Before Covid 20-30% of death certificates were wrong. Now it’s a lot worse.

Corrections & clarifications: A previous version of this story stated that Bob Anderson, chief of the mortality statistics branch at the National Center for Health Statistics, believed that up to 1 in 3 death certificates nationwide were incorrect before COVID-19. Anderson clarified his estimate to be between 20 and 30 percent.

As the United States struggles to track coronavirus fatalities amid spotty testing, delayed lab results and inconsistent reporting standards, a more insidious problem could thwart the country’s quest for an accurate death toll.

Between 20 and 30 percent of death certificates nationwide were wrong before COVID-19, Bob Anderson, chief of the mortality statistics branch at the National Center for Health Statistics, said in an interview with the USA TODAY Network.

“I’m always worried about getting good data. I think this sort of thing can be an issue even in a pandemic,” Anderson said.

Experts said the inaccuracies are part and parcel of a patchwork, state-by-state system of medical examiners, coroners and doctors who have disparate medical backgrounds, and in some cases none at all.

The problem is likely to get worse as the pandemic inundates overworked and sometimes untrained officials who fill out the forms.

Accurate death certificates are paramount for health officials trying to determine where to focus resources to fight the spread of the coronavirus, said Umair Shah, executive director of the Public Health Department in Harris County, Texas, which includes Houston.

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“That death represents an ecosystem of people,” Shah said.

Inaccurate death reporting is a long-standing problem.

A review of Missouri hospitals in 2017, for example, found nearly half of death certificates listed an incorrect cause of death. A Vermont study found 51% of death certificates had major errors. Nearly half of the physicians the Centers for Disease Control and Prevention surveyed in 2010 admitted that they knowingly reported an inaccurate cause of death.

Death certificates regularly lack enough details to accurately pinpoint the cause of death, Anderson said.

“For example, cardiac arrest is not an acceptable cause of death, because everybody dies of cardiac arrest,” Anderson said. “That just means your heart stopped.”

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