Philadelphia, Pennsylvania – Over 1.2 million people have lost their lives to COVID-19 in the United States, according to official federal counts. However, studies on excess mortality suggest that the true death toll may be higher than reported. Excess deaths are those that occur beyond what is expected under normal circumstances, and a new study led by the University of Pennsylvania and Boston University provides concrete evidence that many of these excess deaths were likely uncounted COVID-19 fatalities.
Published in the Proceedings of the National Academy of Science, the study compared reported COVID-19 deaths to excess deaths from non-COVID, natural causes such as cardiovascular diseases and chronic illnesses. The researchers found that increases in non-COVID excess deaths occurred around the same time or prior to reported COVID-19 deaths in most US counties. This suggests that many deaths attributed to other causes were likely unrecognized COVID-19 fatalities.
The study highlights the discrepancies in coding COVID-19 deaths on death certificates across the country, pointing to the overlooked impact of the pandemic in nonmetropolitan areas with limited healthcare resources. By analyzing excess deaths from natural causes, the researchers were able to paint a more accurate picture of the true toll of COVID-19.
Geographical variations in death patterns were observed, with nonmetropolitan counties in the West and South showing the largest gaps between non-COVID excess deaths and reported COVID-19 fatalities. The study also found that the second year of the pandemic saw almost as many non-COVID excess deaths as the first year, contradicting previous research.
The research team suggests that differences in state policies, coding practices on death certificates, and political biases may explain these geographical variations. Limited COVID-19 testing in rural areas and stigma surrounding the virus may have led to underreporting of COVID-19 deaths. Conversely, successful mitigation policies in some regions may have contributed to lower cases of other respiratory diseases.
Moving forward, the researchers hope that the data from this study will encourage further analyses using local data to accurately account for uncounted COVID-19 deaths. Accurate information on COVID-19 fatalities is crucial for public health decision-making and providing closure to families who have lost loved ones. The study underscores the importance of ensuring accurate death investigations to capture the true impact of the pandemic.