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Not everyone is tested for COVID-19, so the total number of cases is higher than the number of confirmed cases. Whenever there are cases of the disease that are not counted, the probability of dying from the disease is lower than the reported case fatality rate. Remember our imaginary scenario with 10 deaths and 100 cases.
Nov 11, 2020 · Estimating the real death rate is hard for two reasons. First, the odds of dying from covid-19 vary greatly depending on a person's age, sex, health and the standard of care received. This means death rates will vary from place to place and at different times.
- Michael Le Page
- 2020
- Overview
- Discussion
- References
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During January–December 2022, 244,986 deaths with COVID-19 listed as an underlying or contributing cause of death occurred among U.S. residents. The age-adjusted COVID-19 death rate was 61.3 per 100,000 persons. COVID-19–associated death rates were highest among males, older adults, and AI/AN persons. The COVID-19–associated age-adjusted death rate varied by HHS region, with the lowest rates in New England (Region 1) and highest rates in the south central United States (Region 6).
Some demographic characteristics of COVID-19–associated deaths have remained similar since 2020; however, changes in other characteristics have occurred over time. During the first 2 years of the COVID-19 pandemic, for example, COVID-19 was listed as the underlying cause on approximately 90% of death certificates. In 2022, the percentage of deaths with COVID-19 as the underlying cause decreased to 76% (7). Changes were also observed in the setting where COVID-19 deaths are occurring. Whereas most COVID-19 deaths still occur in hospital inpatient settings, the proportion of those deaths decreased in 2022, as more deaths occurred in decedents’ homes and nursing homes or long-term care facilities.
The findings in this report are subject to at least three limitations. First, data are provisional, and numbers and rates might change as additional information is received. Described changes in mortality trends might be underestimates. Second, timeliness of death certificate submission can vary by jurisdiction. As a result, the national or regional distribution of deaths might be affected by the distribution of deaths reported from jurisdictions reporting later, which might differ from those in the United States or in a region overall. Finally, potential exists for misclassification of certain categories of race (i.e., AI/AN and Asian) and Hispanic ethnicity reported on death certificates (8). Thus, death rates for some groups might be under- or overestimated.
This report provides an overview of COVID-19–associated mortality in the United States in 2022 and highlights changes in the characteristics of COVID-19 deaths. These data provide updated information that advances understanding of the impacts of COVID-19 on mortality and how these have continued to shift during the course of the pandemic. These findings also help to guide public health policies and interventions intended to reduce severe COVID-19 impact by providing insight into groups that remain vulnerable to COVID-19–associated mortality.
Corresponding author: Farida B. Ahmad, fbahmad@cdc.gov.
1National Center for Health Statistics, CDC.
1.World Health Organization. International statistical classification of diseases and related health problems, tenth revision (ICD–10). 2008 ed. Geneva, Switzerland: World Health Organization; 2009. https://icd.who.int/browse10/2008/en
2.National Center for Health Statistics. National Vital Statistics System. Instruction manual, part 2a: instructions for classifying underlying and multiple causes of death, ICD-10. Hyattsville, MD: US Department of Health and Human Services, CDC, National Center for Health Statistics; 2020. https://www.cdc.gov/nchs/nvss/instruction-manuals.htm
3.Heron M. Deaths: leading causes for 2017. Natl Vital Stat Rep 2019;68:1–77. PMID:32501203
4.US Census Bureau. National population by characteristics: 2020–2021. Washington, DC: US Department of Commerce, US Census Bureau; 2021. https://www.census.gov/programs-surveys/popest/technical-documentation/research/evaluation-estimates/2020-evaluation-estimates/2010s-national-detail.html
5.US Census Bureau. Methodology for the United States population estimates: vintage 2021. Washington, DC: US Department of Commerce, US Census Bureau; 2021. https://www2.census.gov/programs-surveys/popest/technical-documentation/methodology/2020-2021/methods-statement-v2021.pdf
6.CDC. Medical examiners’ and coroners’ handbook on death registration and fetal death reporting, 2003 revision. Hyattsville, Maryland: US Department of Health and Human Services, CDC, National Center for Health Statistics; 2003. https://stacks.cdc.gov/view/cdc/6636
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