The Tennessee Department of Health (TDH) released year-end, reconciled COVID-19 data, process improvements and previewed 2022 operational priorities.

“Year-end data reconciliation is an important step to ensure the public has an accurate view of how COVID-19 has affected our state this year and also identify areas where the department can improve services,” said Tennessee Department of Health Commissioner Lisa Piercey, MD, MBA, FAAP. “Data reporting for COVID-19 is unique, as it is the only infectious disease where real-time progression is tracked from positive test to death, compared to typical monthly or annual reports.”

TDH anticipates changes to national COVID-19 reporting standards in early 2022 based on recommendations from the Council of State and Territorial Epidemiologists (CSTE) and has reconciled data to comply with upcoming standards. This data update will be completed the week of January 4. “This enhanced review is a valuable process, and I’ve encouraged my colleagues in other states to do the same,” said Piercey. “Trust in public health data is key to our response and data accuracy is a top priority for TDH.”

2021 Key COVID-19 Data Points*

• Total tests processed this year: 5,394,058
• Total cases reported this year: 762,964
• Total vaccines administered this year: 8,280,246

The TDH Office of State Chief Medical Examiner reconciled outstanding death certificates with COVID-19 as an underlying cause of death, bringing COVID-19 fatalities spanning spring 2020-December 2021 to 20,644.



The lag in death reporting data can be contributed to many factors including the manual process most providers and facilities undertake, the increase in at-home deaths, and the strain on the public health infrastructure during case surges. On average, the Centers for Disease Control and Prevention (CDC) notes that approximately 75 percent of mortality data is complete by eight weeks, given the time it takes to determine the cause of death in some cases.

“COVID-19 death certificate processing is complex, and the department is committed to continuously improving information flow,” said Piercey. “As we continue to analyze Tennessee death data, we have seen a year-over-year increase in COVID deaths occurring at home. This is a trend we will further examine and assess how the department can respond.”

Process Improvements and Data Integrity

TDH is pursuing process improvements for COVID-19 death reporting to ensure data accuracy, including automation and additional verification around cause of death. Providers in Tennessee received the following memo to encourage electronic reporting and emphasize best practices for data submission to the department, to improve the timely reporting of death data.

In the new year, COVID-19 data will be reported on a weekly basis consistent with other infectious diseases.

Return to Pre-Pandemic Priorities in 2022

TDH will continue to support COVID-19 vaccine distribution across all 95 counties and support access to approved treatments. TDH will also resume full-time attention to ongoing, traditional public health priorities, including

• Access to preventative health services and primary care
• Improve routine immunization rates for children and adults
• Address substance misuse and drug overdoses
• Support overall family health and wellness