Officials raise concerns about ‘antiquated’ CDC counting systems

Us Health Virus Epidemic Cdc
Photo by Tami Chappell / AFP

The public health system by which Covid-19 deaths are reported to the US Centers for Disease Control and Prevention is “antiquated” and “not timely,” often lagging by up to three weeks, causing senior leaders at the agency to believe the current death count in the US could be significantly higher, two federal health officials tell CNN.

Both of the federal health officials said it is not clear just how much higher the Covid-19 death toll might be — potentially thousands or tens of thousands higher. At issue is the way in which data is sent in from states, the officials said.

“Provisional death counts may not match counts from other sources, such as media reports or numbers from county health departments,” the CDC says on its website. “Our counts often track 1–2 weeks behind other data.”

When reached for comment, CDC spokesman Benjamin Haynes directed CNN to its provisional death counts for Covid-19 on its website.

As of May 15, CDC data indicates 60,299 deaths. CNN’s US death count, fueled by Johns Hopkins University data, currently stands at more than 86,000.

When asked by CNN’s Kaitlan Collins on Friday if he believes the death toll to be accurate, President Donald Trump said, “Those are the numbers that are being reported. I assume they’re correct.”

The CDC says states report at different rates. Currently, 63% of all US deaths are reported within 10 days of the date of death, but there is significant variation between states, the agency said.

“That’s part of the problem, we don’t know how far of a lag there is, but there definitely is a lag,” one of the officials told CNN.

Currently, the data sent to the CDC is captured two ways, the officials said. The first is through clinicians on the frontlines and state health departments, which both officials told CNN was “not up to date for the year 2020” and is contributing to the lag.

“It’s hard to say how far behind, but on the weekend it goes down. Monday and Tuesday, it goes back up. There is some natural lag,” one of the officials said about the death counts being reported to the CDC.

“The data that CDC gets is only as good as the data submitted to the agency by the clinics on the frontline and the state health departments,” the second official added. “There’s varying degrees of states’ abilities to use electronic systems to gather and share that data with the CDC.”

Specifically, local health officials must physically write the death certificates and send them to the National Center for Health Statistics, causing what can be a two-to-three week delay in recording results accurately.

As a result of the lag, in mid-April the Council of State and Territorial Epidemiologists began a second way of collecting data on Covid-19 deaths, which included counting deaths due to Covid-19 from “actual confirmed cases as well as probable cases,” one official said.

The CDC has been working on a major data modernization initiative to “spruce up the system,” primarily by giving the state and local health departments the ability to gather data electronically in real time, the federal officials said.

The system, which would help digitize the data using modern technology, will not be up and running until later this year, one official said.

The officials are not the only ones raising concerns that America’s true death toll might be much higher — for a variety of reasons.

The CDC, in several reports, has found the nation’s “excess deaths” have exceeded the coronavirus death counts. And at a Tuesday hearing before the Senate Committee on Health, Education, Labor and Pensions, Vermont Sen. Bernie Sanders told White House task force member Dr. Anthony Fauci that there are “some epidemiologists who suggest the number may be 50% higher.”

Fauci responded that he wasn’t sure about the 50% number, “but most of us feel that the number of deaths are likely higher than that number because given the situation, particularly in New York City, when they were really strapped with a very serious challenge to their health care system that there may have been people who died at home who did have Covid, who were not counted as Covid because they never really got to the hospital.”

“So in direct answer to your question, I think you are correct that the number is likely higher. I don’t know exactly what percent higher,” Fauci said.