When you exclude people who have died in nursing homes and those who died with at least four comorbidities, are there only 28,000 people a year in the United States dying "from" COVID-19? No, that's not true: As of the week ending January 22, 2022, that total for the pandemic was 861,792, according to the CDC's National Center for Health Statistics. The Centers for Disease Control and Prevention (CDC) counts COVID deaths as cases where COVID was the immediate cause of death.
The claim appeared in a meme on Instagram on January 20, 2022. It opened:
It's just simple math. Even with these inflated numbers, is 28k deaths a year worth what we are doing society and peoples lives? This is insane... #wakeup #exposethetruth #exposetheagenda
This is what the post looked like on Instagram on January 25, 2022:
(Source: Instagram screenshot taken on Tue Jan 25 16:11:02 2022 UTC)
The math used in this meme is dodgy. While the 880,976 COVID deaths listed are an exaggeration as of January 25, 2022, it's close enough to work with. Immediately excluding half that number (440,448) has no basis in fact. To be listed as a COVID death, the virus has to be the immediate cause of death; they died "from" COVID. In a January 25, 2022, email to Lead Stories, a spokesman for the CDC's National Center for Health Statistics (NCHS) explained:
When comorbidities are reported on death certificates along with COVID, the comorbidities are typically either complications of COVID, e.g., acute respiratory failure, pneumonia, or common diseases that are known to be risk factors for severe COVID, e.g., diabetes, COPD, hypertension. Death certificates are designed to elicit a causal pathway, i.e., a chain of events leading to death. So, more than one condition should generally be reported on any death certificate. The number of comorbidities is irrelevant with regard to whether a death should be counted as caused by COVID. The death certificate data show that COVID is the underlying or primary cause in 91% of COVID deaths, i.e., it caused the chain of events leading to death. In 9% of cases, COVID was a factor that contributed to death but wasn't part of the chain of events.
To be counted as a COVID death, a physician or a board-certified forensic pathologist must determine the immediate cause of death and whether the primary cause was COVID. An August 31, 2020, article by Lead Stories explained the difference between dying "from" COVID and "with" COVID:
'Comorbidity' is not the same as cause of death
'Comorbidity' data has been collected since early in the pandemic. It's a scientific term that means the simultaneous presence of two chronic diseases or conditions in a patient, not two or more causes of death. The medical professional who signs a death certificate determines the immediate cause of death, but often notes other conditions the patient had at the time of death. Those are comorbidities.
Board-certified forensic pathologists are trained to determine the immediate cause of death, but often note co-existing and contributing factors, says Dr. Patricia A. Aronica, Florida District 19 medical examiner.
So, when a person who dies in a car crash also has COVID-19, the death certificate correctly declares the crash injuries as the cause of death. Conversely, when a person dies of the lung and organ failure that are the body's response to COVID-19 infection, the death certificate correctly attributes the death to COVID-19, even if the person was previously living with diabetes, heart disease or other conditions. 'They would die with it, not because of it,' said Aronica of the comorbidities.
Comorbidities are common. As many as 82 million Americans with employer-based insurance have a pre-existing condition, ranging from life-threatening illnesses like cancer to chronic conditions like diabetes, asthma, or heart disease, according to analysis by the Department of Health and Human Services. Some 50 million to 129 million (19% to 50% of) non-elderly Americans have some type of pre-existing health condition.
More bad math
Having already reduced the COVID death toll by 50%, or 440,448, the meme discounts another 50% of the remaining COVID deaths (220,244) because it says they took place in nursing homes. The number is greatly exaggerated, according to the NCHS. With data through January 19, 2022, some 127,000 COVID deaths in nursing homes had been reported (see Table 2). The true figure is about 15% of total U.S. COVID deaths.
In its final dismissal of COVID numbers, the meme removes another 165,183 deaths from the total. It says the number represents 75% of virus deaths with four or more comorbidities. As mentioned previously, the CDC COVID death toll only includes cases where the virus was the immediate cause of death. It doesn't matter how many contributing factors there were.
All these questionable deletions leave a total of 55,061 COVID deaths deemed to be worthy of counting. Because the pandemic has lasted about two years, the number was cut in half, giving:
27,530 Estimated annual deaths FROM COVID-19, by people NOT in nursing homes, with LESS THAN four comorbidities.
The final figure downplays the impact of the pandemic and minimizes the deaths of the elderly and those with health conditions that may have increased their chances of dying from the virus. This is what the person who posted the meme said about it:
It's just simple math. Even with these inflated numbers, is 28k deaths a year worth what we are doing [to] society and peoples lives? This is insane...
As opposed to overestimating the COVID death toll, the CDC believes its numbers are an undercount. According to its COVID-19 Mortality Overview, the CDC estimates 968,036 excess deaths due to the virus through January 8, 2022:
Excess deaths are typically defined as the difference between the observed numbers of deaths in specific time periods and expected numbers of deaths in the same time periods.
If the excess count is correct, nearly an additional 109,000 people may have lost their lives to COVID than are part of the official count.