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DHEC responds to confusion about COVID death data from CDC

People online saw numbers last week that made some believe the number of coronavirus deaths was lower than reported.

COLUMBIA, S.C. — South Carolina's health agency is weighing in on some misunderstandings online about some recent CDC data on the number of deaths from the coronavirus.

DHEC put out a statement Thursday afternoon about the issue, which had been discussed on social media and on TV in the last week.

The CDC released updated death data last week showing that for six percent of COVID-19 deaths, COVID-19 was the only cause of death mentioned. The remaining 94 percent of deaths were among people with other underlying or contributing conditions but COVID-19 was still a factor in the deaths.

That led some to conclude that only 6 percent of deaths nationally can be attributed to COVID, and the other deaths were from other illnesses. 

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But DHEC and other medical officials around the country say that's a misinterpretation of the numbers. 

DHEC explains that cause of death, as listed on a death certificate, includes an immediate cause, intermediate causes, underlying cause, and contributing conditions. 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. The underlying cause of death is the condition that leads, via intermediate causes, to the immediate cause of death. 

RELATED: Can someone get the coronavirus twice?

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.

Credit: SCDHEC
This graphic shows a sample of how a coroner might fill out a death certificate with immediate causes and the underlying cause.

In the example above, DHEC say, COVID-19, as the underlying cause of death, is the condition that triggered the cascade of events that eventually lead to death. 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 chain of events that lead to death. 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.

DHEC says this is not new information, and that it’s been understood for quite some time that individuals with certain underlying conditions are at greater risk for severe illness and death, which is why DHEC provides underlying health conditions data, also called comorbidity information, for COVID-19-associated deaths on its county-level dashboard, under the “Deaths” data section

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