The Pandemic Was Even Deadlier Than We Thought This Spring and Summer

A health care worker prepares to screen people for the coronavirus at a testing site erected by the Maryland National Guard in a parking lot at the FedEx Field earlier this March in Landover, Maryland

A health care worker prepares to screen people for the coronavirus at a testing site erected by the Maryland National Guard in a parking lot at the FedEx Field earlier this March in Landover, Maryland
Photo: Chip Somodevilla (Getty Images)

A new study estimates that between March and July, there were 225,000 more deaths in the U.S. than expected, based on the previous five years of data. Of those, a little over half were officially attributed to the covid-19 pandemic. It’s the latest research to suggest that we’ve been seriously undercounting deaths caused by the viral illness and its second-order effects.

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The study was published Monday in the Journal of the American Medical Association (JAMA). It looked at mortality data collected by the federal government from 2014 to 2020. From March to July 2020, there were 1,336,561 deaths recorded, a number roughly 20% higher than expected, according to a model created by the authors. That amounts to 225,530 excess deaths during that time, the authors calculated, with 150,541 of these deaths officially attributed to covid-19 at the time. That’s as many as 75,000 deaths not currently included in the 210,000 (and rising) pandemic fatalities in the U.S.

This is far from the first study to find a large gap between the official death toll of the pandemic and excess deaths, though this study looks to provide one of the most up-to-date estimates so far.

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According to lead author Steven Woolf, a physician and population health researcher at Virginia Commonwealth University, some of these uncounted deaths are surely directly linked to coronavirus infections that went undocumented. It’s known, for instance, that covid-19 can damage the heart, which may partially account for the increase in deaths attributed to heart disease that Woolf and his colleagues saw during some weeks. States with reported spikes in covid-19 deaths also experienced more excess deaths generally during those spikes, further implicating the virus itself as their main source.

Undoubtedly, some of these uncounted deaths may also represent disruptions from pandemic-related public health measures that hindered or discouraged people’s access to health care or increased their risk of dying, even if they were never infected themselves. Evidence has suggested, for instance, that people have became more reluctant to visit the ER in recent months, while growing rates of unemployment and housing instability may have contributed to problems with mental health and substance use. However, the emotional or financial stress indirectly caused by the pandemic shouldn’t be seen as a justification for governments to rush ahead with reopening in places where the virus is still clearly spreading, according to Woolf.

“Inadequate efforts to control community spread allow infections to spread, and this only worsens and prolongs the pain and adverse health effects of the pandemic. The public shouldn’t be fooled by short-term gain,” Woolf said. “Not enforcing masks and social distancing, and refraining from closing businesses or venues that fuel the spread of disease might seem to lessen disruption in the short term, but the surge in cases that will surely follow a few weeks later will force elected officials to reinstate restrictions, prolong the epidemic, and claim even more lives.”

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Indeed, when judged on a global scale, it’s obvious the U.S.’s vacillations have made for a historically bad containment plan, as another new study out Monday in JAMA shows.

That study found that most other countries similar to the U.S., including those with huge outbreaks in the beginning like Italy and France, have experienced lower excess death rates this year, thanks in part to strict restrictions early on that greatly suppressed the spread of the virus. Some countries, such as South Korea, have now resumed nearly all normal activities. And though there are now worrying spikes in much of Europe that have propelled fears of a second wave, these countries are likely on firmer ground to contain their respective outbreaks than they were earlier in the year. (For one, we now have cheap steroid treatments for the most severe cases).

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Meanwhile, the U.S. is now likely experiencing the third peak of a first wave that has never truly ended, with many states reporting daily case tolls not seen since the summer. “Our inability to organize a similar national response and the impatience of Americans to stay the course has left us not only with higher death rates but a more prolonged epidemic and more devastated economy,” Woolf noted.

It’s likely that we won’t know the true toll of both the pandemic and the U.S.’ collective failure in controlling it for quite some time. “It will probably take one to two years to accurately describe the deaths that occurred in 2020 and even longer to document the ripple effects, such as excess deaths in the next few years stemming from complications that were set into motion by the pandemic,” Woolf said. “Although much of this picture will fill in within one to three years, it may take much longer—perhaps decades—to track the effects on today’s children and how exposure to the trauma of the pandemic changed their health trajectory.”

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