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The current COVID-19 pandemic made me curious how deaths are counted by various governments at all levels. As there is a lot of doubt as to how the cause of death is attributed in various cases, I was wondering how to get real-time numbers of total deaths.

I live in Florida and, as far as I can tell, this data is not collected locally or in a timely manner. I emailed medical examiners and it seems that several different entities (e.g. coroners, hospitals, funeral homes) are responsible for issuing death certificates and sending them to the state. The state then takes a long time to provide these numbers back to the citizens. There do not seem to be accessible data sets at the city and county level to see the numbers.

This seems like a terrible process in a world with increasing risk of pandemics. Local leaders seem to have no insight into real-time death counts that would help them make decisions.

My question is:

  • What is the process for recording and reporting deaths in the US? I want to know how deaths are recorded and reported in general, not just with respect to COVID-19.
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    You tagged this [united-states] but asked about practices around the world. Which are you asking about? The former is answerable, the second one is too broad and will likely be closed – Machavity May 14 '20 at 20:17
  • Maybe I should ask two separate questions then. Or just generalize this into asking for around the world. I'm astounded that the process, at least where I live, is so broken. I'm wondering if there are better systems we can learn from. – Gene McCulley May 14 '20 at 20:19
  • That sounds like a good idea. "Best practices" really seems out of scope. if you want to limit it to just the US, I can give you an answer – Machavity May 14 '20 at 20:20
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    I've edited out the second question to reduce the scope of the question. Feel free to make another question asking about best practices – divibisan May 14 '20 at 20:22
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    Also, are you asking generally about cause of death in general, or specifically about how deaths are attributed to COVID-19? – divibisan May 14 '20 at 20:23
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The US COVID-19 deaths are compiled and reported by the CDC. The question asked about finding demographic data. The CDC provides that data.

Who determines what a COVID-19 death is? That's determined by the person issuing the death certificate

When a person dies, the cause of death is determined by the certifier – the physician, medical examiner, or coroner who reports it on the death certificate. States register all death certificates and send them to the National Center for Health Statistics, where they are used to produce the nation’s official death statistics.

Certifiers are asked to use their best medical judgmentbased on the available information and their expertise. When a definitive diagnosis cannot be made, but the circumstances are compelling within a reasonable degree of certainty, certifiers may include the terms“probable” or “presumed” in the cause-of-death statement.

Who exactly issues the death certificate varies from state to state. Florida takes death determinations from physicians and funeral home directors. New York allows a much larger list

use of EDRS is mandatory for all hospitals (all departments including Emergency Room and Special Units where deaths may occur), nursing homes, certified hospice providers, primary care physicians, specialty providers (oncologists, cardiologists, surgeons, etc.), medical examiners, coroners, funeral directors, and local registration officials in New York State, excluding New York City.

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  • Nice answer, however what I believe to be the main point of the question was "how are deaths counted and reported" in the first place. Does every dead body in the US need to be seen by a coroner in order to be certified "dead"? By a doctor? By anyone? After all, if it is possible to be born and have no record of the event happening (note: it is), is it also possible to die and not be counted? – CGCampbell May 14 '20 at 20:40
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    @CGCampbell Good point. Added a section on that – Machavity May 14 '20 at 20:47
  • This is a useful answer. Thank you. Questions I have and maybe I need to draft top-level question for them: Why the heck is data from the beginning of 2019 still "provisional"? Do any cities or counties in the United States require local reporting, or do they just all defer to the state/CDC and make do with what data comes back? – Gene McCulley May 14 '20 at 20:53
  • NY and MN stand accused of inflating COVID-19 deaths . Even liberal press admits there could be something in this: usatoday.com/story/news/factcheck/2020/04/24/… – rs.29 May 15 '20 at 19:11
  • @rs.29 The catch there is that there may be deaths that are attributable to Covid that are not reported at all since we're still trying to figure out what symptoms look like – Machavity May 15 '20 at 19:36

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