The state Health Department has belatedly published a more complete COVID death count for the pandemic’s first year, accounting for more than 6,000 victims who were left out of the state’s previous tallies because they died at home.

In a report last week on the state’s leading causes of death, the department put the number of COVID death in 2020 at 36,337, which is 21 percent higher than the figure in its online database.

This marks the first time the state has disclosed pandemic data drawn from death certificates rather than its Health Emergency Response Data System, or HERDS.

While HERDS draws information only from hospitals, nursing homes and other similar facilities, death certificates reflect the full range of pandemic losses – including the roughly one in five deaths that occurred outside of institutions.

The more complete accounting shows that COVID-19 was New York City’s No. 1 cause of death in 2020 and the No. 2 cause statewide. The state’s age-adjusted death rate surged 30 percent – including 54 percent in New York City – and life expectancy dropped by 1.6 to 3.4 years depending on age.

The findings parallel those in a similar report issued the same day by the New York City Department of Health and Mental Hygiene. 

As seen in the table, the 6,283 newly reported deaths were concentrated in the downstate region that was the epicenter of the early pandemic, adding more than 1,000 deaths each to the state’s previous tolls for Brooklyn and Queens.


(Small numbers in some counties were omitted for privacy reasons by DOH)


The biggest increase upstate was in Monroe County, where the toll grew by 77.

Although other agencies, including the city health department and the CDC, used death certificates to track COVID since early in the pandemic, the state Health Department did not follow suit.

In 2021, the Health Department turned down the Empire Center's request for complete death data, including deaths outside institutions. It claimed that state law declares "no certified death record shall be subject to disclosure" under the state's Freedom of Information Law. That was a misquote of Public Health Law Section 4174, which actually says "no certified copy or certified transcript of a death record shall be subject to disclosure" (emphasis added). The center was requesting tabular data based on death records – the same type of information the Health Department is disclosing now – not certified copies or transcripts of individual certificates.

Shortly after Governor Hochul took office in August 2021, her press aides added the CDC's much higher statewide death toll to its routine pandemic updates. This served as a reminder that the HERDS data were incomplete.

However her administration did not provide county-specific information until last week – and it still has not shared date-specific numbers that would provide a more accurate understanding how the pandemic unfolded.

Although last week's report brought the state's toll for 2020 more in line with those from the CDC and the city, disparities remain.

As seen in the second table, the city, state and federal government have arrived at different totals for 2020 – possibly because they are using different methodologies or definitions of what constitutes a COVID death. For both the city and the state, there are also disparities between the numbers in the respective vital statistics reports from last week what they post separately in their data portals.



The CDC's data also include another revelation: It apparently has evidence of at least one COVID death in New York during the week before January 25, 2020 and at least three more in February. All were reported somewhere in the state outside New York City. (These deaths appear as blank spots in the agency's reporting because it redacts numbers less than 10 for patient privacy reasons – but it's still clear that each of those blank spots reflects at least one victim.)

Those deaths, if verified, would dramatically rewrite the timeline of New York's pandemic. They're a reminder of how much remains to be learned about the state's worst public health disaster in more than a century.

About the Author

Bill Hammond

As the Empire Center’s senior fellow for health policy, Bill Hammond tracks fast-moving developments in New York’s massive health care industry, with a focus on how decisions made in Albany and Washington affect the well-being of patients, providers, taxpayers and the state’s economy.

Read more by Bill Hammond

You may also like

Hochul Signals Tough Budget Ahead

Governor Hochul’s administration this week urged agency heads to keep their budgets flat next year. It's the most serious acknowledgement yet of state government’s looming financial shortfall. Read More

Federal Staffing Rule Would Compound Hiring Pressure for New York Nursing Homes

Nursing homes that are struggling – and mostly failing – to comply with the state's two-year-old minimum staffing law would face even stiffer hiring challenges under newly proposed federal standards. Read More

As migrants flow to NY, so does red ink 

The influx of foreign migrants to New York could cost the state $4.5 billion more than expected next year, Governor Hochul today warned.  Read More

Beware of Medicaid’s Spending Swings

The state's Medicaid spending is becoming increasingly volatile from month to mo Read More

Unlikely Pair Tries to Blow Open Secret Wind Deal 

Offshore wind developers, citing changing market conditions, are demanding what could be billions of dollars in additional subsidies—but refusing to let the public see how much or explain their reasoning. Read More

The Health Department’s Medicaid ‘Unwinding’ Report Leaves a Key Question Unanswered

As Medicaid downsizes in the aftermath of the coronavirus pandemic, reporting by New York and other states is missing data on an important group – outgoing enrollees who successfully made the switch to job-based insurance Read More

At mid-year, NY still far below most states in pandemic jobs recovery

New York has added private-sector jobs in all but three of the 38 months since the COVID-19 outbreak of March 2020—but the Empire State remains below its pre-pandemic employment level and continues to trail the national recovery. On a seasonally adju Read More

The Uncertain Math of ‘Coverage for All’

State lawmakers are divided over proposal known as "Coverage for All," which would allow low-income undocumented immigrants to obtain free health insurance through the state-run Essential Plan. Read More

Empire Center Logo Enjoying our work? Sign up for email alerts on our latest news and research.
Together, we can make New York a better place to live and work!