Collateral Costs of the Coronavirus Pandemic on Deaths in America

How much excess death has COVID-19 caused; who and what diseases are most affected?

There have been 273,675 deaths from coronavirus 2019 (COVID-19) in the U.S. as of today, December 1, 2020. No doubt, this is tragic. Yet this figure underestimates the total mortality attributable to the pandemic since its start in March. What is missing is “excess” death.

Excess deaths include the number of people who died of all causes minus the expected number of deaths for a specific time period. For example, let’s say 100,000 people would have been expected to die from all causes while 120,000 actually died during a time period. Excess deaths would be 20,000.

When scientists calculate the excess deaths from 2020, they are viewed as indirectly attributable to the pandemic because COVID-19 is the most important “shock” to the system during this period. What this means: not only have people died from the virus but from its collateral effects.

Some examples of the pandemic’s collateral effects that may explain excess (i.e. non-virus) deaths:

· Early in the pandemic, there were large declines in emergency department visits during the early stay-at-home orders. While many people stayed home with their low acuity conditions, many others with stroke and heart attack also avoided care. People who avoided the hospital may have died at home. Alternatively, they may have delayed care and had a worse outcome.