The South Carolina Department of Health and Environmental Control (DHEC) is clarifying misunderstanding around newly released data from the U.S. Centers for Disease and Prevention Control (CDC) regarding deaths associated with COVID-19.
Provisional death data updated by the CDC last week shows that for six percent of COVID-19 deaths, COVID-19 was the only cause of death mentioned. The remaining 94 percent of deaths were among people with other underlying or contributing conditions but COVID-19 was still a factor in the deaths.
Cause of death, as listed on a death certificate, includes an immediate cause, intermediate causes, underlying cause, and contributing conditions. A common example of cause of death involving COVID-19 would have acute respiratory distress syndrome as the immediate cause of death, which is the ultimate condition that caused the death. The intermediate cause of death would have been pneumonia, with COVID-19 as the underlying cause of death. The underlying cause of death is the condition that leads, via intermediate causes, to the immediate cause of death.
Contributing factors could have been asthma, chronic obstructive pulmonary disease (COPD), diabetes, or any other illness or condition that may have made the condition that was the cause of death worse than it would have been.
In the example above, COVID-19, as the underlying cause of death, is the condition that triggered the cascade of events that eventually lead to death. While certain people such as older adults are more likely to have more contributing factors, if the person doesn’t contract COVID-19, then those factors don’t start the cascade of events that lead to death. Therefore, while COVID-19 infection had a significant role in causing the death in the example, it was not the only cause of death listed. As a result, that death would not count in the six percent from the CDC.
This is not new information. It’s been understood for quite some time that individuals with certain underlying conditions are at greater risk for severe illness and death, which is why DHEC provides underlying health conditions data, also called comorbidity information, for COVID-19-associated deaths on its county-level dashboard, under the “Deaths” data section.
Learn more about conditions that increase the risk of severe illness on the CDC website here. This updated data from the CDC further emphasizes the risk for people with these underlying health conditions.