There have been more than 1m excess deaths in the US during the pandemic, according to the US Centers for Disease Control and Prevention (CDC).
The deaths are mainly attributable to Covid-19, as well as conditions that may have resulted from delayed medical care and overwhelmed health systems.
At least 923,000 Americans have died from confirmed Covid cases, according to the CDC. Other causes of death above the normally expected number have included heart disease, hypertension and Alzheimer’s disease.
Some Americans also die months after their initial Covid diagnosis, because the virus created other fatal complications.
Excess deaths are calculated by looking at previous years’ fatalities. In 2019, there were 2.8m deaths in the US; in 2020, it was approximately 3.3m.
“All-cause excess mortality is one of the most reliable and unbiased ways to look at the effect of the Covid-19 pandemic,” said Jeremy Faust, an emergency physician at Brigham and Women’s Hospital and an instructor at Harvard Medical School.
“It does not rely on how many tests were done or on subjective cause of death designations.”
While cause of death can sometimes be difficult to ascertain, and political pressures can lead to miscounting, excess deaths can indicate the broad scope of a health emergency.
“Whenever we hear that another 100,000 people died of Covid, there’s a reliable chorus of naysayers who claim that these deaths would’ve happened anyway,” Faust said. “Excess deaths cuts through that, because it’s about reporting whether the total number of deaths is out of the ordinary.”
These figures can reveal the truer toll of Covid – including deaths directly from infection as well as deaths from the circumstances of the crisis.
The global number of excess deaths may be millions higher than the official count of Covid deaths.
The toll of Covid has been geographically uneven in the US. At first the virus was largely confined to major cities, but then it began spreading in rural areas, with devastating effect.
Deaths among working-age Americans are up 40% during the roughly two years of the pandemic, one insurance executive said in December.
Many Americans delayed seeking care during the pandemic, and others may have seen the quality of their care decrease as health systems were overburdened by Covid.
The US is also in the midst of an overdose crisis, with more than 100,000 overdose deaths in the first year of the pandemic.
Excess deaths are also known as untimely or “early” deaths. While the majority of excess deaths in the US occurred among those 65 and older, many of those Americans had many years left to live.
The average 80-year-old in the US has a life expectancy of eight more years, Faust noted. “If suddenly more 80-year-olds are dying than usual, it’s a simple fact that many of them had not just months but years, even a decade or more, of life left otherwise in some cases.
“Sometimes people say that stopping Covid merely ‘delays death’. To that, I say, ‘Exactly. That’s what medicine and public health are all about.’”
