COVID source callout: COVID-19 deaths in U.S. hospitals

Readers active on COVID-19 Data Twitter may have seen this alarmist Tweet going around earlier this weekend. In this post, a writer (notably, one with no science, health, or data background) posted a screenshot showing that the Department of Health and Human Services (HHS) is no longer requiring hospitals to include COVID-19 deaths that occur at their facilities in their daily reports to the agency.

This is not the end of U.S. COVID-19 death reporting, as the Tweet’s author insinuated. Primarily because: hospitals are not the primary source of COVID-19 death numbers. These statistics come from death certificates, which are processed by local health departments, coroners, and medical examiners; death certificate statistics are sent to state health departments, which in turn send the numbers to the CDC. The CDC is still reporting COVID-19 deaths with no disruptions, and, in fact, released a highly detailed new dataset on these deaths last month.

For more explanation, see this thread by Erin Kissane (COVID Tracking Project co-founder) and this one from epidemiologist Justin Feldman. It’s particularly important to note here that, as Feldman points out, plenty of COVID-19 deaths don’t occur in hospitals! About one-third of COVID-19 deaths occurred outside these facilities in 2020.

(Note: The Documenting COVID-19 project has written, in great detail, about how COVID-19 deaths are reported in our Uncounted series. See: this article at USA Today and this reporting recipe.)

It is certainly worth asking why the HHS took in-hospital COVID-19 deaths off the list of required metrics for hospitals. This data field had some utility for researchers looking to identify COVID-19 mortality rates within these facilities—though, from what I could tell, nobody was looking at it very much before this weekend.

But, again, this is not the end of COVID-19 death reporting! This is the HHS making one small change to a massive hospitalization dataset—which was primarily used for looking at other metrics—while the CDC’s death reporting continues as usual.

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