COVID-19 death toll has not been overcounted

An Instagram post imploring readers to use "simple math" asserts that U.S. deaths from COVID-19 are vastly overcounted.

The viral post says the number of estimated annual COVID-19 deaths in the United States is 27,530. That’s a long way away from the 385,460 people who the Centers for Disease Control and Prevention says died from COVID-19 in 2020 and the 453,707 who died in 2021.

The premise of the post is that a more factual number of deaths would subtract those who died "with COVID, not from," those who didn't die in nursing homes and those who didn't have four or more comorbidities.

"It's just simple math," the caption says. "Even with these inflated numbers, is 28k deaths a year worth what we are doing (to) society and peoples lives? This is insane."

But in this case, the post itself just doesn’t add up.

It was flagged as part of Facebook’s efforts to combat false news and misinformation on its News Feed. (Read more about our partnership with Facebook.)

Two of the post’s main premises — that the overall COVID-19 death count is inflated by people who died "with" rather than "from" the virus, and that 75% of COVID-19 deaths occurred in people with four or more comorbidities — have been previously debunked.

And though nursing home residents are an already-vulnerable population, studies showed that their risk of dying increased during the pandemic.

The false notion that the numbers of people dying from COVID-19 have been skewed because they include people who died "with" rather than "from" COVID-19 dates to August 2020. That’s when then-President Donald Trump retweeted several posts that claimed the CDC was adjusting coronavirus deaths downward.

The claims were based on a federal report that indicated that of all Americans whose deaths were attributed to COVID-19 on their death certificates, only 6% did not also list other conditions as being factors.

The vast majority of coronavirus-related deaths occur in patients who have other conditions, which are also listed on their death certificates, but that doesn’t mean COVID-19 was not a factor in their deaths.

"Early in the pandemic, some of the answers provided by public officials — who were scrambling to track the disease as it overwhelmed health systems — fed skepticism," according to an article by the Association of American Medical Colleges. The article pointed to April 2020 comments by one White House official who was asked about people who have COVID-19 but die from preexisting conditions; she answered: "If someone dies with COVID-19, we are counting that as a COVID-19 death."

But "federal and state governments gradually altered such policies over the spring and summer to say that in order for a death to be counted as a COVID-19 death, the disease had to have played a role," AAMC reported.

The CDC considers the underlying cause of death as "the condition that began the chain of events that ultimately led to the person’s death," Jeff Lancashire, acting associate director for communications at the NCHS told PolitiFact in August 2020. In 92% of death certificates that mention the virus, COVID-19 was the underlying cause of death.

The post’s claim about nursing home deaths appears to stem from the same logic — that the deaths occurred in an already-vulnerable population that often has comorbidities, so they should be excluded from the overall count. But we found nothing that would suggest a solid, scientific reason for backing those numbers out of the equation.

One study found that for those in long-term care facilities, the risk of dying increased by 4.29% during the pandemic compared with before the pandemic. What’s more, research and news stories have found evidence that even with the official data collection processes, deaths from COVID-19 have been underreported in nursing homes.

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Former President Donald Trump posted on Truth Social and addressed claims of his “incontinence,” saying, “I don’t poop myself.”

The claim that 75% of COVID-19 deaths occurred in people with four or more comorbidities is False. It originated when social media users skewed a Jan. 7 statement from CDC Director Dr. Rochelle Walensky pertaining to deaths of vaccinated people.

She said in an interview that a study of COVID-19 deaths in people who had been vaccinated found that more than 75% of them occurred in those who had at least four other illnesses or diseases at the time they became infected with the virus. She cited it as evidence of the vaccines’ effectiveness.

However, an edited clip of the interview that circulated heavily did not include the fact that the study only included vaccinated people, leaving a  false impression that the 75% statistic reflected all COVID-19 deaths and that the pandemic’s severity had been exaggerated.

Contrary to the assertion of the post, researchers have found evidence that overall deaths from COVID-19 have been undercounted, not overcounted, since the start of the pandemic.

The CDC tracks what it calls "excess deaths" — the difference in the observed numbers of deaths in a period of time compared with prior years. Deaths from all causes, not just COVID-19, have increased since the pandemic started. The CDC says undercounts could be attributed to a number of factors, including deaths being misclassified or those indirectly related to the pandemic, like health conditions that went untreated due to overburdened health care systems. 

USA Today analyzed that data and other research and in December found that public health experts believe the true death toll of the pandemic in the U.S. to be "upward of 20% or more higher than the official tally."

An Instagram post says the number of estimated annual COVID-19 deaths in the United States is 27,530, after you subtract those who died "with, not from" COVID-19, not in nursing homes and who didn't have four or more comorbidities.

That’s bad math built on several false assumptions and arriving at a false conclusion.

COVID-19 was found to be a cause of death for 385,460 people in 2020 and 452,707 people in 2021, according to the CDC. And research shows that, if anything, deaths resulting from COVID-19 have been undercounted, not overcounted, in the U.S.

We rate this claim Pants on Fire!