Coronavirus deaths by state: Why COVID-19 fatality rates are different across the US

·3 min read

The United States has the most confirmed cases of coronavirus in the world, and all the states have been affected in varying degrees, including the death rates.

“Death rate” refers to the number of people who die from coronavirus compared with the number of confirmed cases. To give some perspective, the global death rate is 4.5%, while the U.S. has a death rate of 1.5%, according to the Johns Hopkins University Coronavirus Resource Center.

So while the U.S. has an overall lower death rate than the world’s, some states have a higher fatality rate than the global average. Washington, one of the hardest-hit states, has a death rate of 4.6%, which is more than four times higher than even New York’s death rate, of 1.1%, according to Hopkins’ data.

How can that be?

Health officials and experts believe there are three main reasons for the variation in death rates from state-to-state: Overwhelmed hospitals may be reporting the numbers to state and county authorities late; some hospitals reporting totals on a daily basis see some state and county reports lag in reflecting the numbers; and a lack of tests and protective equipment results in fewer diagnoses of coronavirus, according to BuzzFeed News.

Because testing was slow to start in the U.S., the number of confirmed cases is much lower than the actual number of people who have coronavirus, according to The Washington Post.

The reported number of deaths may be skewed because of differences in reporting by local jurisdictions, The Post reports. Medical professionals across the country say that the official death counts are not consistent with the number of deaths they’re seeing on the front lines, BuzzFeed said.

That’s due, in part, to delays in hospitals’ reporting to local officials, caused by possible breakdowns in logging positive tests, according to BuzzFeed. But in some cases, medical experts think it’s because people are not being tested before or after they die, BuzzFeed reported.

“Those medical records aren’t being audited by anyone at the state and local level currently and some people aren’t even testing those people who are dead. We just don’t know,” an ER doctor working at several hospitals in California – where the death rate is 2% - told BuzzFeed. “The numbers are grossly underreported. I know for a fact that we’ve had three deaths in one county where only one is listed on the website.”

The Centers for Disease Control and Prevention issued guidelines for reporting, but ultimately local authorities in each state have the power to decide who, living or dead, is tested and how they administer those tests, BuzzFeed reports.

Another factor is how prepared the state’s health system is to deal with a spike in patients. There is a shortage of ventilators and protective equipment for health-care workers in many states, including Louisiana, where the death rate is 4.3%, according to The Post.

Hospitals in New York City, New Orleans, Detroit and other hot spots are concerned about scarcities of drugs, medical supplies and trained staff, Reuters said. One emergency room doctor in Michigan, where the death rate is 2.1%, says severely ill patients will not be able to get the proper treatment because hospitals lack the equipment, according to Reuters.

“We have hospital systems here in the Detroit area in Michigan who are getting to the end of their supply of ventilators and have to start telling families that they can’t save their loved ones because they don’t have enough equipment,” Dr. Rob Davidson said in a video he posted on Twitter.