The coronavirus pandemic may have killed 24,172 people in New York City from March 11 to May 1, a new report by the Centers for Disease Control and the New York City Department of Health and Mental Hygiene said.

The New York metro area has suffered the worst coronavirus outbreak in the United States, with over confirmed 14,482 novel coronavirus disease (COVID-19) deaths in the city alone. But the true number of deaths is almost definitely higher than the official death toll, with virus testing lagging behind and thousands dying at home.

A paper by federal authorities and the city health department, published on Monday, tried to put a number on the unknown by comparing deaths this year to the baseline number of deaths in previous years.

Health officials reported 32,107 deaths in New York City from March 11 to May 1, nearly a third higher than the seasonal baseline. This includes 13,831 laboratory-confirmed COVID-19 cases and 5,048 “probable” COVID-19 cases.

New York City allows doctors and medical examiners to mark deaths as probable COVID-19 cases at their discretion, and is not testing all deceased persons for the virus. Some critics say that the system is undercounting COVID-19 deaths.

The paper noted that the probably and confirmed case count “might not include deaths among persons with [novel coronavirus] infection who did not access diagnostic testing, tested falsely negative, or became infected after testing negative, died outside of a health care setting, or for whom COVID-19 was not suspected by a health care provider as a cause of death.”

The total number of “excess” deaths was between 22,980 and 25,364, with 95% confidence, including 5,293 deaths that were neither confirmed nor “probable” COVID-19 cases.

“Tracking excess mortality is important to understanding the contribution to the death rate from both COVID-19 disease and the lack of availability of care for non-COVID conditions,” the authors wrote. Some of the excess deaths “might have been directly or indirectly attributable to the pandemic,” but the percentage of them directly caused by COVID-19 will “require further investigation.”

Excess deaths peaked at over 1,100 on April 7, including nearly 300 that were not confirmed or probable COVID-19 deaths.

The number of excess deaths has since fallen to around 200 per day, nearly all of them confirmed or probable COVID-19 deaths.

Random antibody testing of supermarket shoppers suggested that around a fifth of New Yorkers had been exposed to the novel coronavirus by late April.

COVID-19 has killed 81,795 people total in the United States as of Monday night. Over one million people are known to be currently infected by the novel coronavirus, and 262,225 people have recovered from COVID-19.

Matthew Petti is a national security reporter at the National Interest. Follow him on Twitter: @matthew_petti.

Image: Reuters