The true toll of the COVID-19 pandemic on communities of color is likely much higher than official figures and may never be fully documented, USA Today reports.

An analysis of mortality data from the U.S. Centers for Disease Control and Prevention (CDC) by the Documenting COVID-19 Project at Columbia University’s Brown Institute for Media Innovation and MuckRock, in collaboration with Boston University’s School of Public Health (SPH), the Arizona Center for Investigative Reporting; Willamette Week in Portland, Oregon, and the Texas Observer indicates that the death rate in BIPOC (Black, Indigenous, and people of color) communities from COVID-19 may have been underreported by as much as 20 percent.

Deaths attributed to nonspecific or unknown causes—what researchers describe as “garbage code deaths,” because investigators were unable or unwilling to spend the time to determine a proper cause of death—increased for nearly all racial and ethnic minorities. Where excess deaths among white people remained nearly unchanged throughout the pandemic, comparing 2021 figures to 2020, excess deaths among Latinos increased by 12.5 percent, African Americans by 15 percent, Indigenous peoples and Native Americans by 28 percent, and Asians by 30 percent.

Exemplified by USA Today’s reporting from Texas, at-home deaths in rural counties—with overwhelmed, under-resourced, and untrained personnel—were far more likely not to be assigned COVID-19 as a cause of death. Moreover, the data show that deaths from heart disease, respiratory illnesses, diabetes, and hypertension—all causes the CDC and physicians have routinely linked to COVID—have soared and remain high for communities of color, making incorrect death certificates another manifestation of the racial and ethnic health disparities exacerbated by the pandemic.

“When the information pipeline is clogged by underreporting, we don’t know what our risk is,” said Rebecca Fischer, an epidemiologist at Texas A&M University.

“Our death investigation system structurally disadvantages communities of color by obscuring the causes of death in those communities, which hinders our policy response,” said SPH researcher Andrew Stokes, who co-authored the study. “[S]evere underreporting…could be significant enough to skew decision making by policy makers.”

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