Fact check: COVID-19 deaths don’t automatically include anyone who tested positive within 20 days

The claim: COVID-19 tally includes anyone who tested positive within 20 days of death

Nearly one-third of Americans have been fully vaccinated against the coronavirus, and the daily death rate is falling. But on social media, misinformation about what counts as a COVID-19 death persists.

In a May 2 Instagram post, Bryson Gray, a rapper and conservative social media personality, published a screenshot of a tweet that makes it seem like the United States is overcounting coronavirus deaths.

“Funny isn’t it, if you die within 20 days of testing positive for the Rona (no matter what other factors were involved) You’ll be counted as a COVID death,” the tweet says. “However, if you drop dead within 24 hours of taking the vaccine it has nothing to do with it.”

The post’s insinuation that coronavirus vaccines cause death is wrong — and so is the claim about how COVID-19 deaths are counted.  

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Local medical examiners, coroners and physicians decide whether COVID-19 contributed to someone’s death. The U.S. Centers for Disease Control and Prevention, which maintains a tally of COVID-19 deaths, has guidance on how officials should fill out death certificates, but that guidance does not include a 20-day rule. False claims that the U.S. is padding coronavirus statistics have circulated since the early days of the pandemic.

USA TODAY reached out to Gray and the Twitter user who originally published the claim for comment.

How the CDC counts COVID-19 deaths

The CDC guidance for how local officials should count COVID-19 deaths says nothing about including everyone who tests positive for the virus within a certain time frame.

The CDC gets data on COVID-19 deaths through the National Center for Health Statistics (NCHS), which gets its data from death certificates filed in state vital registration offices. When a local medical examiner, physician or coroner lists the coronavirus as a cause of death on a certificate, the CDC counts it as a COVID-19 death.

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“When COVID-19 is reported as a cause of death — or when it is listed as a ‘probable’ or ‘presumed’ cause — the death is coded as U07.1,” said Jasmine Reed, a public affairs specialist for the CDC, in an email to USA TODAY. “This can include cases with or without laboratory confirmation.”

In April 2020, the NCHS issued guidance on how local officials should count COVID-19 deaths. That guidance, based on widely adopted recommendations from the World Health Organization, says: “If COVID-19 played a role in the death, this condition should be specified on the death certificate.”

“When determining whether COVID-19 played a role in the cause of death, follow the CDC clinical criteria for evaluating a person under investigation for COVID-19 and, where possible, conduct appropriate laboratory testing using guidance provided by CDC or local health authorities,” the document says.

Medical workers test a local resident at a drive-thru coronavirus testing site in Waterloo, Iowa, on May 1, 2020. (Photo: Charlie Neibergall/AP)

That guidance, as well as the CDC’s overview of testing for COVID-19, says nothing about a 20-day rule for counting coronavirus deaths. USA TODAY and other fact-checkers could find no evidence such a rule exists.

The 20-day figure in the Instagram post may stem from what the CDC has said about the contagiousness of coronavirus for certain groups of people.

“Adults with more severe illness or who are immunocompromised may remain infectious up to 20 days or longer after symptom onset, so a test-based strategy could be considered in consultation with infectious disease experts for these people,” the agency says on its website.

Claim part of disinformation narrative

Allegations that the U.S. is overcounting COVID-19 deaths aren’t new — they’ve spread on social media and in Washington since the pandemic began.

In June, USA TODAY fact-checked false claims that the CDC was adding influenza and pneumonia to its COVID-19 death tally to make the pandemic seem worse than it was. The misinformation continued in the fall, when former President Donald Trump falsely claimed the U.S. was counting deaths that shouldn’t have been attributed to COVID-19. Conspiracy theories that the CDC was intentionally inflating coronavirus deaths reemerged in February.

The notion that the U.S. is overcounting COVID-19 deaths doesn’t hold water. In fact, public health officials have repeatedly said their tallies are likely an undercount because of factors like false negatives on tests and people who have died at home without being diagnosed with COVID-19.

Our rating: False

The claim that anyone who dies within 20 days of testing positive for COVID-19 automatically counts as a COVID-19 death is FALSE, based on our research. Whether COVID-19 contributed to someone’s death is left up to the judgment of local medical examiners, physicians and coroners. There is no rule that people who die within 20 days of receiving a positive COVID-19 diagnosis are automatically added to the pandemic’s death tally.

Our fact-check sources:

• Anthea, May 3, tweet
• Bryson Gray, May 2, Instagram
• Centers for Disease Control and Prevention, accessed May 4, COVID Data Tracker
• Centers for Disease Control and Prevention, May 4, Ending Home Isolation for Persons with COVID-19 Not in Healthcare Settings
• Centers for Disease Control and Prevention, April 2020, Vital Statistics Reporting Guidance
• Centers for Disease Control and Prevention, accessed May 4, International Classification of Diseases, Tenth Revision (ICD-10)
• Centers for Disease Control and Prevention, March 17, Overview of Testing for SARS-CoV-2 (COVID-19)

   

• Email interview with Jasmine Reed, May 4
• Lead Stories, May 3, Fact Check: Patients Who Die Within 20 Days Of Positive COVID Test Are NOT Automatically Added To Pandemic Death Tally
• National Center for Health Statistics, accessed May 4, Technical Notes: Provisional Death Counts for Coronavirus Disease (COVID-19)
• National Center for Health Statistics, accessed May 4, COVID-19 Mortality Overview
• The New York Times, May 4, Coronavirus in the U.S.: Latest Map and Case Count
• The New York Times, June 27, Actual Coronavirus Infections Vastly Undercounted, C.D.C. Data Shows
• NPR, May 13, Fauci Says U.S. Death Toll Is Likely Higher. Other COVID-19 Stats Need Adjusting, Too
• PolitiFact, Dec. 16, Lie of the Year: Coronavirus downplay and denial
• PolitiFact, Oct. 27, Trump wrong to claim U.S. is padding COVID-19 stats
• USA TODAY, June 28, Fact check: CDC did not add flu and pneumonia cases to its COVID-19 death count
• USA TODAY, Feb. 16, Fact check: CDC is not inflating the COVID-19 death count
• USA TODAY, Sept. 1, Fact check: CDC’s data on COVID-19 deaths used incorrectly in misleading claims
• USA TODAY, April 30, Fact check: COVID-19 vaccines don’t cause death, won’t decimate world’s population
• USA TODAY, April 17, 2020, Fact check: Is US coronavirus death toll inflated? Experts agree it’s likely the opposite
• World Health Organization, April 16, 2020, INTERNATIONAL GUIDELINES FOR CERTIFICATION AND CLASSIFICATION (CODING) OF COVID-19 AS CAUSE OF DEATH

• National Center for Health Statistics, accessed May 4, COVID-19 Death Data and Resources

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Our fact check work is supported in part by a grant from Facebook.

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