Even worse than we thought
Having passed 60,000, eclipsing every other country’s losses as well as our casualties in Vietnam, the known count of U.S. coronavirus deaths is high by any measure except perhaps one: the actual toll. The evidence is mounting that many more Americans have died of coronavirus complications than we know. It’s the grimmest of many unknowns about the pandemic whose spread could accelerate again as the president and some state and local officials push to resume business as usual.
California’s deaths have exceeded projections by 9% this year, according to a Los Angeles Times analysis of Centers for Disease Control and Prevention data released last week. That amounts to about 4,500 socalled excess deaths in the state, more than four times the CDC’s count of coronavirus deaths and more than twice the total from local reports reflected in The Chronicle’s tracker as of last week.
Seven other states with high numbers of infections saw deaths exceed expectations by still more in the early weeks of the pandemic, with 15% to 72% more fatalities than projected in March and early April. Four of the states had at least twice as many unexpected deaths as were attributed to the coronavirus at the time, suggesting a total of 9,000 uncounted fatalities at that point. Federal statistics also show a recent surge in pneumonia deaths not attributed to COVID19, though the disease is likely to be a cause of many such cases.
Such questions were at the heart of a recent backandforth between the United States and Belgium, of all places, after President Trump displayed a chart showing that a few European countries have suffered more coronavirus deaths per capita than the United States. Even for Europe, Belgium has recorded an extraordinary number of deaths partly because it counts suspected but unconfirmed coronavirus deaths, particularly at nursing homes.
The additional U.S. deaths may not be entirely or directly attributable to the coronavirus. The pandemic’s tendency to overwhelm hospitals and other health care providers — while discouraging people from seeking care for other illnesses — could lead to more deaths from other causes. But while excess deaths are an inexact measure, they are often considered a more accurate gauge of the true toll of a natural disaster, especially in the presence of significant doubt about official reporting.
That is certainly the case here. Santa Clara County officials recently found that the coronavirus was responsible for a San Jose woman’s death in early February, weeks before any previously known U.S. fatality from the epidemic. That indicated the contagion was spreading undetected in the Bay Area soon after the year began.
That’s not surprising given that California and the country are still struggling to mount the testing capacity that has allowed countries such as South Korea to detect and contain new cases. Given the paucity of testing and prevalence of asymptomatic cases, the gap between known and actual infections is thought to be even greater than the discrepancy in deaths. Preliminary studies have estimated that the number of U.S. infections may be 10 or more times the number reported.
Unlike the uncounted deaths, the unknown infections have encouraging aspects. They mean the virus is less deadly as a proportion of those infected, and they could put the population closer to the level of immunity that can slow a virus’ spread.
Unfortunately, even the highest estimates of the extent of the contagion suggest it’s significantly more deadly than seasonal flu and that most of us remain vulnerable. We know enough, that is, to proceed cautiously.