Thread by @39Magilla

(1) United States #COVID19 Death Counts by State
Estimated from CDC Weekly Counts of Deaths by State and Select Causes last updated on July 1st

Data is only complete through week ending May 23rd.
States sorted by composite ranking.

data.cdc.gov/NCHS/Weekly-Co…

(2) United States estimated to have an additional +35,828 additional deaths as of 5/23/2020.

Texas (+2,703), South Carolina (+939), Arizona (+1,043), California (+3,030), Virginia (+1,321) and Florida (+1,766) have both high counts & high percentages of under-reported deaths.

(3) United States current #COVID19 Death Count estimated to be +35,000 to +47,000 higher than JHU count thru July 5.

129,931: JHU CSSC COVID-19 Deaths
165,759: XND Estimated Deaths, Constant Delta
177,370: XND Estimated Deaths, Constant % Delta

(4) "Excess Natural Deaths" Estimate falls within estimate based on "Excess Deaths Associated with COVID-19" dataset.

US Excess Deaths Estimate, Updated to 7/5:
161 ,589 (95% CI, 148,611-181,433)

US Excess Natural Deaths Estimates, 7/5:
165,759-177,370

data.cdc.gov/NCHS/Excess-De…

(5) Texas appears to have a significant underreporting problem due to misattribution of the Cause of Death for many cases

(6) The Estimated COVID-19 Deaths for each state exclude the Baseline trend established over the first 8 weeks of the year.

This plot illustrates the concept using data for Texas.

(7) I calculate the solid Blue line using 2020 Natural Deaths minus the average of 2014-2019 for the same MMWR week.

I use the first 8w to estimate a baseline (Dashed Blue Line) that accounts for population growth and other non-CV19 effects.

The Gap is the COVID-19 Estimate.

(8) For Texas, there are over 1,000 Excess Death Entries for the following Cause thru 5/30/2020:

"Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99)"

This appears to be a major source of misattribution there.

(9) The Trend in Texas for:

"Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99)"

Parallels the COVID-19 Outbreak. The number of misattributions was not declining as of 5/23/2020.

(10) Some States with very high counts of Confirmed #COVID19 Infections have reported suspiciously low apparent Case Fatality Rates (CFRs).

For instance, Texas has reported a 1.3% CFR, while New York has reported a 7.6% value.

(11) The Excess Natural Deaths analysis suggests Texas has 5,331-7,435 COVID-19 Deaths, but has only reported 2,628.

This partially explains its low CFR raising it from 1.3% to the 2.7-3.8% range.

The remaining discrepancy is likely due to the high number of unresolved cases.

(12) Like Texas, many other states with suspiciously low apparent CFR values have high counts of Excess Natural Deaths, and high counts of unresolved cases.

South Carolina, Arizona, California, Virginia, Florida, Tennessee, and the list goes on,

(13) Here's a slightly better plot of "R00-R99" death counts for Texas. The Blue Line is 2019; The Red Line is 2020.

In 2020, MMWR Week 8, ended 2/22/20.
Week 14, 4/4/20.
Week 21, 5/23/20.

(14) Per CDC dataset, Arizona also has rising death counts assigned to:

"Symptoms, signs and abnormal clinical and laboratory findings not elsewhere classified (R00-R99)"

More than 360 Excess Deaths assigned to this category in June alone. No sign of decline.

(15) For New York City, Excess Natural Deaths that were not attributed to COVID-19 occurred early, but all were attributed to COVID-19 by 5/3/2020.

The Medical Examiners seemed to go up a learning curve.

(16) The table below shows the most common causes assigned to Excess Deaths in New York City.

R00-R99 was the second most common attributed cause.

Many were assigned to heart disease.

(17) For Florida, R00-R99 was by far the most common attributed cause of death for Excess Deaths not attributed to COVID-19.

(18) For Arizona, "R00-R99" took the top spot, "Diseases of heart" took second, and "Cerebrovascular Diseases" took third.

(19) The CDC "Death Counts by ... Select Causes" updated 7/1.

US COVID-19 Deaths were 165,759 to 177,370 on 7/5.

Many states (AZ, FL, TX, ...) are misattributing causes of death.

"R00-R99", "Disease of heart", & "Cerebrovascular Diseases" were the most common misattributions.

(20) Credits:

@COVID19Tracking
Data.CDC.gov
@Worldometers

data.cdc.gov/NCHS/Weekly-Co…

data.cdc.gov/NCHS/Weekly-Co…

data.cdc.gov/NCHS/Excess-De…

(21) JAMA Research Paper estimates true COVID-19 deaths are 28% higher than reported, using "Excess Deaths by All Causes".

I estimate 36.5% using only "Excess Deaths by Natural Causes".

jamanetwork.com/journals/jamai…