In California, one ER doctor who works at multiple hospitals in a hard-hit county told BuzzFeed News, “those medical records aren’t being audited by anyone at the state and local level currently and some people aren’t even testing those people who are dead.”

“We just don’t know. The numbers are grossly under-reported. I know for a fact that we’ve had three deaths in one county where only one is listed on the website,” the doctor said.

A spokesperson for the California Department of Health told BuzzFeed News in an email that “local health jurisdictions are required to report all positive COVID-19 cases to the state. In addition, when a death or impending death from COVID-19 occurs, health care facilities must immediately notify their local health jurisdiction and the state.”