Use of Unofficial Newspaper Data for COVID-19 Death Surveillance

Objective. To highlight the critical importance of unofficially reported newspaper-based deaths from coronavirus disease 2019 (COVID-19)–like illness (CLI) together with officially confirmed death counts to support improvements in COVID-19 death surveillance. Methods. Both hospital-based official COVID-19 and unofficial CLI death counts were collected from daily newspapers between March 8 and August 22, 2020. We performed both exploratory and time-series analyses to understand the influence of combining newspaper-based CLI death counts with confirmed hospital death counts on the trends and forecasting of COVID-19 death counts. An autoregressive integrated moving average–based approach was used to forecast the number of weekly death counts for six weeks ahead. Results. Between March 8 and August 22, 2020, 2,156 CLI deaths were recorded based on newspaper reporting for a count that was 55% of the officially confirmed death count (n = 3,907). This shows that newspaper reports tend to cover a significant number of COVID-19 related deaths. Our forecast also indicates an approximate total of 406 CLI expected for the six weeks ahead, which could contribute to a total of 2,413 deaths including 2,007 confirmed deaths expected from August 23 to October 3, 2020. Conclusions. Analyzing existing trends in and forecasting the expected number of newspaper-based CLI deaths indicates yet-unreported COVID-19 death counts, which could be a critical source to estimate provisional COVID-19 death counts and mortality surveillance. Public Health Implications. Considering unofficial newspaper-based CLI death counts is essential to identify COVID-19 death severity and surveillance needs to advance public health research efforts to prepare appropriate response strategies for low- and middle-income countries.