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How Accurate Is New York’s Covid Death Toll? - The New York Times

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The state’s methodology has allowed it to report 11,000 fewer coronavirus-related deaths than the count from the National Center for Health Statistics.

For more than a year since the coronavirus outbreak, New York State officials have stuck with an approach that has allowed the state to report a lower and incomplete death toll.

The number of deaths reported on the state’s online dashboard, and during Gov. Andrew M. Cuomo’s numerous coronavirus briefings, only includes people who died at hospitals, nursing homes and adult-care facilities, but not at home or prisons, for example. The toll also includes only deaths that were confirmed with a coronavirus test by a lab.

New York’s methodology differs from that of many other states, as well as the federal government’s National Center for Health Statistics, which uses more precise criteria to assemble state-by-state death tolls, relying on death certificates submitted by state health departments.

Now, the effect of New York’s more constrained count has begun to show: The state’s official coronavirus death toll as of Wednesday was about 43,000, compared with the death toll of more than 54,000 compiled by the N.C.H.S., a subdepartment of the Centers for Disease Control and Prevention.

New York is not alone: At least half of states, including big states like California and Texas, have publicly reported a lower number of deaths than the N.C.H.S. for different reasons.

But other states with lower death tolls were below the N.C.H.S. number by about 3,000 or fewer; nowhere is the gap between the reported deaths larger than the 11,000-death discrepancy in New York, according to a New York Times analysis.

The disparity in the death tolls underscores the lasting and painful difficulties of accounting for the full scope of coronavirus fatalities, even as much of the government’s response has turned toward expanding the vaccine rollout and the nation’s economic reopening and recovery.

But the wide variance in New York also comes as Mr. Cuomo is facing a series of state and federal investigations into his administration’s efforts to obscure the actual death toll of nursing home deaths during the pandemic.

Johnny Milano for The New York Times

Revelations that Cuomo officials undercounted the deaths of thousands of nursing home residents, as Mr. Cuomo wrote and promoted a book about his leadership during the crisis last year, have led to calls for his resignation and the threat of impeachment.

State health officials defended their accounting methods on Wednesday, arguing that the number of recorded deaths was never portrayed as exhaustive; they noted a sentence in the state’s online dashboard that explains how the state reports deaths. Health officials noted that the C.D.C.’s database relies on death certificate data submitted by the state, evidence that the state was not trying to hide anything.

“New York State reports every single Covid-19 death publicly — every confirmed death reported by hospitals, nursing homes and adult care facilities in the state tracker and all preliminary death certificate data, including unconfirmed cases and home deaths, to the federal government which in turn reports that data online, allowing the public full access to all of this detailed data on a daily basis,” Jill Montag, a spokeswoman for the state Health Department, said in a statement.

Mr. Cuomo, a third-term Democrat, echoed that assessment during a news conference in Brooklyn on Wednesday following a report from The Associated Press that described New York’s approach to counting deaths as conservative.

“We have always reported lab-tested Covid results,” Mr. Cuomo said. “That’s what our reporting has always been.” He added that the C.D.C. asks for additional information, “which we report to them and then they report.”

Indeed, the C.D.C. has clear guidelines specifying how localities should report death certificate data compiled by doctors and coroners to the federal government. The C.D.C.’s system is a lengthy, more accurate process that can often lead to a lag, but is intended to construct the country’s official death toll of the disease.

“With regards to deaths, the gold standard is the death certificate,” said Bob Anderson, chief of mortality statistics at the N.C.H.S. “The reporting in the permanent record will be from the death certificates and that will be true for New York and for the United States.”

He said a death would be added to the official tally “if the death certificate says the death was caused by Covid-19, or Covid-19 was a significant factor.”

State and local officials, however, have taken very different approaches to how they report those deaths to the public on an ongoing basis.

New York State, for example, keeps “probable” deaths from its total counts, even though many states post them regularly; the state includes only lab-confirmed deaths in its total death count. In contrast, New York City, which keeps track of virus deaths separately, accounts for probable deaths.

The New York Times’s coronavirus tracker, which uses data from state, county and local health agencies, puts New York’s virus death toll at about 53,000, which includes 10,000 deaths reported by the New York City health department that the state does not include in its online dashboard.

The difference in the death tolls led some of the governor’s political opponents to criticize Mr. Cuomo’s pandemic response, citing it as yet another example of the governor’s lack of transparency.

“This administration and those unwilling to speak up for our most vulnerable, isolated and ignored have lost any credibility,” Marc Molinaro, the Republican Dutchess County executive who unsuccessfully ran against Mr. Cuomo in 2018, said on Twitter. “Why does it matter? Trust is the currency of leadership.”

Federal investigators and the Assembly’s judiciary committee are currently scrutinizing Mr. Cuomo’s handling of nursing home deaths during the pandemic, among other issues, while the state attorney general is overseeing an investigation into sexual harassment claims lodged by several former and current female aides to the governor.

Reporting was contributed by Albert Sun, Lisa Waananen and Katie Glueck.

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