COVID

Here’s why the number of reported COVID-19 deaths in Massachusetts will drop by 3,700 Monday

"This updated definition gives us a truer picture of mortality associated with COVID-19."

In this May 1, 2020, file photo the Rev. Eric Bennett, left, says a funeral Mass for a man who died of COVID-19 in Boston. His family lives in Italy and could not travel for the funeral, so the only other person attending was funeral director Joe Ruggiero, right. Jessica Rinaldi/The Boston Globe via AP

By Christopher Gavin

March 10, 2022

COVID

The Massachusetts Department of Public Health announced Thursday it will soon change which deaths are attributed to COVID-19 — a shift that will result in several thousand fewer deaths in the state’s official, overall count.

On Monday, when the reclassification takes hold, that total will drop by 3,700 deaths, as 4,081 previously counted deaths are removed, according to a statement from the DPH.

Additionally, the department will add approximately 400 deaths to the total, deaths that were “not previously counted but identified through a manual process of matching death certificates with medical records,” officials said.

The criteria change will bring Massachusetts into conformity with guidance for identifying COVID deaths from the Council of State and Territorial Epidemiologists.

The council, in collaboration with the U.S. Centers for Disease Control and Prevention, issued a recommendation in late 2021 that states adhere to a uniform standard for how they count virus-related fatalities.

According to the DPH, Massachusetts currently counts deaths of people with COVID listed as a cause of death on their death certificate and any person who had a COVID diagnosis within 60 days before their death but does not have the virus listed as a cause of death. The new definition reduces the timeframe from 60 to 30 days.

DPH State Epidemiologist Dr. Catherine Brown said Massachusetts will adopt the definition because the department supports the need to standardize how those deaths are counted.

“Prior to the CSTE definition, states did not have a nationally recommended definition for COVID-19 deaths and, as such, have been using a variety of processes and definitions to count their deaths,” Brown said in a statement. “In Massachusetts, our definition has consistently been broader than most other states. After a deep dive into our data and reviewing thousands of death certificates we recognize that this updated definition gives us a truer picture of mortality associated with COVID-19.”

Nicolas Menzies, associate professor of global health at the Harvard T.H. Chan School of Public Health, called the new definition “a reasonable balance between sensitivity and specificity,” which will allow health experts to better compare data between states and jurisdictions.

Previously, when cases first surged in Massachusetts in March 2020, state officials matched COVID-19 surveillance case information with death certificates to confirm fatalities and also included the deaths of any persons who previously tested positive for the virus at any point in time.

On Thursday, officials said that approach was “overly broad,” stating that it “led to an over-counting of COVID-19-associated deaths.”

The 60-day timeframe was introduced in April 2021 as experts learned more about the virus.

“Beginning Monday, all calculations involving deaths posted in the COVID-19 dashboard and the raw data file will contain the updated data,” the DPH said in a statement. “Previous raw data files will still be available on the website and will not be updated.”

Deaths in long-term care facilities will still be reported directly to the state from those facilities. However, “the updated definition will align surveillance deaths more closely with the long-term care facility-reported counts,” officials said.

Additionally, several new data points and functionality and design changes will be added to the state’s COVID-19 dashboard on Monday, though no existing data sets will be removed.