The bipartisan CARES Act and the Paycheck Protection Program and Health Care Enhancement Act provided $175 billion in relief funds to hospitals and other healthcare providers on the front lines of the coronavirus response. The Department of Health and Human Services through the Health Resources and Services Administration is distributing two rounds of payments to hospitals in High Impact areas for positive COVID-19 admissions. In the first round of the High Impact Allocation, $12 billion was distributed to nearly 400 hospitals who provided inpatient care for 100 or more COVID-19 patients through April 10, 2020. $2 billion of these payments was distributed to these hospitals based on their Medicare disproportionate share and uncompensated care payments. In the second round of funding, $10 billion will be distributed to hospitals having over 161 COVID-19 admissions between January 1 and June 10, 2020.
CDC reports aggregate counts of COVID-19 cases and death numbers daily online. Data on the COVID-19 website and CDC’s COVID Data Tracker are based on these most recent numbers reported by states, territories, and other jurisdictions. This data set of “United States COVID-19 Cases and Deaths by State over Time” combines this information. However, data are dependent on jurisdictions’ timely and accurate reporting.
Separately, CDC also regularly reports provisional death certificate data from the National Vital Statistics System (NVSS) on data.cdc.gov. Details are described on the NCHS website. Reporting the number of deaths by using death certificates ultimately provides more complete information but is a longer process; therefore, these numbers will be less than the death counts on the COVID-19 website.
Accuracy of Data
CDC tracks COVID-19 illnesses, hospitalizations, and deaths to track trends, detect outbreaks, and monitor whether public health measures are working. However, counting exact numbers of COVID-19 cases is not possible. COVID-19 can cause mild illness, symptoms might not appear immediately, there are delays in reporting and testing, not everyone who is infected gets tested or seeks medical care, and there are differences in how completely states and territories report their cases.
COVID-19 is one of about 120 diseases or conditions health departments voluntarily report to CDC. State, local, and territorial public health departments verify and report cases to CDC. When there are differences between numbers of cases reported by CDC versus by health departments, data reported by health departments should be considered the most up to date. Health departments may update case data over time when they receive more complete and accurate information. The number of new cases reported each day fluctuates. There is generally less reporting on the weekends and holidays.
CDC reports death data on three other sections of the website: U.S. Cases & Deaths, COVID Data Tracker, and NCHS Provisional Death Counts. The U.S. Cases and Deaths webpages and COVID Data Tracker get their information from the same source (total case counts); however, NCHS Death Counts are based on death certificates that use information reported by physicians, medical examiners, or coroners in the cause-of-death section of each certificate. Data from each of these pages are considered provisional (not complete and pending verification) and are therefore subject to change. Counts from previous weeks are continually revised as more records are received and processed. Because not all jurisdictions report counts daily, counts may increase at different intervals.
Confirmed & Probable Counts
As of April 14, 2020, CDC case counts and death counts include both confirmed and probable cases and deaths. This change was made to reflect an interim COVID-19 position statement issued by the Council for State and Territorial Epidemiologists on April 5, 2020. The position statement included a case definition and made COVID-19 a nationally notifiable disease. Nationally notifiable disease cases are voluntarily reported to CDC by jurisdictions. Confirmed and probable case definition criteria are described here:
https://wwwn.cdc.gov/nndss/conditions/coronavirus-disease-2019-covid-19/case-definition/2020/. Not all jurisdictions report probable cases and deaths to CDC. When not available to CDC, it is noted as N/A. Please note that jurisdiction
The COVID-19 case surveillance system database includes patient-level data reported to U.S. states and autonomous reporting entities, including New York City and the District of Columbia (D.C.), as well as U.S. territories and states. On April 5, 2020, COVID-19 was added to the Nationally Notifiable Condition List and classified as “immediately notifiable, urgent (within 24 hours)” by a Council of State and Territorial Epidemiologists (CSTE) Interim Position Statement (Interim-20-ID-01). The statement also recommended that all states and territories enact laws to make COVID-19 reportable in their jurisdiction, and that jurisdictions conducting surveillance should submit case notifications to CDC. COVID-19 case surveillance data are collected and reported voluntarily to CDC’s COVID-19 Response.
These deidentified data include demographic characteristics, exposure history, disease severity indicators and outcomes, clinical data, laboratory diagnostic test results, and comorbidities. All data elements can be found on the COVID-19 case report form located at www.cdc.gov/coronavirus/2019-ncov/downloads/pui-form.pdf.
The Case Surveillance Task Force and Surveillance Review and Response Group (SRRG) within CDC’s COVID-19 Response provide stewardship for datasets that support the public health community’s access to COVID-19 data while protecting patient privacy.
COVID-19 case reports have been routinely submitted using standardized case reporting forms. On April 5, 2020, CSTE released an Interim Position Statement with national surveillance case definitions for COVID-19 included. Current versions of these case definitions are available here: https://wwwn.cdc.gov/nndss/conditions/coronavirus-disease-2019-covid-19/. All cases reported on or after were requested to be reported by public health departments to CDC using the standardized case definitions for lab-confirmed or probable cases. On May 5, 2020, the standardized case reporting form was revised. Implementation of case reporting using this new form is ongoing among U.S. states and territories.
The COVID-19 case surveillance data are dynamic; case reports can be modified at any time by the reporting jurisdiction as new information becomes available (i.e., data are subject to change). Furthermore, reporting jurisdictions may report cases late. Version updates to the detailed and limited datasets will be available for request once a month.
The datasets will include all cases with an initial report date of case to CDC at least 14 days prior to the creation of the previously updated datasets. This 14 day lag will allow case reporting to be stabilized and ensure that time-dependent outcome data, including death, are accurately captured.
CDC’s Case Surveillance Task Force routinely performs data quality assurance procedures (i.e., ongoing corrections and logic checks to address data errors). To date, the following data cleaning steps have been implemented:
Questions that have been left unanswered (blank) on the case report form are re-classified to a Missing value, if applicable to the question. For example, in the question “Was the patient hospitalized?”, where the possible answer choices include “Yes”, “No”, or “Unknown”, the missing value is re-coded to Missing if the respondent did not answer the question.
Logic checks are performed for date data. If an illogical date has been provided, CDC reviews the data with the reporting jurisdiction. For example, if a symptom onset date that is in the future is reported to CDC, this value is set to null until the reporting jurisdiction updates this information appropriately.
The initial report date of the case to CDC is intended to be completed by the reporting jurisdiction when data are submitted. If blank, this variable is completed using the date
The U.S. Census Bureau, in collaboration with five federal agencies, launched the Household Pulse Survey to produce data on the social and economic impacts of Covid-19 on American households. The Household Pulse Survey was designed to gauge the impact of the pandemic on employment status, consumer spending, food security, housing, education disruptions, and dimensions of physical and mental wellness.
The survey was designed to meet the goal of accurate and timely weekly estimates. It was conducted by an internet questionnaire, with invitations to participate sent by email and text message. The sample frame is the Census Bureau Master Address File Data. Housing units linked to one or more email addresses or cell phone numbers were randomly selected to participate, and one respondent from each housing unit was selected to respond for him or herself. Estimates are weighted to adjust for nonresponse and to match Census Bureau estimates of the population by age, gender, race and ethnicity, and educational attainment. All estimates shown meet the NCHS Data Presentation Standards for Proportions,
Estimates of excess deaths can provide information about the burden of mortality potentially related to COVID-19, beyond the number of deaths that are directly attributed to COVID-19. Excess deaths are typically defined as the difference between observed numbers of deaths and expected numbers. This visualization provides weekly data on excess deaths by jurisdiction of occurrence. Counts of deaths in more recent weeks are compared with historical trends to determine whether the number of deaths is significantly higher than expected.
Estimates of excess deaths can be calculated in a variety of ways, and will vary depending on the methodology and assumptions about how many deaths are expected to occur. Estimates of excess deaths presented in this webpage were calculated using Farrington surveillance algorithms (1). For each jurisdiction, a model is used to generate a set of expected counts, and the upper bound of the 95% Confidence Intervals (95% CI) of these expected counts is used as a threshold to estimate excess deaths. Observed counts are compared to these upper bound estimates to determine whether a significant increase in deaths has occurred. Provisional counts are weighted to account for potential underreporting in the most recent weeks. However, data for the most recent week(s) are still likely to be incomplete. Only about 60% of deaths are reported within 10 days of the date of death, and there is considerable variation by jurisdiction. More detail about the methods, weighting, data, and limitations can be found in the Technical Notes.
Deaths involving coronavirus disease 2019 (COVID-19), pneumonia, and influenza reported to NCHS by sex and age group and state.
NOTICE TO USERS: As of September 2, 2020, this data file includes the following age groups in addition to the age groups that are routinely included: 0-17, 18-29, 30-49, and 50-64. The new age groups are consistent with categories used across CDC COVID-19 surveillance pages. When analyzing the file, the user should make sure to select only the desired age groups. Summing across all age categories provided will result in double counting deaths from certain age groups.