DHEC clarifies ’misunderstanding’ surrounding CDC data on COVID-19-related deaths

Protecting Yourself from Coronavirus (May 2020)

COLUMBIA, S.C. (WMBF) – State health officials are clarifying a misunderstanding around recently-released data from the Centers for Disease Control and Prevention regarding deaths associated with COVID-19.

According to information from the South Carolina Department of Health and Environmental Control, provisional deaths updated last week by the CDC shows that for 6% of coronavirus deaths, COVID-19 was the only cause of death mentioned. The other 94% were among those with underlying or contributing conditions, but COVID-19 was still a factor in their deaths, state health officials said.

A cause of death, as listed on a death certificate, includes an immediate cause, intermediate causes, underlying cause, and contributing conditions, according to DHEC.

A common example of cause of death involving COVID-19 would have acute respiratory distress syndrome as the immediate cause of death, which is the ultimate condition that caused the death. The intermediate cause of death would have been pneumonia, with COVID-19 as the underlying cause of death, health officials said.

The underlying cause of death is the condition that leads, via intermediate causes, to the immediate cause of death. Contributing factors could have been asthma, chronic obstructive pulmonary disease (COPD), diabetes, or any other illness or condition that may have made the condition that was the cause of death worse than it would have been, DHEC officials said.

In this example, COVID-19, as the underlying cause of death, is the condition that “triggered the cascade of events that eventually lead to death,” according to DHEC.

“While certain people such as older adults are more likely to have more contributing factors, if the person doesn’t contract COVID-19, then those factors don’t start the cascade of events that lead to death,” DHEC officials said in an email to WMBF News. “Therefore, while COVID-19 infection had a significant role in causing the death in the example, it was not the only cause of death listed. As a result, that death would not count in the six percent from the CDC.”

Health officials stressed it’s been understood for some time that people with certain underlying conditions are at greater risk for severe illness and death. DHEC has been providing underlying health conditions data, also called comorbidity information, for COVID-19-associated deaths on its county-level dashboard, under the “Deaths” data section.

Learn more about conditions that increase the risk of severe illness on the CDC website here.

CDC officials told CNN in July that COVID-19 would be a Top 10 leading cause of death for 2020. While the final ranking will not be available until next year, data from 2018, the most recent year available, indicates COVID-19 will rank third behind heart disease and cancer.

As of Sept. 3, the CDC reported 171,787 deaths involving COVID-19 in the U.S. since February. DHEC officials reported 2,652 COVID-19-related deaths in S.C. as of Sept. 2.

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