\n<\/p>\n
March 18, 2026<\/p>\n
3 min read<\/p>\n
Add Us On Google<\/span>Add SciAm<\/span><\/span><\/p>\n COVID probably killed 150,000 more people in its first two years than official U.S. tolls show<\/p>\n We have severely undercounted the number of COVID deaths, scientists say<\/p>\n By Meghan Bartels edited by Tanya Lewis<\/span><\/p>\n White flags are displayed in front of the Washington Monument in a 2021 commemoration of those killed by COVID.<\/p>\n Douglas Rissing\/Getty Images<\/p>\n COVID may have killed significantly more people in the U.S. in the first two years of the pandemic than official records indicate, with as many as one overlooked death for every five recorded ones. That brings the total to nearly one million deaths just in 2020 and 2021.<\/p>\n That calculation comes from research published today in Science Advances that seeks to understand how many COVID deaths fell through the cracks of official reporting systems. The untallied cases show the burden of the pandemic in the U.S. fell most heavily on marginalized people.<\/p>\n \u201cThese vulnerable groups are just taking a higher risk at every step, and the accumulation of all of that is this disparity in COVID mortality at the end,\u201d says Mathew Kiang, an epidemiologist at Stanford University and a co-author of the study.<\/p>\n If you’re enjoying this article, consider supporting our award-winning journalism by subscribing. By purchasing a subscription you are helping to ensure the future of impactful stories about the discoveries and ideas shaping our world today.<\/p>\n In the new research, Kiang and his colleagues analyzed official records published by the Centers for Disease Control and Prevention for deaths occurring from March 2020 through December 2021 for adults aged 25 and older\u2014some 5.7 million records in all. First, they fed a machine-learning algorithm the records of deaths in hospitals, which at the time were testing most patients for COVID. They trained the algorithm to recognize hospital deaths in which COVID was formally identified as an underlying cause. Then they used the algorithm to flag potential unrecognized COVID deaths by identifying records that looked like hospitalized COVID deaths but occurred in other settings where testing was less likely.<\/p>\n All told, the algorithm identified between about 150,000 and 160,000 potential unrecognized COVID deaths on top of the 840,251 that were officially reported. Those numbers suggest that for every five recognized COVID deaths, one additional death went unmarked. That ratio is on par with other analyses that have simply compared the total observed number of deaths with the number of total deaths expected based on historical data, says Daniel Weinberger, an epidemiologist at the Yale School of Public Health, but the new method is both more sophisticated and more granular.<\/p>\n Kiang says it isn\u2019t surprising that deaths resulting from COVID were missed. \u201cDeath reporting in the United States is a fragmented infrastructure that\u2019s underresourced,\u201d he says. \u201cDuring the pandemic, it was highly strained. We had more deaths than we\u2019d ever had\u201d in modern history.<\/p>\n But what stood out to him were the patterns behind the unrecognized likely COVID deaths: they were most likely to have occurred among Hispanic people, at home, among less educated people, and among people with lower incomes. When analyzed by state, Alabama, Oklahoma and South Carolina had the highest ratios of such deaths.<\/p>\n Those patterns tell an important story about how COVID unfolded within the U.S. and its fragmented health systems. \u201cThis underreporting that we found wasn\u2019t random,\u201d Kiang says. \u201cPretty systematically, what we found was that communities in areas that were most impacted by the pandemic were also the ones with the most unrecognized COVID-19 mortality.\u201d By analyzing the dramatic case of the COVID pandemic\u2019s early years, researchers can better understand how the same factors that made people vulnerable to COVID affect more routine health conditions, Kiang says.<\/p>\n During the pandemic, \u201csystems in our society, including barriers to accessing health care, kept desperately ill Americans from recognizing the need for care and getting to the hospital,\u201d says Steven Woolf, a physician and social epidemiologist at Virginia Commonwealth University, who was not involved in the new research. He worries not only that those barriers remain but also that cuts to Medicaid and increasing health insurance premiums may be exacerbating them. \u201cPeople on the margins continue to die at disproportionate rates because they can\u2019t access care.\u201d<\/p>\n If you enjoyed this article, I\u2019d like to ask for your support. Scientific American<\/span> has served as an advocate for science and industry for 180 years, and right now may be the most critical moment in that two-century history.<\/p>\n I\u2019ve been a Scientific American<\/span> subscriber since I was 12 years old, and it helped shape the way I look at the world. SciAm <\/span>always educates and delights me, and inspires a sense of awe for our vast, beautiful universe. I hope it does that for you, too.<\/p>\n If you subscribe to Scientific American<\/span>, you help ensure that our coverage is centered on meaningful research and discovery; that we have the resources to report on the decisions that threaten labs across the U.S.; and that we support both budding and working scientists at a time when the value of science itself too often goes unrecognized.<\/p>\n In return, you get essential news, captivating podcasts, brilliant infographics, can’t-miss newsletters, must-watch videos, challenging games, and the science world’s best writing and reporting. You can even gift someone a subscription.<\/p>\n There has never been a more important time for us to stand up and show why science matters. I hope you\u2019ll support us in that mission.<\/p>\n","protected":false},"excerpt":{"rendered":" March 18, 2026 3 min read Add Us On GoogleAdd SciAm COVID probably killed 150,000 more people in its first two years than official U.S. tolls show We have severely undercounted the number of COVID deaths, scientists say By Meghan Bartels edited by Tanya Lewis White flags are displayed in front of the Washington Monument<\/p>\n","protected":false},"author":1,"featured_media":47090,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[50],"tags":[5333,632,5323,364,241,23895,811,637],"class_list":{"0":"post-47089","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-environment","8":"tag-covid","9":"tag-killed","10":"tag-official","11":"tag-people","12":"tag-show","13":"tag-tolls","14":"tag-u-s","15":"tag-years"},"_links":{"self":[{"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/posts\/47089","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=47089"}],"version-history":[{"count":0,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/posts\/47089\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/media\/47090"}],"wp:attachment":[{"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=47089"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=47089"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=47089"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}On supporting science journalism<\/h2>\n
It\u2019s Time to Stand Up for Science<\/h2>\n