A state-by-state analysis shows that deaths officially attributed to covid-19 only partially account for unusually high mortality during the pandemic
Andrew Ba Tran, Leslie Shapiro and Leslie Shapiro write in the Washington Post that the number of people reported to have died of the novel coronavirus in the United States surpassed 100,000 last week, a grim marker of lives lost directly to the disease, but an analysis of overall deaths during the pandemic shows that the nation probably reached a similar terrible milestone three weeks ago.
Between March 1 and May 9, the nation recorded an estimated 101,600 excess deaths, or deaths beyond the number that would normally be expected for that time of year, according to an analysis conducted for The Washington Post by a research team led by the Yale School of Public Health. That figure reflects about 26,000 more fatalities than were attributed to covid-19 on death certificates during that period, according to federal data.
Those 26,000 fatalities were not necessarily caused directly by the virus. They could also include people who died as a result of the epidemic but not from the disease itself, such as those who were afraid to seek medical help for unrelated illnesses. Increases or decreases in other categories of deaths, such as motor vehicle accidents, also affect the count.
Such “excess death” analyses are a standard tool used by epidemiologists to gauge the true toll of infectious-disease outbreaks and other widespread disasters.
The Yale-led team used historical death data to estimate the expected number of deaths for each week this year, adjusting for such factors as seasonal variation and the intensity of flu epidemics. To calculate excess deaths, the researchers subtracted their estimate of expected deaths from the overall number of deaths reported by the National Center for Health Statistics.
The covid-19 death toll, a key data point in shaping the public-health response to the pandemic, has become a political flash point. Allies of President Trump have claimed that the government tally is inflated, contending that it includes people with other medical conditions who would have died with or without an infection.
The Yale-led analysis, however, suggests that the actual number of people who have died because of the pandemic is far greater than the official government death tallies. The researchers estimated that the number of excess deaths between March 1 and May 9 was most likely between 97,500 and 105,500.
“It’s clear that the burden is quite a bit higher than reported totals,” said Daniel Weinberger, the Yale professor of epidemiology who led the analysis.
At the same time, an examination of excess deaths by state paints a portrait of two Americas, one pummeled by the pandemic and the other only lightly scathed.
Many Republican strongholds, including Alaska, South Dakota and Utah, did not have an unusual number of overall deaths during the period covered by the analysis. The numbers of deaths in those states rarely rose above the expected ranges and sometimes were slightly below them, the researchers found.
In contrast, some of the nation’s most populous blue and purple states — including New York and New Jersey but also Maryland, Massachusetts, Michigan and Illinois — experienced staggering surges in deaths. In every one of those states, the spike surpassed the number of deaths attributed to covid-19 in official tallies. New York City had an estimated 6,500 excess deaths beyond those attributed to the virus, according to the analysis.
The state-by-state analysis indicates that, as testing has become more widely available, covid-19 deaths have accounted for larger and larger percentages of the excess deaths. It also suggests that the gap between excess deaths and official covid-19 tallies has been particularly pronounced in several states that currently have the least restrictive social distancing rules in place.
The number of excess deaths fell nationally in the weeks leading up to May 9 — the last week for which data is complete enough to be reliable — largely because of the easing of the pandemic in such hot spots as New York City and New Jersey. However, that decline is overstated in the data due to delays between when a death occurs and when it is reported to the federal government.
Among the states where those reporting lags have been most pronounced are New Mexico, Kentucky, Rhode Island, Louisiana, Ohio and Georgia, according to the analysis.