactly how death certificates work. Congestive heart failure runs in my family, and it is deadly. But it often shows as contributory, with cardiac arrest or other acute heart failure as the cause of death.

    The increase in deaths this year over normal EXCEED the number of COVID deaths, making it unlikely that COVID deaths are being overcounted. We see similar levels of death all over Western Europe. This isn’t a trick or a conspiracy or a mistake. It is real.

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  7. Joe1776



    “If you died of a clear alternate cause, but you had Covid at the same time, it’s still listed as a Covid death,” Dr. Ngozi Ezike, the director of Illinois's Department of Public Health, explained to reporters.

    https://fee.org/articles/physicians-say-hospitals-are-pressuring-er-docs-to-list-covid-19-on-death-certificates-here-s-why/

    You can see the video if you don't believe me or the article.

    When you combine this with a very hyper sensitive test for covid where it is like saying a person is still in a room when really there is just a hair left - we should all be able to see these numbers are likely quite inflated.

    https://thedispatch.com/p/a-different-question-about-our-covid

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    1. Avatar photo
      JohnF

      The article you are citing was written at the end of April and appears on a site that immediately switched me to an ad denouncing the evils of Socialism.
      Meanwhile, the Doctor you are citing was quoted two weeks later stating the opposite of what you are claiming:
      https://www.nbcchicago.com/news/coronavirus/dr-ngozi-ezike-refutes-notion-that-illinois-is-over-counting-covid-19-deaths/2270810/

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      1. Joe1776

        I am claiming she said what you can hear her say yourself if you watch the video of her talking.

        She is not stating the opposite of what I said at all although she did make a very slight correction. Here is your article:

        “There are also some additional deaths that happen in someone who happened to be COVID positive, but where the COVID infection had nothing to do with the deaths,” she said. “So we are at IDPH trying to remove those obvious cases where the COVID diagnosis was not the reason for the death. If there was a gunshot wound, if there was a motor vehicle accident, we know that that was not related to the COVID positive status.

        “We are trying to make sure that things that aren’t related at all to the COVID diagnosis are removed, but if someone has another illness, like heart disease, and then had a stroke or other event, it’s not as easy to separate that and say COVID didn’t exacerbate that existing illness. That would not be removed from the count,” she added."

        So the only way you are not counted as a covid death is if it is "obvious" covid wasn't related at all. Like being killed by a gunshot. Great. Counting everything else as covid is still going to lead to a gross inflation of the number of covid deaths. Every single heart attack is "covid death" if the person happened to have a positive test. Even though we know many tests are positive in people with no symptoms because they are showing the person positive for the slightest trace of covid.

        https://thedispatch.com/p/a-different-question-about-our-covid

        That is the point in saying that 94% of the "covid deaths" have on average 2.6 other conditions or causes of death listed. Were those other conditions or causes of death going to kill the person if they didn't get covid? Certainly in some people it would. How many? Who knows but it is certainly more than 0. So if you want to say it is false to claim the the number of covid deaths are 9,000 it is equally false to claim the number of covid deaths is 180,000.


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          Gene Godbold

          When you say "gross inflation", what do you mean? Do you have any idea yourself? The article shows that there has to be some *pathology* due to Covid-19 (pneumonia or blood clotting) before it can be listed as a cause of death. Medical personnel know from education and experience and empirical testing (I have worked with some) what people ill and dying from COPD and heart disease and diabetes look like. Similarly, they know what the conditions of Covid-19 look like. When the conditions ("co-morbidities") intersect they are deadly. When the patient dies, they can describe it. Simply having a PCR result reveal the presence of SARS-CoV-2 without underlying pathology (pneumonia, blood clots, leukopenia and other weirdnesses in the blood tests, really high cytokine levels, inflammatory exudates) is NOT going to make it onto the death chart. But if those other things *are* present and it looks like the virus actually *contributed* to the cause of death, then it will be listed as (among other things) a "Covid-19" death.
          Because it is.

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          1. Joe1776

            Pneumonia, blood clotting and heart attacks happened before Covid. Before covid arrived they happened quite a bit in the elderly that account for the 80% of covid deaths. So that is the question was this "due to" Covid-19?

            Look at this guide to help doctors give cause of death specifically look at slide 13 "A Familiar Scene - Two hours after a death in a hospital":

            https://www.cdc.gov/nchs/training/improving_cause_of_death_reporting/

            Even without covid it was hard to say what actually caused many elderly people's deaths. Now we have instructions from hospitals and others in charge of state health departments that every time someone who had a positive covid test dies, unless it is obvious it wasn't covid - such as gun shot, it should be listed as a "covid death."

            Combine that with the fact that we now know these tests are hyper sensitive and show positive even when no symptoms are present and I think we can safely say yes it is a gross misrepresentation to take the absolute highest possible number of 180k and say they all died from covid. Just like it is a gross misrepresentation to say only 9k died from covid. These represent the highest possible and lowest possible numbers.

            The actual number is somewhere in between but claiming either extreme is accurate is a clear misrepresentation.

            Where is the number? We don't know. I guess you can say we don't know the 9k figure is a gross misrepresentation either.

            Look my point is not that covid is more or less deadly than it is. My point is people are routinely being told the 180k death toll is due to covid just like the lives lost in war a due to the war. But that clearly is not the case.

            The scientific community is not informing people what that 180k actually means. They are themselves acting policitally when they let these misrepresentations happen in one direction but then scream and cry when it is the other direction. Perhaps they do not know the real number themselves. But they need to start be honest and open about what the various numbers represents and what economic, political (as in head of department of health instructions) or other factors go into that number.

            I have asked people in health care how this is done and they are confirming every death that even could have the most remote possibility of being blamed on covid is listed as covid. And you know what that is exactly what we are hearing the state department of health is telling them to do. And yes they are also getting more money for doing that.

            What number should people believe? I really don't care what they conclude. My issue is that people are not being given the facts about what is happening and possible influences on what is happening. Twitter and Facebook decides to shut down people arguing the unrealistic lowest number but never does that for people arguing the unrealistic highest number. They shut down anyone that disagrees with their own party's perspective. Where were they when people were posting how trump committed treason or that he was a Russian spy?

            Oh yeah the fact checkers never police their own parties conspiracy theories. Isn't that convenient. Honestly most conservatives see that the vast majority of these "fact checkers" are really just political hacks so they are not going to bother.

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          JohnF

          You are basing everything you are saying on statements that were made within weeks of this pandemic starting up. Meanwhile you are ignoring everything that has happened since then and you are refuting the words of a real Emergency Doctor who has actually been working with COVID patients for the past six months.
          You are either a representative of the Trump campaign, a GRU operative, or an innocent dupe of irresponsible right-wing media sites. What you are not is any kind of credible medical expert or medical statistician that we should believe.
          I trust what this author says. If you were to actually read what this author says, I think you might also agree.
          Meanwhile, I think you are either a political operative or someone who only reads things written by political operatives (or said on FOX News).

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          1. Joe1776

            I am basing what I am saying on what I am hearing from health care workers in my state of Illinois. What they are telling me is confirmed by the video of *the head of the Illinois Department of Health* telling doctors in my state how to fill out these certificates.

            If you see that the guidance given by the Illinois state department of health has changed please give me a link. I don't think they would keep it a secret do you?

            Also if you see that the guidance is different in other states that is good to know as well. I am just asking for information that I think is important in assessing how many people are, in fact, dying from covid. If our media wasn't so political we would not have to dig so much for answers to these obvious questions.

            I read the article and nothing I am saying contradicts what the author said.

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      JohnF

      Did you even read the article?

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      1. Joe1776

        Yes did you even listen to Dr. Ngozi Ezike, (the director of Illinois's Department of Public Health) explain how she is counting covid deaths?

        I would love to hear if this is the standard practice in other states as well.

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    Douglas Brown

    Excellent. My father's death certificate stated he died of complications related to Parkinson's. Even though he had a heart attack a year earlier which was cause by a serious UTI infection. Two weeks before he died we had to admit him to the hospital once again due to another severe UTI. I wonder why they just don't report COVID deaths with an underlying cause as simply - "COVID complications relate to "under lying cause" or some such statement? A second question; I keep hearing, mostly from strong Trump supporters, that hospitals make money when they record a death cause by COVID. Is there any truth to that?

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    1. Joe1776

      Yes it is true hospitals make more if covid is the cause of death. I do not think that is leading hospitals to falsely claim that patients had covid when they didn't have a positive test. But when I do think it would tip the scales in favor of covid being the cause of death when there is more than one reasonable explanation for the cause of death. That is the problem. Lots of conditions can lead to the same sorts of problems that result in covid deaths. When a doctor can get paid more by just listing covid as the cause many will do that. Many may do that because that is the policy.

      https://fee.org/articles/physicians-say-hospitals-are-pressuring-er-docs-to-list-covid-19-on-death-certificates-here-s-why/

      “If you died of a clear alternate cause, but you had Covid at the same time, it’s still listed as a Covid death,” Dr. Ngozi Ezike, the director of Illinois's Department of Public Health, explained to reporters.

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  9. deathtomcmansions

    Here's another good article in a bit more detail: https://respectfulinsolence.com/2020/08/31/only-six-percent-gambit-latest-viral-covid-19-disinformation/

    The author is also an editor for sciencebasedmedicine.org

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    JohnF

    Great article! This is exactly what I expect from the Dispatch, an objective explainer that provides a different angle to a complex issue. Thank you.

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