Abstract

Efforts to mitigate the spread of coronavirus disease 2019 (COVID-19) in the United States require an accurate understanding of how the epidemic is progressing. Datasets available from the National Center for Health Statistics (NCHS) record weekly numbers of deaths attributed to a set of ‘select causes’ from 1 September 2019 through 12 August, 2020, including deaths from COVID-19 from 1 February through 12 August, 2020 in the entire United States (US), by state, and cumulatively for individual counties. Comparing US and state level deaths from select causes recorded in 2020 with values from 2014-2019 identified a number of changes that exceeded 95% confidence limits on historical mean values, including three states with possible deaths from COVID-19 in December 2019. Comparing the NCHS datasets with data compiled by four public pandemic tracking sites on deaths from COVID-19 suggests that a large number of deaths counted by the public data tracking sites have not yet been reported to the NCHS. Estimates using the percentage of deaths from COVID-19 relative to all Natural Causes as reported to the NCHS and the numbers of COVID-19 deaths counted by the public tracking sites suggests that perhaps 20% of deaths from Natural Causes, as many as 200,000, may not yet have been reported to the NCHS. Evaluating changes in the fractions of deaths attributed to COVID-19 and other specific causes or nonspecific outcomes during the epidemic, relative to 2020 totals or historical mean values, can provide a valuable perspective on the public health consequences of COVID-19.