Newly published American mortality data for 2020 reveals just how deadly last year was. More than half a million more US residents died in 2020 than on average from 2014-2019 – an 18 percent increase on 2019. By comparison, numbers of deaths have varied by just 1-2 percent for decades. Excluding the two months before COVID became widespread, the increase in deaths was 23 percent. The increase was not evenly spread across the country, however – some states were almost untouched, while others suffered increases over 30 percent
A favorite claim among those who consider COVID-19 a hoax, or at least exaggerated, is that most of the deaths attributed to the disease were actually caused by something else. Accepting these statements means believing that the person making them knows more about what killed someone than the doctor who signed the death certificate. Nevertheless, the statements have been made so frequently and ferociously that doubts have persisted.
Epidemiologists have tried to counter these conspiracy theories almost from the beginning by pointing to figures for excess deaths, showing total mortality has jumped wherever COVID-19 became widespread. Unfortunately, weekly and monthly data can be confusing, particularly if delays in reporting cloud the picture. Some have taken advantage by comparing figures for part of 2020 with the whole of previous years.
The release of figures covering an entire year, broken down both by state and cause of death, provide an ideal opportunity to take stock.
These are now published in the Journal of the American Medical Association. Total US deaths for 2020 were 3,358,814, an increase of 503,976 on 2019, which itself was marginally up on previous years. Proportionally more died in the Civil War years and the 1918/19 flu, but in absolute numbers, no previous year came close.
"COVID-19 accounted for roughly 72% of the excess deaths we're calculating, and that's similar to what our earlier studies showed,” said first author Dr Steven Woolf of Virginia Commonwealth University in a statement. “There is a sizable gap between the number of publicly reported COVID-19 deaths and the sum total of excess deaths the country has actually experienced."
When the pandemic first took hold, there were fears lockdowns and economic disruption might trigger a surge in suicides. Instead, as a paper in the same journal the day before notes, 2020 had 5.6 percent fewer suicides than 2019. Cancer deaths were almost unchanged, but most other leading causes of death were up by 5-10 percent on past years. It's not clear how many deaths attributed to heart disease, stroke, diabetes and Alzheimer's had COVID-19 as an exacerbating factor.
The geographic distribution of the excess deaths is consistent with COVID-19 being responsible, directly or indirectly, for almost all the increased toll. States where COVID-19 rates were low, including Hawaii, Vermont, and Maine saw almost no extra deaths compared to normal years, although none matched New Zealand, where deaths actually fell.
On the other hand, places with the largest increases include the New York area, where the virus hit hardest, the Deep South, and South Dakota – a state that achieved prominence for its legislative response.
"They said they were opening early to rescue the economy. The tragedy is that policy not only cost more lives, but actually hurt their economy by extending the length of the pandemic," Woolf said. "One of the big lessons our nation must learn from COVID-19 is that our health and our economy are tied together. You can't really rescue one without the other."