Excess death estimates compared with state-reported and observed COVID-19 deaths, New Jersey and the United States, 2020–2022

TL;DR

This study compares reported and excess death estimates for New Jersey and the U.S. during the 2020–2022 pandemic to assess the accuracy of COVID-19 mortality data.

Contribution

The study highlights how New Jersey's detailed reporting system aligns closely with excess death estimates, unlike the U.S. as a whole.

Findings

New Jersey's reported deaths slightly exceeded its excess death estimates for 2020–2022.

U.S. reported deaths did not match the estimated excess deaths for the same period.

New Jersey's early classification system may have improved the accuracy of its death reporting.

Abstract

Deaths associated with COVID-19 in the United States are currently estimated to be over 1.2 million, but the true burden of mortality due to the SARS-CoV-2 virus is unknown. Methods for identifying and reporting deaths related to COVID-19 differ between jurisdictions, and concerns about overreporting and underreporting exist. Excess death estimates for the pandemic period, based on data from the National Center for Health Statistics, may be used to approximate the number of COVID-19-associated deaths. In this analysis, we first describe the process by which the New Jersey Department of Health identified, classified, and reported COVID-19-associated deaths from January 2020 through December 2022. The National Center for Health Statistics’ excess deaths estimates are first compared with New Jersey’s reported COVID-19-associated deaths, and then with the observed COVID-19-associated deaths in the entire United States, by month, from January 2020 through December 2022. New Jersey’s reported COVID-19-associated deaths (n = 35,555) accounted for (and slightly exceeded) the state’s excess deaths estimated by the National Center for Health Statistics for 2020–2022 (n = 30,365). However, the overall number of United States observed COVID-19 deaths for 2020–2022 (n = 1,094,230) for the study period did not account for all estimated excess deaths in the nation for the same period (n = 1,233,366). The general congruence of New Jersey’s reported COVID-19 deaths and the National Center for Health Statistics’ excess death estimates may be due in part to New Jersey’s early detailed classification system for identifying and reporting deaths associated with COVID-19, leading to more accurate COVID-19 death reporting by the state.

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