Erickson: why NYC's adjusted count now compares apples-to-apples on COVID-19 and flu deaths

[I'm sharing excerpts from this article by Erick Erickson because it addresses a common reaction I've seen online to the news that New York City is counting presumed cases in addition to confirmed cases in their COVID-19 death toll. Be sure to read his full article.]

Why NYC Adjusted Its Death Count for COVID-19

It allows an apples to apples comparison with flu now

by Erick-Woods Erickson

I hate to do a Vox style explainer on this, but I already see people on the right asserting some pretty wild claims about this New York Times story and I actually did pick up the phone, talk to people at the CDC, and have an accurate understanding of what is going on.



First, here is the story that has people riled up:

New York City, already a world epicenter of the coronavirus outbreak, sharply increased its death toll by more than 3,700 victims on Tuesday, after officials said they were now including people who had never tested positive for the virus but were presumed to have died of it. The new figures, released by the city’s Health Department, drove up the number of people killed in New York City to more than 10,000, and appeared to increase the overall United States death count by 17 percent to more than 26,000.

It makes it look like New York is trying to exacerbate the death toll. Actually, what New York is now doing brings COVID-19 death analysis in line with flu analysis.

Most people skimmed over the bottom of the article.

New York City has been reporting the probable cases to the federal National Center for Health Statistics for more than a week, health officials said. But Dr. Barbot said that the city would continue reporting only confirmed cases to the Centers for Disease Control and Prevention for its coronavirus tracker, because the agency requested those statistics. “We are more than happy to report on probables,” she said. The C.D.C., in its guidance to local governments, has recommended that cases of “assumed” coronavirus infection be noted on death certificates since before New York City recorded its first death on March 14. On Tuesday, the city’s count of confirmed cases went up to 6,589.

What gives?

The CDC had guided local governments that they should note presumptions of COVID-19 as causes of death on death certificates but had also only wanted confirmed cases in its overall listing of deaths in the CDC database. New York is still only going to send the CDC what it wants for its tracking data, i.e. confirmed cases only, but will now follow CDC guidelines for death certificates and make that information public.

What the CDC is doing for tracking purposes is tracking the confirmed spread nationally with testing. This is different from how the CDC tracks seasonal flu. Essentially, the CDC is asking states to only send it confirmed COVID-19 tests, but keep information handy on presumptive deaths for later review.

In 2009, the CDC changed the way the seasonal flu was tracked. Prior to 2009, the CDC only tracked confirmed flu cases. But in 2009 with the H1N1 outbreak, the CDC also started keeping count of presumptive flu cases. [emphasis mine]

[...]

Put more broadly, we have been comparing COVID-19 confirmed deaths to flu deaths, which have included both confirmed and presumed deaths. What New York City is now doing is providing a better apples to apples comparison. Now, in their public release of data, New York City will have confirmed and presumed COVID-19 deaths just as all previous reports of flu deaths in New York had both confirmed and presumed deaths in that total. [emphasis mine]

Read Erickson's full article at this link for greater detail.