A new report from the US Centers for Disease Control and Prevention (CDC) says nearly 300,000 more deaths than expected have occurred in the United States so far in 2020. Only two-thirds of these “excess deaths” are directly attributed to COVID-19, suggesting the real death toll of the pandemic is likely higher than the confirmed mortality numbers.

From year to year, overall mortality rates in the United States (and other countries around the world) are generally remarkably consistent. Excess deaths is a metric often used to evaluate the impact of unusual events, and it calculates how many extra deaths occurred above the expected average.

“Measures of excess deaths have been used to estimate the impact of public health pandemics or disasters, particularly when there are questions about underascertainment of deaths directly attributable to a given event or cause,” the CDC explains in its latest report.

Using provisional data, the report estimates the number of excess deaths that have occurred in the United States between late January and October 3 this year to be 299,028. Up to the same date, the report notes only 198,081 of those deaths are directly attributed to COVID-19. So over one-third of excess deaths so far this year have not been directly associated with COVID-19.

At this point it is difficult to attribute causes to this large volume of non-COVID-19 excess mortality. However, the CDC report does suggest it may be indicative of, among other things, some misclassified COVID-19 related deaths.

“… estimates of excess deaths attributed to COVID-19 might underestimate the actual number directly attributable to COVID-19, because deaths from other causes might represent misclassified COVID-19–related deaths or deaths indirectly caused by the pandemic,” the report states. “Specifically, deaths from circulatory diseases, Alzheimer disease and dementia, and respiratory diseases have increased in 2020 relative to past years, and it is unclear to what extent these represent misclassified COVID-19 deaths or deaths indirectly related to the pandemic (e.g., because of disruptions in health care access or utilization).”

As speculated in the report, a number of the excess deaths seen in the United States so far this year may be indirectly related to the pandemic. Concerns have been raised that many people are putting general health care treatments on hold due to either disruptions in access to health care or fear of attending hospitals during a viral pandemic.

CDC

Studies have already cited significant drops this year in cancer diagnoses relative to prior years. Other research is revealing opioid overdoses, already nearing record levels in early 2020, have risen even further in response to the pandemic.

The age and race trends in the CDC report also reveal how the pandemic is disproportionately hitting certain demographic groups. Graphs displaying weekly deaths relative to average numbers in the same weeks from previous years show excess death higher in Hispanic, Black and Asian communities compared to White mortality rates.

CDC

Age demographics suggest the excess deaths are mostly occurring in older age groups. However, there was a notable spike in excess deaths for 25 to 44 year olds during the July COVID-19 wave. This is a reminder COVID-19 is not only dangerous to older demographics.

Earlier in October researchers from the Virginia Commonwealth University School of Medicine looked ahead, modeling likely excess deaths to the end of 2020. The study suggested by the end of 2020 the United States can expect to exceed 400,000 excess deaths.

Source: CDC