The true coronavirus death toll in the US has already surpassed 200,000

Denise Lu, The New York Times

Posted at Aug 15 2020 12:57 AM

A temporary morgue outside the medical examiner's office in New York, April 9, 2020. This spring, death rates rivaled those seen during the country’s deadliest pandemic, a new study finds. Brittainy Newman, The New York Times

Across the United States, at least 200,000 more people have died than usual since March, according to a New York Times analysis of estimates from the Centers for Disease Control and Prevention. This is about 60,000 higher than the number of deaths that have been directly linked to the coronavirus.

As the pandemic has moved south and west from its epicenter in New York City, so have the unusual patterns in deaths from all causes. That suggests that the official death counts may be substantially underestimating the overall effects of the virus, as people die from the virus as well as by other causes linked to the pandemic.

When the coronavirus took hold in the United States in March, the bulk of deaths above normal levels, or “excess deaths,” were in the Northeast, as New York and New Jersey saw huge surges.

The Northeast still makes up nearly half of all excess deaths in the country, although numbers in the region have drastically declined since the peak in April.

But as the number of hot spots expanded, so has the number of excess deaths across other parts of the country. Many of the recent coronavirus cases and deaths in the South and the West may have been driven largely by reopenings and relaxed social distancing restrictions.

Counting deaths takes time and many states are weeks or months behind in reporting. The estimates from the CDC are adjusted based on how mortality data has lagged in previous years. Even with this adjustment, it’s possible there could be an underestimate of the complete death toll if increased mortality is causing states to lag more than they have in the past or if states have changed their reporting systems.

But comparing recent totals of deaths from all causes can provide a more complete picture of the pandemic’s effect than tracking only deaths of people with confirmed diagnoses.

Deaths Above Normal in the South

Nine of the 13 states in the South started seeing excess deaths surge in July, months into the pandemic. A spike in cases in places like Texas put pressure on hospitals, echoing the chaos that ensued in New York months earlier. South Carolina, among the first states to reopen retail stores, saw deaths reach 1.6 times normal levels in mid-July. Unlike other states in this region, Louisiana saw its excess deaths peak in April — when total deaths reached 1.7 times normal levels. Medical experts said Mardi Gras gatherings most likely contributed to this spike.

Deaths Above Normal in the West

In July, coronavirus deaths in Arizona surged, although new daily cases have since decreased. In California, the first state to issue a stay-at-home order this spring, coronavirus deaths climbed up in July, after a reopening that some health officials warned was too fast.

Deaths Above Normal in the Midwest

In the Midwest, states like Michigan and Illinois saw their peaks in April. Detroit was particularly hard hit by the virus.

Deaths Above Normal in the Northeast

New York City in the first few months of the pandemic was the epicenter of the coronavirus outbreak, and it was plagued by staggering death totals, which peaked at more than seven times normal levels. Other areas of the Northeast, including New Jersey, Massachusetts and Connecticut, also saw early surges. Overall, rates have decreased significantly since then in much of the region.

Methodology: Total death numbers are estimates from the Centers for Disease Control and Prevention, which are based on death certificates counted by the CDC and adjusted to account for typical lags in the reporting of deaths. Only weeks in which the CDC estimates the data to be at least 90% complete or estimated deaths were above expected death numbers are included. Weeks in which reported deaths were less than 50% of the CDC estimate are not included. Because states vary somewhat in their speed in reporting deaths to the federal government, state charts may have data for different time periods. Expected deaths were calculated with a simple model based on the weekly number of all-cause deaths from 2017 to 2019 released by the Centers for Disease Control and Prevention, adjusted to account for trends, like population changes, over time.