2020 was especially deadly for the US, not just from Covid-19

The year 2020 has been abnormal for mortalities. At least 356,000 more people in the United States have died than usual since the coronavirus pandemic gripped the country in the spring. But not all of these deaths have been directly linked to Covid-19.

More than a quarter of above-normal deaths are due to other causes, including diabetes, Alzheimer’s disease, high blood pressure and pneumonia, according to a New York Times analysis of estimates from the Centers for Disease Control and Prevention. of Diseases.

Some of these additional deaths may have been due to Covid-19, but they may not have been misdiagnosed or wrongly attributed to other causes.

Many of them are very likely indirectly related to the virus and caused by disruptions from the pandemic, including strains on healthcare systems, inadequate access to supplies like ventilators, or people avoiding hospitals for fear of exposure. to the coronavirus.

Research has shown that people with underlying health conditions like diabetes, high blood pressure, and heart disease are particularly vulnerable to serious illness and death if they contract Covid-19.

In several states, deaths attributed to diabetes are at least 20% above normal this year.

The prolonged economic stress on families during the pandemic could also be contributing to an increase in deaths among people with chronic diseases.

“You end up having to choose between your prescription drugs or buy food or keep a roof over your head,” said Steven Woolf, director emeritus of the Virginia Commonwealth University Center for Society and Health, whose research has also shown deaths from other causes. be taller than normal.

At least 10 states have seen deaths from hypertension, a common comorbidity like diabetes, rise even more than the national percentage. These can include deaths from heart failure, kidney failure, or stroke.

Many people who die from high blood pressure are also at high risk for severe Covid-19, so some of these deaths could be missed Covid-19 deaths, according to Robert Anderson, head of the statistics branch. mortality at the CDC National Center. for Health Statistics.

Nationally, deaths from Alzheimer’s disease, which generally affects older adults, are 12% above normal this year, with several southern states seeing larger increases. This could be related to the challenges of providing adequate nursing home care during the pandemic: Deaths in nursing homes account for more than a third of the total number of coronavirus victims in the nation. The virus may also have aggravated some of the existing health conditions of these patients.

Other factors related to the pandemic, such as social isolation and challenges in obtaining emergency services, could also have contributed to the deaths, Woolf said.

Many of the higher-than-normal pneumonia deaths are likely Covid-19 deaths that were not identified as such, especially early in the pandemic, when coronavirus testing was scarce. Chest X-rays of the virus and pneumonia also look especially similar, experts said.

New York City, one of the early epicenters of the pandemic, has seen deaths from pneumonia reach 50% above normal, more than double the percentage in states with the highest rates.

As the pandemic has progressed, coroners and medical examiners have improved in recognizing deaths caused by the virus.

Counting deaths takes time and many states are weeks or months late in reporting. CDC estimates are adjusted for lag in mortality data in previous years.

Woolf also cautioned that many people who are not included in mortality statistics can still have adverse health outcomes.

“A person who survived the pandemic may end up deteriorating in the next few years due to the problems that occurred during the pandemic,” he said. This could include those who have missed routine check-ups or have had delays in receiving appropriate treatment for an ailment.