Deaths in US Surged in 2020, Well Beyond Official Covid-19 Toll

The covid-19 pandemic drove a horrifying surge in U.S. deaths last year, new research published Friday has shown. According to the study, over half a million more people died than would have been expected during the last 10 months of 2020. Most of these deaths were directly attributed to the viral illness, but some could also represent delays in health care and other indirect consequences of the pandemic.

From the very start, scientists and public health agencies have been tracking excess deaths—total reported deaths above the average number seen in recent years—as a way to more accurately understand the impact of the pandemic. Though countries have gotten much better at identifying covid-19 cases and related deaths over time, our official tolls are still an underestimate of the destruction it’s caused. In the U.S., studies have consistently shown a sizable gap behind excess deaths and those officially tied to covid-19.

Covid-19 may have been in the U.S. as early as late 2019, but the first peak of illness and death started by March 2020. This new study, published Friday in JAMA and led by researchers by Virginia Commonwealth University, analyzed U.S. mortality data from March 1, 2020 to January 1, 2021.

Between those months, the team estimated that the country experienced 522,368 excess deaths, compared to the past five years. Though deaths do tend to slightly rise year after year (thanks in part to a growing population), this usually only results in an excess death jump of 1% to 2% annually. 2020, however, saw a 22.9% spike in excess deaths during that time period, the authors found.

“The 22.9% increase in all-cause mortality reported here far exceeds annual increases observed in recent years,” the authors wrote.

Just this week, data from the Centers for Disease Control and Prevention cemented that covid-19 was the third leading cause of death in the U.S. last year, with nearly 350,000 deaths officially attributed to it. In this study, the researchers calculated a similar direct death toll (378,039 deaths) from covid-19 that accounted for about 72% of the excess deaths they found.

Much of the remaining 28% could be hidden deaths from the pandemic or deaths from causes that were exacerbated from having had covid-19. The infection is suspected to raise the risk of life-threatening health problems like heart attack and stroke, as well as the risk of dying from chronic conditions like diabetes and dementia. But some uncounted deaths are also likely the result of indirect impacts from the pandemic that affected people who never even contracted the virus. There’s evidence, for instance, showing that visits to the emergency room or hospitals declined last year, especially during peaks of the pandemic.

Though no country has completely avoided the pandemic, it’s likely that the U.S. and local states could have done a much better job of preventing a substantial amount of these deaths, according to the researchers.

“Excess deaths surged in the east in April, followed by extended summer and early winter surges concentrated in southern and western states, respectively,” they wrote. “Many of these states weakly embraced, or discouraged, pandemic control measures and lifted restrictions earlier than other states.”

Other data has shown that more than 3.1 million people died in the U.S. overall last year, the sort of substantial increase from the previous year not seen since 1918, when World War I and the deadliest pandemic in recorded history were both ongoing.