Excess Deaths From COVID-19 and Other Causes in the US, March 1, 2020, to January 2, 2021

Woolf, Steven H.; Chapman, Derek A.; Sabo, Roy T.; Zimmerman, Emily B.

doi:10.1001/jama.2021.5199

Cited by 254 publications

(261 citation statements)

References 2 publications

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“… 8 Studies have found an even larger number of excess deaths during the pandemic, inflated by undocumented deaths from covid-19 and by deaths from non-covid-19 causes resulting from disruptions by the pandemic (eg, reduced access to healthcare, economic pressures, and mental health crises). 9 10 11 12 Some racial and ethnic populations and age groups have been disproportionately affected. 13 14 15 Research on how the pandemic has affected life expectancy is only just emerging.…”

Section: Introductionmentioning

confidence: 99%

Effect of the covid-19 pandemic in 2020 on life expectancy across populations in the USA and other high income countries: simulations of provisional mortality data

Woolf

Masters

Aron

2021

BMJ

133

128

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Objective To estimate changes in life expectancy in 2010-18 and during the covid-19 pandemic in 2020 across population groups in the United States and to compare outcomes with peer nations. Design Simulations of provisional mortality data. Setting US and 16 other high income countries in 2010-18 and 2020, by sex, including an analysis of US outcomes by race and ethnicity. Population Data for the US and for 16 other high income countries from the National Center for Health Statistics and the Human Mortality Database, respectively. Main outcome measures Life expectancy at birth, and at ages 25 and 65, by sex, and, in the US only, by race and ethnicity. Analysis excluded 2019 because life table data were not available for many peer countries. Life expectancy in 2020 was estimated by simulating life tables from estimated age specific mortality rates in 2020 and allowing for 10% random error. Estimates for 2020 are reported as medians with fifth and 95th centiles. Results Between 2010 and 2018, the gap in life expectancy between the US and the peer country average increased from 1.88 years (78.66 v 80.54 years, respectively) to 3.05 years (78.74 v 81.78 years). Between 2018 and 2020, life expectancy in the US decreased by 1.87 years (to 76.87 years), 8.5 times the average decrease in peer countries (0.22 years), widening the gap to 4.69 years. Life expectancy in the US decreased disproportionately among racial and ethnic minority groups between 2018 and 2020, declining by 3.88, 3.25, and 1.36 years in Hispanic, non-Hispanic Black, and non-Hispanic White populations, respectively. In Hispanic and non-Hispanic Black populations, reductions in life expectancy were 18 and 15 times the average in peer countries, respectively. Progress since 2010 in reducing the gap in life expectancy in the US between Black and White people was erased in 2018-20; life expectancy in Black men reached its lowest level since 1998 (67.73 years), and the longstanding Hispanic life expectancy advantage almost disappeared. Conclusions The US had a much larger decrease in life expectancy between 2018 and 2020 than other high income nations, with pronounced losses among the Hispanic and non-Hispanic Black populations. A longstanding and widening US health disadvantage, high death rates in 2020, and continued inequitable effects on racial and ethnic minority groups are likely the products of longstanding policy choices and systemic racism.

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Section: Introductionmentioning

confidence: 99%

Effect of the covid-19 pandemic in 2020 on life expectancy across populations in the USA and other high income countries: simulations of provisional mortality data

Woolf

Masters

Aron

2021

BMJ

133

128

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“…Although we would like to analyze external mortality in more detail, monthly death counts by age group are not yet available for sub-categories within external causes. Nonetheless, we were able to do some exploratory analyses based on monthly crude death rates for drug overdoses, 4 homicides, suicides, motor vehicle accidents, and unintentional injuries as a whole 5 (19). Currently, these provisional data are available only through October 31, 2020.…”

Section: Exploratory Analysis Of Sub-categories Of Mortality From External Causesmentioning

confidence: 99%

“…Depending in part on the period of coverage, prior studies have reported a 16-23% increase in excess mortality during the pandemic (2)(3)(4), but only 72-89% of those deaths can be attributed directly to COVID-19 (2)(3)(4)(5). During the period from January 26, 2020 to October 3, 2020, Americans aged 25-44 suffered the largest relative increase in excess mortality (27% peaking at nearly 50% in mid-July), whereas those aged 85 and older experienced a smaller increment (15%, but also peaking near 50% in late April) (6).…”

Section: Introductionmentioning

confidence: 99%

The Us Midlife Mortality Crisis Continues: Excess Cause-Specific Mortality During 2020

Glei

2021

Preprint

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COVID-19 has prematurely ended many lives, particularly among the oldest Americans, but the pandemic has also had an indirect effect on health and non-COVID mortality among the working-age population, who have suffered the brunt of the economic consequences. This analysis quantifies the changes in mortality for selected causes of death during the COVID 19 pandemic up to December 31, 2020, and investigates whether the levels of excess mortality varied by age group. The data comprise national-level monthly death counts by age group and selected causes of death from January 1999 to December 2020 combined with annual mid-year population estimates over the same period. A negative binomial regression model was used to estimate monthly cause-specific excess mortality during 2020 controlling for the pre-pandemic mortality patterns by age, calendar year, and season. To determine whether excess mortality varied by age, we tested interactions between broad age groups and dichotomous indicators for the pre-pandemic (January-February) and the pandemic (March-December) portions of 2020. In relative terms, excess all cause mortality (including COVID-19) peaked in December at ages 25-44 (RR=1.58 relative to 2019, 95% CI=1.50-1.68). Excluding COVID-19, all of the excess mortality occurred between ages 15 and 64, peaking in July among those aged 25-44 (RR=1.45, 95% CI 1.37-1.53). We find notable excess mortality during March-December 2020 for many causes (i.e., influenza/pneumonia, other respiratory diseases, diabetes, heart disease, cerebrovascular disease, kidney disease, and external causes), but almost exclusively among young and midlife (aged 25-74) Americans. For those aged 75 and older, there was little excess mortality from causes other than COVID-19 except from Alzheimer's disease. Excess non-COVID mortality may have resulted, at least partly, from incorrectly classified COVID-19 deaths, but neither misclassification nor an atypical flu season that disproportionately affected younger people is likely to explain the increase in mortality from external causes, which was evident even during January-February 2020. Exploratory analyses suggest that drug-related mortality may be driving the early rise in external mortality. The growth in drug overdoses well before there was any hint of a pandemic suggests it is probably not solely an indirect effect of COVID-19, although the pandemic may have exacerbated the problem.

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“…As prolonged second waves as well as third waves for the COVID-19 pandemic strike a large number of nations world-wide, effective treatment of this viral pneumonia remains by and large an unmet need [1,2]. In addition to supportive care, dexamethasone provides relief to acutely ill patients [3].…”

Section: Treating Covid-19: Current Status and Room For Passive Immunotherapymentioning

confidence: 99%

Convalescent plasma to treat COVID-19: Following the Argentinian lead

Tiberghien

Toussirot

Richard

et al. 2021

Transfusion and Apheresis Science

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Excess Deaths From COVID-19 and Other Causes in the US, March 1, 2020, to January 2, 2021

Cited by 254 publications

References 2 publications

Effect of the covid-19 pandemic in 2020 on life expectancy across populations in the USA and other high income countries: simulations of provisional mortality data

Effect of the covid-19 pandemic in 2020 on life expectancy across populations in the USA and other high income countries: simulations of provisional mortality data

The Us Midlife Mortality Crisis Continues: Excess Cause-Specific Mortality During 2020

Convalescent plasma to treat COVID-19: Following the Argentinian lead

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