Opinion: The ‘died with’ vs. ‘died of’ measles discussion misses something very important

Summary

The article examines disagreement over how Pennsylvania measles-associated deaths should be counted nationally. Pennsylvania reported four deaths, but the CDC initially omitted three while awaiting confirmation that measles was the underlying cause on death certificates. The authors explain that death certificates record a causal chain, distinguishing diseases that initiate fatal complications from incidental conditions. They argue that the frequently cited “died with COVID, not from COVID” example was largely based on preliminary data and does not demonstrate widespread official overcounting. They recommend transparent reporting of deaths under review and the standards used.