More than 150,000 uncounted COVID-19 deaths occurred early in the
pandemic, a study finds
[March 19, 2026]
By MIKE STOBBE
NEW YORK (AP) — The COVID-19 pandemic's early death toll was much higher
than the official U.S. count, according to a new study that spotlights
dramatic disparities in the uncounted deaths.
About 840,000 COVID-19 deaths were reported on death certificates in
2020 and 2021. But a group of researchers — using a form of artificial
intelligence — estimate that as many as 155,000 unrecognized additional
deaths likely occurred in that time outside of hospitals. That would
mean about 16% of COVID-19 deaths went uncounted in those years.
The overall findings, published Wednesday by the journal Science
Advances, were close to estimates from other studies of pandemic deaths
during that time. But the authors of the new study tried to determine
exactly which deaths were more likely to be missing from the official
tallies.
The answer: The undiagnosed dead were more likely to be Hispanic people
and other people of color, who had died in the first few months of the
pandemic, and who had been in certain states in the South and Southwest
— including Alabama, Oklahoma and South Carolina.
Six years after the coronavirus swept through the U.S., barriers remain
for many of the same people, said Steven Woolf, a Virginia Commonwealth
University researcher not involved in the study.
“People on the margins continue to die at disproportionate rates because
they can’t access care,” he said in an email.
Access to care wasn't the only challenge
While hospital patients were routinely tested for COVID-19, many who
grew sick and died outside of hospitals were not tested — often because
at-home testing was not readily available early in the pandemic, said
one of the study's authors, the University of Minnesota's Elizabeth
Wrigley-Field.
In some parts of the country, death investigations are handled by
elected coroners who don't necessarily have the specialized training
that medical examiners do. Some research has suggested partisan opinions
could affect whether a sick person or their family members sought
COVID-19 testing, and whether coroners pursued postmortem coronavirus
testing. Indeed, some coroners said families had pressed them not to
list COVID-19 as a cause of death.
“Our antiquated death investigation system is one key reason why we fell
short of accurate counts, particularly outside of big metropolitan
areas,” said Andrew Stokes of Boston University, the senior author on
the paper.
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Steve Grove, a chaplain at Hennepin County Medical Center, prays in
a COVID-19 patient's room, Dec. 10, 2021, in Minneapolis. (AP
Photo/Charlie Neibergall, File)
Death counts were swept up in COVID politics
The Centers for Disease Control and Prevention data count more than 1.2
million COVID-19 deaths since the pandemic erupted in early 2020. More
than two-thirds of those reported deaths occurred in 2020 and 2021.
The count has long been debated, as false claims on social media said
the number of COVID-19 deaths was inflated. Adding to the rancor was
President Donald Trump, who in August 2020 retweeted a post claiming
only 6% of reported deaths were actually from COVID-19 — a post Twitter
later removed.
To be sure, there were other kinds of pandemic deaths. For example,
uninfected people died from other medical conditions because they could
not get care at hospitals overloaded with COVID-19 patients. People with
drug addictions died of overdoses as a result of social isolation and
losing access to treatment. Other studies that have estimated the actual
number of pandemic deaths have taken those deaths into account.
But Stokes and his collaborators wanted to focus on the deaths of people
infected by the coronavirus. They used machine learning to sift through
the death certificates of infected patients who died in hospitals and
then used patterns observed in those records to evaluate death
certificates of people who died outside hospitals and whose deaths were
attributed to things like pneumonia or diabetes.
Scientists' understanding of the strengths and weaknesses of machine
learning-reliant research is still evolving, but Woolf called this
team's use of it “intriguing.”
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