Number of COVID-19 deaths in Mass. will drop under state’s new counting method

Empty chairs were placed in a park in Lawrence to honor coronavirus victims in December 2020.Erin Clark/Globe Staff

The official count of COVID-19 deaths in Massachusetts will decline by about 3,700 under a new surveillance system that state health leaders say more accurately captures the true toll from the virus.

“We think this is an absolutely critical step in improving our understanding of who COVID has impacted most significantly during the pandemic,” Dr. Catherine Brown, the state’s epidemiologist, said at a media briefing Thursday.

Currently, the state’s reported confirmed and probable deaths total about 23,700. Under the new method, that could drop to about 20,000. But Brown said a team at the state’s health department is still crunching the numbers and would release them Monday.

The new system will narrow the state’s definition of who died of COVID. Currently, Massachusetts records anyone who died within 60 days of a COVID diagnosis as having died from COVID, unless it is clear the person died from another cause, such as a traumatic accident.

Under the new system, recommended by the Council of State and Territorial Epidemiologists, COVID deaths will now be those that occur within 30 days of a diagnosis. The council helps establish uniform methods for states to track and record various diseases.

This “will also improve our ability to compare our data with data from other jurisdictions and other states,” Brown said. She said most, but not all, states have adopted this new method.

Some COVID patients are hospitalized for weeks past the 30-day window, raising potential concerns they may be missed in the new system. But Brown said her team’s analysis indicates that is not the case.

“People who ... are seriously ill and hospitalized for longer and end up dying after that 30 days have almost invariably had COVID listed on their death certificate and so they end up being counted under another method,” she said.

The state’s method allows for COVID deaths to be counted beyond the 30 days if COVID or an “equivalent term” is listed on the death certificate, or if investigators, such as a medical examiner, concludes the death was COVID related.

Throughout the pandemic, data has indicated that communities of color have been disproportionately impacted by COVID, with more infections and deaths. Brown said the new method does not change that overall picture.

“While we acknowledge that we are moving to a more accurate and appropriate way to count deaths... it does not alter our understanding of who has died from COVID and where the most disproportionate impacts have been,” she said.

Early in the pandemic, when officials knew very little about the virus, it made sense to use an expansive definition of COVID deaths, Brown said. The state for the first year counted anyone who had been diagnosed with COVID at any time as a COVID death.

Over time, Brown said, it became clear that that method led to an overcount.

“Beginning in the summer of 2020 ... we began to see some real discrepancies in the second wave of the pandemic, during the winter of 2020 into 2021,” she said.

Most of the overcount, she said, occurred between the summer of 2020 and April 2021, before the state adopted an updated system.

That updated method used the 60-day window, counting anyone who died within 60 days of a COVID diagnosis as a COVID death, as well as those in which COVID or an equivalent term was listed on their death certificate.

Beginning Monday, the state said that all calculations involving deaths posted in the COVID-19 dashboard, and in accompanying raw data files, will contain the updated data. Previous raw data files will still be available on the website and will not be updated, it said.

But Barbara Anthony, a former state undersecretary of consumer affairs and business regulation, said the Baker administration has been less than transparent about COVID death counts. She said the state did not publicly announce it had significantly changed its system for counting total deaths last April, when it switched to the 60-day method.

At that time, the state dramatically changed the way it counted COVID nursing home deaths to align with national standards, but made no mention at that time of also changing its approach to total COVID deaths.

“It’s mind boggling, frankly,” said Anthony, who also is a senior fellow in health care policy at the Pioneer Institute. “It’s not a transparent way to run an operation, and it undermines the faith of the public.”