How America lost 1 million to COVID
The magnitude of the country's loss is nearly impossible to grasp.
More Americans have died of COVID-19 than in two decades of car crashes or on battlefields in all of the country's wars combined.
Experts say deaths were all but inevitable from a new virus of such severity and transmissibility. Yet, 1 million dead is a stunning toll, even for a country the size of the United States, and the true number is almost certainly higher because of undercounting.
It is the result of many factors, including elected officials who played down the threat posed by the coronavirus and resisted safety measures; a decentralized, overburdened health care system that struggled with testing, tracing and treatment; and lower vaccination and booster rates than other rich countries, partly the result of widespread mistrust and resistance fanned by right-wing media and politicians.
The virus did not claim lives evenly, or randomly. The New York Times analyzed 25 months of data on deaths during the pandemic and found that some demographic groups, occupations and communities were far more vulnerable than others. A significant proportion of the nation's oldest residents died, making up about three-quarters of the total deaths. And among younger adults across the nation, Black and Latino people died at much higher rates than white people.
Understanding the toll — who makes up the 1 million and how the country failed them — is essential as the pandemic continues. More than 300 people are dying of COVID-19 every day.
“We are a country with the best doctors in the world, we got a vaccine in an astoundingly short period of time, and yet we've had so many deaths,” said Mary T. Bassett, the health commissioner for New York state.
“It really should be a moment for us all to reflect on what sort of society we want to have,” she added.
The coronavirus arrived in the United States by early 2020, setting off wave after wave of infection and death in the months that followed. An alarming peak that first spring was followed by an even deadlier wave that winter.
More Americans died then than in any other period of the pandemic, just as vaccines were arriving and offering hope that it might soon be over. But new variants emerged: delta in the summer of 2021, followed by omicron, which spread so widely that deaths surged again.
What began as a crisis in cities spread to rural areas and back again, until the path of the virus traced the full geography of the country.
The first wave of deaths was concentrated in the Northeast, especially New York City and its suburbs. No one knew much in those early months. Doctors were not sure how best to treat the disease. Hospitals were overwhelmed. Deaths climbed sharply.
New York City was hit harder in March and April 2020 than any other city in the country has been during the pandemic. At the height of this outbreak, a New Yorker was dying of COVID-19 almost every two minutes — nearly 800 people per day, a rate five times as high as the city's normal pace of death.
About 60% of all deaths at the beginning of the pandemic happened in the Northeast, as the virus tore through cities and suburbs on the Eastern Seaboard.
New York City alone saw 20% of the nation's deaths in the first wave, despite making up just 3% of the U.S. population.
A spike in emergency room visits to New York City hospitals by people who had “flulike symptoms” in early March suggested that thousands of city residents were infected.
On March 15, New York Mayor Bill de Blasio shuttered bars and restaurants and announced public schools would close the next day. Gov. Andrew Cuomo imposed broad restrictions on nonessential businesses March 22. Those near-lockdown measures were most likely responsible for a more than 50% reduction in transmission of the virus, a Columbia University study found.
By summer, New York was garnering praise as a model of infection control.
But Dr. Thomas Frieden, a former head of the Centers for Disease Control and Prevention and a former commissioner of New York City's Health Department, said he believed that restrictions came too late. More than half of the New Yorkers who died in the earliest days might have lived, he estimated, had officials put the lockdown measures in place even a week or two earlier. “Cases were doubling every two days, and every two days you were doubling the impact,” he said.
Among wealthy countries, the United States has been notably unsuccessful at persuading residents to get fully vaccinated and boosted. Today, about onethird of people across the United States have not been fully vaccinated, and some 70% of the population has not received a booster. (By contrast, 17% of people in Canada have not been fully vaccinated, and 46% have not had boosters.)
Nearly half of the deaths from COVID-19 in the U.S. occurred after vaccines were made widely available. The failure to vaccinate, public health researchers say, contributed to hundreds of thousands of deaths. During the omicron wave in December 2021 and January 2022, for instance, the COVID-19 death rate in the United States was higher than in Germany, France, Britain or Canada, which had each fully vaccinated and boosted larger shares of their populations.
More than 429,000 people have died of COVID-19 since all adults in the United States became eligible for vaccination in April 2021.
A majority of them were unvaccinated, but as the virus has continued to spread, it has killed thousands of vaccinated people, too.
“It's just sobering that in a country with remarkable resources like ours that we are seeing deaths like this,” said Dr. Lisa Cooper, director of the Johns Hopkins Center for Health Equity. “And we're seeing a lack of benefit from therapy that we know is accessible.”
Public health experts say the government failed to do enough to help the public understand how effective the vaccines are, or to combat misinformation and conspiracy theories by some right-wing media and politicians.