Houston Chronicle

CDC: U.S. death toll far higher than reported

- By Josh Katz, Denise Lu and Margot Sanger-Katz

Total deaths in seven states that have been hard-hit by the coronaviru­s pandemic are nearly 50 percent higher than normal for the five weeks from March 8 through April 11, according to new death statistics from the Centers for Disease Control and Prevention. That’s 9,000 more deaths than were reported as of April 11 in official counts of deaths from the coronaviru­s.

The new data is partial and most likely undercount­s the recent death toll significan­tly. But it still illustrate­s how the coronaviru­s is causing a surge in deaths in the places it has struck, probably killing more people than the reported statistics capture.

These increases belie arguments that the virus is only killing people who would have died anyway from other causes. Instead, the virus has brought a pattern of deaths unlike anything seen in recent years.

If you look at the provisiona­l deaths from all causes, death counts in New York, New Jersey, Michigan, Massachuse­tts, Illinois, Maryland and Colorado have spiked far above their normal levels for the period.

In New York City, the home of the biggest outbreak, the number of deaths over this period is more than three times the normal number. (Recent data suggests it could have reached six times higher than normal.)

In New Jersey, deaths have been 172 percent of the normal number so far — more than 5,000 additional deaths, compared with an average count from the past five years. In Michigan, the partial death count is 121 percent of the count in a normal year, the equivalent of nearly 2,000 more deaths.

These numbers are preliminar­y because death certificat­es take time to be processed and collected, and complete death tallies from the CDC can take up to eight weeks to become final.

The speed of that data reporting varies considerab­ly by state. In Connecticu­t, for example, where reported coronaviru­s deaths are high, the CDC statistics include zero reported deaths from any cause since Feb. 1 because of reporting lags.

These provisiona­l death counts were compared with the average number of deaths each week over the past five years. Public health researcher­s use the term “excess deaths” to describe a gap between recent trends and a typical level of deaths.

It’s difficult to know whether the difference­s between excess deaths and the official counts of coronaviru­s deaths reflect an undercount­ing of coronaviru­s deaths or a surge in deaths from other causes. It’s likely a mix of both.

There is evidence, in New York and other places, that the official coronaviru­s counts are probably too low. Tests for the illness can be hard to get, and not all who die now are being tested, particular­ly if they die outside a hospital. New York City recently revised its own statistics for the number of coronaviru­s-related fatalities, saying thousands of additional deaths were probably because of COVID-19, even though no tests had been conducted.

There is also increasing evidence that stresses on the health care system and fears about catching the disease have caused some Americans to die from ailments that are typically treatable.

A recent draft paper found that hospital admissions for a major type of heart attack fell 38 percent in nine major U.S. hospitals in March. In a normal year, cardiovasc­ular disease is the country’s leading cause of death.

Some causes of death may actually be going down. There appear to be fewer road fatalities in California

as more U.S. residents stay at home, for example. It is possible that those reductions could cancel out coronaviru­s deaths in places where the virus is not yet widespread. But in many states, any such reductions have been clearly outweighed by increases in deaths directly and indirectly related to the virus.

Demographe­rs often use measures of total deaths, sometimes called all-cause mortality, to evaluate the effects of natural disasters, where it can be difficult to trace particular causes.

In Puerto Rico in 2017, only 64 deaths were initially attributed to Hurricane Maria. But an analysis of the additional deaths showed the way that the disaster had directly and indirectly led to nearly 3,000 deaths over six months.

The coronaviru­s is clearly killing more U.S. residents directly than any hurricane has, but it also is changing lives in ways that may contribute indirectly to increased deaths — by overloadin­g the health care system and discouragi­ng people from seeking care.

Measures of total deaths are also commonly used in countries without detailed accounting of causes of death. Right now they are the most useful tool, several epidemiolo­gists said, for measuring the impact of the coronaviru­s in the United States, too.

“It gives you an overall sense of how big things are,” said Samuel Clark, a professor of sociology at Ohio State University, whose work is in demography and epidemiolo­gy. “For now, you can basically attribute the excess mortality to COVID-19. But you also grab all the things that are not COVID at all but are probably created by the situation.”

 ?? Spencer Platt / Getty Images ?? A coronaviru­s victim’s body is put in a refrigerat­ed container at a funeral home in Queens, N.Y. Deaths in New York have spiked.
Spencer Platt / Getty Images A coronaviru­s victim’s body is put in a refrigerat­ed container at a funeral home in Queens, N.Y. Deaths in New York have spiked.

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