This means that for every 3.5 known victims of COVID-19, another American loses his life as a result of the coronavirus outbreak.
“Official records are likely to underestimate deaths due to the virus,” researchers reported Wednesday at JAMA Internal Medicine. The extent of this under count varies “markedly between states,” they added.
Between March 1 and May 31, the number of COVID-19 deaths reported to the National Center for Health Statistics it was 95,235. But there are good reasons to suspect that this number is a sub-account, explained the study’s authors.
The country did not have enough coronavirus test kits to make a definitive diagnosis for all those suspected of having COVID-19, especially in the early days of the pandemic, they wrote. In addition, the tests available were sometimes wrong, letting people who were actually infected with the coronavirus know that they didn’t have it. And some states have not compiled their death certificate data as quickly as others.
For a more reliable count of coronavirus-related deaths, a team led by the Yale epidemiologist Daniel Weinberger established to determine the number of “excess deaths” that occurred in the US in March, April and May.
They started by gathering weekly death counts for each state, starting in January 2015 and ending in January 2020. Then, they used that data to project what the weekly death count would have been until the end of May 2020, if the pandemic had not happened. This gave them an initial number of expected deaths for 48 of the 50 states, along with the District of Columbia. (North Carolina and Connecticut were not included because some mortality data were missing.)
Next, the researchers calculated the actual number of deaths reported in each state between March 1 and May 30. The difference between expected deaths and actual deaths gave them the number of excess deaths.
Actual deaths exceeded expected deaths in all but seven of the states analyzed. In other words, 41 states and the District of Columbia have had at least some excess deaths.
In California, for example, the historical trend suggested that the state would have about 65,600 deaths in March, April and May. In reality, there were 72,407 – a difference of just over 6,800 deaths. However, the state attributed only 4,406 deaths to COVID-19 during that period, suggesting that the official count did not capture the true cost of the Golden State pandemic.
Analyzing California data week by week, the study authors noted that excess deaths began to appear several weeks before the state began the extensive coronavirus test. This could help explain the deficit in the official count, they wrote.
The researchers also calculated that, for every 100,000 California residents, there were 17.2 excess deaths from March to May. This placed the Golden State well below the national number of 37.3 excess deaths per 100,000 people.
At the top of the list was New York. In New York City alone, there were 299.1 excess deaths per 100,000 people; in the rest of the state, there were 111.4 excess deaths per 100,000 inhabitants. Neighboring New Jersey came in second, with 182.3 excess deaths per 100,000 inhabitants.
The seven states that resisted the trend of fewer deaths than expected were North Dakota, Wyoming, West Virginia, Alaska, South Dakota, Hawaii and Maine.
The more the pandemic occurs, the smaller the difference between excess deaths and official deaths from COVID-19, wrote the study authors. This is probably the result of many factors, including more widespread tests.
Not all excess deaths are a direct result of coronavirus infection, the researchers wrote. Some people have suffered indirectly from being away from – or away from – overburdened hospitals and doctors’ offices, even if they needed care.
In fact, one report published last week Researchers at the Centers for Disease Control and Prevention found that the number of patients arriving at emergency rooms seeking treatment for a heart attack fell 23% in the 10 weeks after the US declared a national emergency on March 13th. Visits to the emergency room for strokes decreased by 20%, and those of patients with diabetes who were in the middle of a life-threatening hyperglycemic crisis fell by 10%, according to a study in the CDC’s Weekly Morbidity and Mortality Report.
“Even in widely tested situations, deaths from viral pathogens, including SARS-CoV-2, it can occur indirectly ”, wrote Weinberger and his colleagues. “Monitoring excess mortality provides an essential tool in assessing the effects of an ongoing pandemic.”