Are we over-counting COVID-19 deaths? Wouldn’t lots of people dying of COVID19 be dying from other causes anyway?

Data and Metrics Data Literacy

A: Sadly, it is clear that we are NOT over-counting COVID deaths.

It’s true that some people who died of COVID-19 over the past 9 months would have died anyway, but we can account for this by counting OVERALL deaths compared to the same period in previous years.
Among the COVID-19 myths that just won’t die, we continue to hear chatter that COVID-19 deaths are being over-counted, such as stories of victims of motorcycle accidents getting tested in the hospital so they can be counted as COVID-19 deaths, or the infamous saying that people are dying *with* COVID-19 rather than *of* COVID-19. We’ve even heard recent rumors claiming that there are not any more deaths so far in 2020 compared to previous years—which is simply false.

We’ve previously covered the myth that doctors and hospitals are purposefully inflating COVID-19 death numbers (TL;DR: not true).

But how can we know for sure, when filling out death certificates is not an exact science, and COVID-19 does hit older people who may be close to death especially hard?

💥 EXCESS MORTALITY 💥

In 2019, there were a little over 2.85 million deaths in the U.S. So yes, sadly many people die every year even without COVID-19. Heart disease, cancer, and drug overdoses kill people every year, and 2020 is no exception.
“Excess mortality” uses the number of deaths in previous years as the baseline for “expected” deaths. These baseline deaths are the counterfactual for what deaths would have looked like in a bizarro 2020 world without COVID-19.

The question is how many MORE deaths from ALL CAUSES have we seen in 2020 compared to previous years?

Through November 7th, this estimate is around *310,576* deaths, or 77,483 MORE than the official COVID-19 deaths in the U.S.

Why would overall excess deaths be higher than confirmed COVID-19 deaths?

➡️ “Direct” deaths: Especially early in the pandemic when testing was low, many COVID-19 cases & deaths were undetected. In New York City for example there was a big increase in dying at home during the first wave. These missed deaths were likely directly due to the virus.

➡️ “Indirect” deaths: when hospitals are overwhelmed (as we are sadly seeing again now) patients may delay seeking care for other causes or not receive the care they need. Indirect deaths would also include increased deaths due to the social or economic impacts of the pandemic.

How do we know how many excess deaths were direct or indirect? It’s difficult to know for sure, but there are some clues in the data we have thus far.

In the U.S., excess mortality has tracked very closely the movement of the pandemic across time and space, showing up first the Northeast in the Spring, moving to the South and West during the summer, and now picking up in the Midwestern States (see figure).

This correspondence of excess mortality with the path of the virus itself suggests many of the excess deaths are due to undetected cases the virus itself, as well as some amount of delayed or reduced care from overstretched health care capacity.

Lockdown restrictions in the Spring and economic impacts were more generally spread across the country, so the pattern of excess mortality does not suggest these types of “indirect” deaths were high, and some evidence has shown that deaths due to car accidents, etc. declined over this period.

What about car accidents? Don’t a lot of people die every year, but we don’t ban driving? Car accidents killed around 38,800 in the U.S. last year. The current excess mortality due to COVID-19 only counts about 8 months (no excess in January and February), so annual COVID excess mortality is likely to be well over 400,000. I am confident if there were 400,000 annual automobile deaths there would be an extreme investment in road and car safety AND an aversion to getting on the roads. Automobile accidents are also not contagious in the same way as a virus (and thus subject to exponential growth), so the approaches required to avoid these deaths are different.

BOTTOM LINE:

➡️The U.S. has seen over 300,000 MORE DEATHS than usual this year.

➡️Excess deaths have been seen in all countries hard hit by the pandemic, but not in countries that were not.

➡️This is not a coincidence and corresponds closely across time and space with the spread of COVID-19.

➡️When the Nerdy Girls get worked up about COVID-19 prevention, THESE NUMBERS are why. COVID-19 is not a hoax, not just a normal cold or flu. Counting all the bodies sadly does not lie.

➡️Hope is on the horizon, and the vaccines soon to be deployed can prevent 2021 from racking up 400,000 more excess deaths.

➡️Until then, hunker down and Stay Safe, Stay Sane!

Love,
Those Nerdy Girls

Further Reading:

The Economist

The New York Times

Our World in Data

 

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