What’s The True Toll Of The Coronavirus Outbreak? Covid-19 Deaths Aren’t The Only Reason For The Rising Death Rates

For every two deaths caused by Covid-19 in the U.S., another American dies from pandemic related causes, according to a new study.

Using mortality data from the Centers for Disease Control and Prevention (CDC) from 2014 to 2020 the authors were able to predict the expected deaths for 2020.

However, the study, published in the Journal of the American Medical Association, found that deaths between March and August increased by 20% compared to previous years.

While this might not be surprising given the current circumstances, the researchers found that deaths linked to Covid-19 only accounted for 67% of those deaths.

“Contrary to skeptics who claim that Covid-19 deaths are fake or that the numbers are much smaller than we hear on the news, our research and many other studies on the same subject show quite the opposite,” said lead author Steven Woolf, M.D., director emeritus of VCU’s Center on Society and Health, in a statement.

The gap between reported Covid-19 deaths and all unexpected deaths can be partially explained by delays in reporting Covid-19 deaths, miscoding or other data limitations, Woolf explained.

It’s also worth mentioning that the CDC has rushed out provisional mortality data this year because of the pandemic. More reliable, granular detail will come out later and allow researchers to unpack the detailed contributors to excess deaths and secondary health impacts of the pandemic.

But early data is showing the pandemic’s ripple effects aren’t something to be brushed off.

“Some people who never had the virus may have died because of disruptions caused by the pandemic,” said Woolf. “These include people with acute emergencies, chronic diseases like diabetes that were not properly care for, or emotional crises that led to overdoses or suicides.”

According to reports from the CDC, there was a 40% drop in emergency visits at the onset of the pandemic and in other countries, like the U.K., researchers have observed spikes in diabetes and asthma-related deaths because people were reluctant to seek treatment.

And further to Woolf’s point about overdoses, The Washington Post reported that suspected overdoses jumped 18% in March, 29% in April and 42% in May. Further, a report from the Overdose Data Mapping Application Program published in May showed fatal overdoses rose by almost 11.4% in comparison to last year. Most recently, a study also published in JAMA found a 123% increase in nonfatal overdoses between March and June this year from last year.

Additionally, this latest study found that deaths from dementia and heart disease increased significantly. Woolf noted that deaths from Alzheimer’s disease and dementia increased not only in March and April, when the pandemic began, but again in June and July when the Covid-19 states in the Sun Belt saw a rise in cases.

“The high death counts in Sun Belt states show us the grave consequences of how some states responded to the pandemic and sound the alarm not to repeat this mistake going forward,” said Woolf.

States like New York and New Jersey, which were hit hard early but were able to control the curve and bring death rates down in less than 10 weeks didn’t show a summer surge. However, states such as Texas, Florida and Arizona that escaped the pandemic at first but reopened early showed a prolonged summer surge that lasted 16-17 weeks — and was still underway when the study ended.

“We can’t prove causally that the early reopening of those states led to the summer surges. But it seems quite likely,” said Woolf. “And most models predict our country will have more excess deaths if states don’t take more assertive approaches in dealing with community spread. The enforcement of mask mandates and social distancing is really important if we are to avoid these surges and major loss of life.”

Woolf paints a grim picture, warning that long-term data may show a broader impact of the pandemic on mortality rates. For example, he mentioned cancer patients who have had their chemotherapy disrupted, women who have had their mammograms delayed could lead to a rise in preventable, early deaths in the coming years.

In fact, one study earlier this year found that cancer diagnoses dropped 50% during the pandemic. A study published in The Lancet estimated almost 4,000 unnecessary cancer related deaths in the U.K. due to the pandemic and more than 60,000 total years of life lost.

And it’s not just America that’s seeing excess deaths due to the pandemic. Nature reported there were nearly 600,000 more deaths than would normally be predicted for the period between the onset of the pandemic and the end of July. This was using data from more than 30 countries, and of the 600,000 deaths only 413,041 of those were officially attributed to Covid-19.

While it’s hard to separate out what exactly that data is telling us due to the numerous limitations in how the data is collected and reported, it’s still a sign that the true burden of Covid-19 is far more complicated than we could ever have imagined.

And as Woolf points out: “death is only one measure of health”.

“Many people who survive this pandemic will live with lifelong chronic disease complications. Imagine someone who developed the warning signs of a stroke but was scared to call 9-1-1 for fear of getting the virus. That person may end up with a stroke that leaves them with permanent neurological deficits for the rest of their life,” he added.

“This isn’t a pandemic involving a single virus,” said Peter Buckley, M.D., dean of the VCU School of Medicine. “This is a public health crisis with broad and lasting ripple effects.”

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