Deaths in the U.S. rose 23% because of the pandemic in 2020, VCU study finds

The number of deaths is predictable from one year to the next. It typically fluctuates between 1 to 2%. But in 2020, there were 520,000 more deaths than normal nationwide and almost 10,000 in Virginia, which experts call “excess deaths.”

According to the Centers for Disease Control and Prevention, life expectancy in the U.S. dropped from 78.8 years in 2019 to 77.8 by the middle of 2020, the largest drop in life expectancy since 1943, during World War II.

The death rate was highest among Black populations, according to the study, which was led by Dr. Stephen Woolf, a VCU professor of family medicine and population health. The report tracked deaths from the beginning of March to the end of 2020 and updates the results of two previous reports directed by Woolf.

While there have been 550,000 U.S. deaths directly attributed to COVID-19, researchers also have pointed to increases in deaths caused by drug addiction, Alzheimer’s Disease, heart disease and diabetes. Some of them can be blamed on the pandemic.

“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,” Woolf said.

It’s not entirely clear why deaths have increased in Alzheimer’s, heart disease and diabetes,” Woolf said in an interview. It’s possible these people had COVID but were never diagnosed with it, and it never appeared on their death certificate. It’s also possible COVID disrupted their health care.

Of the 520,000 excess deaths, 72% can be directly attributed to COVID-19. That percentage grew slightly throughout 2020, meaning fewer people died because of indirect causes. There are a few possible reasons why: People may have felt more comfortable going to hospitals as they better understood the disease or feared it less. The medical community perhaps has done a better job documenting COVID deaths. It turns out COVID can impact heart and kidney health in a way that wasn’t immediately understood.

Black communities suffered the most excess deaths, 208 per 100,000. White populations endured 157 per 100,000, and Hispanic populations saw 140 per 100,000.

That means that not only are Black people dying of COVID at a higher rate than the rest of the country, they also are dying of other causes at an increased rate.

The lower number of Hispanic deaths is surprising, Woolf said. The death rate directly attributed to COVID is higher among Hispanic and Latino communities than white ones. But Hispanic populations also have a higher life expectancy in general, he said. Latino immigrants who have lived in the U.S. for less than 10 years typically have better health outcomes than their white neighbors.

It’s possible that an overall higher life expectancy among Hispanic and Latino populations offset the high COVID death rate, Woolf said.

Different regions of the country saw their excess deaths rise and fall at different points throughout the year. In the Northeast, deaths were the highest in April and May, as the pandemic tore through New York City and New Jersey. After its spring peak, deaths there diminished through the summer and increased slightly at the end of the year.

In the Southern states, deaths surged in July and August when some states began to reopen. They diminished in the fall and climbed to new highs in December.

States that reopened too early caused more people to die, Woolf said.

“One of the big lessons our nation must learn from COVID-19 is that our health and our economy are tied together,” he said in a statement. “You can’t really rescue one without the other.”

In the Midwest and West, deaths climbed slowly throughout the year and peaked in December. Most of the region’s deaths can be attributed to California.

In the states near the Great Lakes, deaths surged in the spring, flattened in the summer and early fall and then surged again in late November and early December.

The states with the highest excess death rate were: Mississippi (260 per 100,000), New Jersey (251), New York (249), Arizona (221) and Alabama (219). Virginia experienced 114 excess deaths per 100,000, ranking 40th out of 49 states for most excess deaths. Data from North Carolina was not included, because the state delayed reporting its numbers.

Increases in excess deaths tended to mirror the time and locations of surges in COVID infections.

Even though vaccinations have begun, the number of excess deaths could remain high in the months and years to come.

The number of cancer deaths could increase for the first time in 30 years because of the pandemic, Dr. Ned Sharpless, head of the National Cancer Institute, said in January. Fewer people were screened and diagnosed for cancer in 2020, meaning it is likely that more people will be diagnosed with late-stage cancer.