Chattanooga Times Free Press

EXCESS DEATHS IN U.S. RISING AT SHOCKING RATE

- BY CORY FRANKLIN AND ROBERT WEINSTEIN Dr. Cory Franklin is a retired intensive care physician. Dr. Robert Weinstein is an infectious disease specialist at Rush University Medical Center.

The current COVID-19 situation in the U.S. is both good and bad. The good news is that COVID-19 deaths are at the lowest levels of the threeyear pandemic. Given current trends, projection­s indicate roughly 100,000 COVID-19 deaths for 2023 — less than half of any of the three previous years.

The bad news is that the number of overall excess U.S. deaths — the difference between expected numbers of deaths from all causes and the actual number of deaths observed — is rising at a shocking rate. COVID-19 is a factor, but the main causes of excess deaths are more social than medical, and the worst aspect is that they are occurring in the younger demographi­c in which homicides, suicides, vehicular deaths and drugs are taking a disproport­ionate toll on what should be the healthiest sector of the population.

Since the pandemic began, excess deaths are up by more than 1.25 million in the U.S., about 15% higher than in the pre-pandemic years. This pattern is not limited to the U.S.; excess pandemic deaths are elevated by 5% to 20% in Great Britain, most of Europe and Australia. The reason for these excess deaths defies simple explanatio­n; the cause is certainly multifacto­rial. Some of this is likely an undercount of COVID-19 deaths. Another factor is delayed deaths caused by past COVID-19 infections. After any acute viral infection like COVID-19 has subsided, patients can suffer longterm medical complicati­ons including problems with inflammati­on and dangerous blood clotting disorders. These late effects of COVID-19 have included increases in fatal heart attacks and strokes.

In the arena of excess deaths, unanticipa­ted effects of lockdowns that resulted in health care and societal disruption­s have been just as important as COVID-19 itself. Patients have found it more difficult to access care. Appointmen­ts with physicians have been delayed; routine surgeries, including biopsies, have been canceled; and even when patients suffer symptoms, many have avoided clinics and hospitals, fearing COVID-19 or just long waits. While telemedici­ne has helped many people, suspicious lumps cannot be diagnosed on Zoom. In the U.S., diagnosis rates of six common cancers fell between 16% and 42% during the early days of the pandemic. These figures probably understate the number of serious conditions that were discovered late or not at all.

Combine this with deaths of despair (suicides and overdoses), vehicular accidents (possibly faster and more reckless driving) and homicides. Further, add the deaths that were occasioned by the unhealthy lifestyle choices — overeating and excessive drinking — prompted by lockdowns.

The most depressing aspect of this excess death phenomenon is that life expectancy in the U.S. has dropped for the second consecutiv­e year. Current life expectancy in the U.S. is 76.4 years, the lowest figure of the past two decades.

The alarming truth is that the decrease in U.S. life expectancy has come at the expense of teenagers, young adults and those in early middle age. This is not the result of COVID-19; in 2021 alone, more potential years of American life were lost because of drugs (primarily opiates), road deaths, firearm violence and obesity than years lost from COVID-19 during the entire pandemic.

Englishman John Burn-Murdoch, a columnist for the Financial Times, has studied mortality patterns in the U.S. and United Kingdom and warns, “One in 25 American five-year-olds today will not make it to their 40th birthday. No parent should ever have to bury their child, but on average across the U.S. one set of parents from every kindergart­en class most likely will.” Surely a clarion call, to which America must respond immediatel­y.

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