Why federal and state COVID-19 death tolls for New York don't match

ALBANY, N.Y. (AP) - The federal government's count of the COVID-19 death toll in New York has 11,000 more victims than the tally publicized by the administration of Gov. Andrew Cuomo, which has stuck with a far more conservative approach to counting virus deaths. 

The discrepancy in death counts continued to widen this year, according to an Associated Press review, even as the Democrat has come under fire over allegations that his office purposely obscured the number of deaths of nursing home residents to protect his reputation.

New York state's official death count, presented daily to the public and on the state's Department of Health website, stood at around 43,000 this week. But the state has provided the federal government with data that shows roughly 54,000 people have died with COVID-19 as a cause or contributing factor listed on their death certificate.

"It's a little strange," said Bob Anderson, chief of the Mortality Statistics Branch at the Centers for Disease Control and Prevention's National Center for Health Statistics. "They're providing us with the death certificate information so they have it. I don't know why they wouldn't use those numbers."

Such a discrepancy can fuel distrust in government tallies of COVID-19 deaths, while making it harder for individuals to know why others in their community died in the pandemic, experts say. 

"We need to make sure we get it right, and people understand what the numbers are. And how we're using them so they can't be misused by people who have a motive to misuse them," said Georges Benjamin, a physician and executive director at the American Public Health Association.

The Cuomo administration's count includes only laboratory-confirmed COVID-19 deaths at hospitals, nursing homes and adult-care facilities. That means its tally excludes people who died at home, hospice, in state prisons or at state-run homes for people living with disabilities. 

It also excludes people who likely died of COVID-19 but never got a positive test to confirm the diagnosis. Tests were scarce in the early stages of New York's outbreak. At least 5,000 New York City residents likely died of COVID-19 without a positive test, according to city statistics.

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The gap has widened even as testing has become more widely available, with the CDC data showing at least 3,200 more COVID-19 deaths in the state than New York's own tracker so far in 2021.

A spokesperson for New York's Department of Health said the state's count is accurate and declined to comment on why it reports its lower tally of COVID-19 deaths in news releases and its coronavirus tracker rather than the CDC's higher number. 

"DOH and the regulators of state-run facilities have gone to great lengths to ensure this data is accurate and reliable, and that process will continue for quite some time following this pandemic to give a complete picture once this data is finalized," spokesperson Jeffrey Hammond said in an email to The Associated Press.

Other states including California, Florida, Pennsylvania and New Jersey have taken approaches in line with the CDC, which includes in fatality counts all cases where COVID-19 is an associated or contributing factor. Texas, however, only counts a COVID-19 death in cases where the death certificate lists the virus as the main cause.

Generally, states' death counts are higher than the federal government's because the CDC needs time to tally records collected from the states. 

"The feds are always going to be behind," Benjamin said. "They've got to do their due diligence to validate their numbers they've got. It's most likely the feds are going to have a lower number than what states have."

New York's refusal to share details comes amid months-long scrutiny over how the state has reported COVID-19 data.

Federal prosecutors, the state attorney general's office and the state Assembly's judiciary committee are conducting separate probes after Cuomo's administration minimized its toll of nursing home residents' deaths by excluding all patients who died after being transferred to hospitals. Cuomo used those lower numbers last year to erroneously claim that New York was seeing a much smaller percentage of nursing home residents dying of COVID-19 than other states.

"Unfortunately New York state has chosen to politicize epidemiological information so I feel like they're lost all credibility over what's the best estimate of COVID deaths in New York State," CUNY professor Dennis Nash said.

New York City health officials, who are keeping their own separate fatality count, have asked the state to clarify its reporting practices, according to spokesperson Bill Neidhardt. The city's website reports the name number of COVID-19 deaths as the CDC.

"The CDC, WHO, those are the epidemiologically standard ways of counting mortality, of counting positivity," city hall spokesperson Bill Neidhardt said. "That is what we reflect. I can't tell you why the state numbers are different."