July 17, 2020

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The number of deaths from COVID-19 reported in the news is likely underestimating the pandemic’s actual death toll, according to a pair of research letters by the Center on Society and Health at VCU and Yale published in the Journal of the American Medical Association in July and October.

From March 1st to August 1st, 2020, the United States saw 225,530 excess deaths, but only 67% of the excess deaths were attributed to COVID-19. The other 33% were linked to other causes such as heart disease, diabetes, cerebrovascular disease, and Alzheimer’s disease. Simply put, for every two deaths attributed to COVID-19, there was another extra death attributed to other causes.

This means that the pandemic is costing more lives than the COVID-19 death count would suggest. In 14 states, including some of the nation’s most populous like California and Texas, less than half of excess deaths were attributed to COVID-19. 

A follow-up study published in October showed that states that were hit hard early in the pandemic but were able to bring death rates down, like New York and New Jersey, didn’t show a summer surge in deaths. However, states that escaped the pandemic at first, like Texas and Florida, but reopened early, show a prolonged summer surge, that was still happening as the study ended. The research can’t prove that early reopenings led to summer surges, but the data suggests that it is likely.  

The persistent attribution of excess deaths to causes other than COVID-19 could have multiple explanations. First, the number of publicly reported COVID-19 deaths is taken from provisional data that are often incomplete and may omit COVID-19 deaths that were misattributed to another cause. And deaths attributed to other causes like heart disease, stroke, and diabetes could reflect undocumented complications from COVID-19 such as clotting disorders or inflammation caused by the virus. 

Additionally, some of the excess deaths may have less to do with the virus itself than the restrictions imposed by the pandemic which may have resulted in reduced access to health care, fears of calling 911 for acute emergencies, or psychological stresses that lead to death.


Additional Resources

Read the October update in JAMA

Read the July report in JAMA

Read more on VCU News (October)

Read more on VCU News (July)


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