A study published shows that the early U.S. death toll during the COVID-19 pandemic was higher than previously recorded.
The journal Science Advances found that more than 155,000 unrecognized additional deaths outside of hospitals between March 2020 and December 2021 likely went uncounted. This suggests that 15.6 percent of deaths went uncounted, as the official death toll during that time frame was more than 840,000.
Researchers said the estimated total number of COVID-19 deaths between that timeline was More than 995,000. The Centers for Disease Control and Prevention (CDC) established that the U.S. hit 1 million COVID-19 deaths in May 2022. The study suggests that possible geographic and sociodemographic inequities contributed to coronavirus deaths not being part of the official death count.
“One prior study found that excess deaths attributed to non–COVID-19 causes were more common in counties with lower socioeconomic status, greater prevalence of preexisting health conditions, and a greater fraction of non-Hispanic Black residents,” researchers wrote.
“Another study found that excess deaths attributed to non–COVID-19 natural causes were more common in rural areas, the South, and the West,” they continued. “While these studies did not examine unrecognized COVID-19 deaths directly, they suggest that the death investigation system may have performed unevenly during the pandemic.”
One of the study’s authors, University of Minnesota associate professor Elizabeth Wrigley-Field, said that the number of reported COVID-19 deaths “was similar to the number of excess natural-cause deaths, suggesting that COVID-19 deaths were accurately identified here.”
“Thus, in-hospital deaths, during this period of near-universal testing, provide a pool of high-quality training data for classification of whether a death was due to SARS-CoV-2 infection for use in predicting whether deaths in out-of-hospital settings were likely to be COVID-19 related,” Wrigley-Field added.
Machine learning algorithms were used to incorporate people who died from COVID-19-related factors. People with medical conditions who did not have the virus died because they could not receive care from hospitals already handling a deluge of COVID-19 cases. Additionally, people died from drug overdoses while in social isolation.
“Death reporting in the United States is a fragmented infrastructure that’s underresourced,” Mathew Kiang, an epidemiologist at Stanford University and a co-author of the study, told Scientific American. “During the pandemic, it was highly strained. We had more deaths than we’d ever had” in modern history.
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Written by Ryan Mancini for Epoch Health ~ March 19, 2026