A study published in the Lancet last week found that the number of unrecognized COVID-related deaths in the US is an astronomical 185,000.
The scale of death the coronavirus pandemic has wrought in the United States since last year has been unprecedented in its modern history. COVID-19 and the social mayhem the pandemic has perpetuated, with drug overdoses, rising homicides, worsening chronic diseases, has cut down the population’s lifespan by an astounding 1.5 years, according to the Centers for Disease Control and Prevention (CDC). The last such decline occurred in 1943 at the height of World War II.
However, the actual COVID-19 death toll remains elusive and may take several years to make a thorough accounting. Nonetheless, future pandemic prevention efforts need to know how these deaths occurred. It has been noted that declines in overall life expectancy directly correlate to the population’s well-being and prosperity.
The disruption of social and health services, delayed treatments for chronic diseases, the stress caused by isolation, compounded by the tens of millions of the population infected with COVID-19, have contributed to the grim figure of over 625,000 reported deaths thus far. As the Delta variant continues to spread unchecked, these numbers will continue their upward trajectory.
Recently, a team of experts from the COVID-19 Emergency Response at the US CDC published their findings on the estimate of unrecognized COVID-19 deaths across the country from March 2020 to May 2021, 15 months. They estimated that the total COVID-19 deaths in the US at 766,611, with 184,477 (24 percent) not documented on death certificates.
The study was published in the Lancet just last week, but there has been barely a whisper in any media outlet. The scale of this death in the US from COVID-19 is unprecedented, placing it even above the death toll from the 1918 Influenza pandemic that killed 675,000 Americans. The silence is deliberate.
Deaths caused by COVID-19 are nationally notifiable in the United States. States and territories utilize the National Notifiable Disease Surveillance System (NNDSS) to report the number of cases of SARS-CoV-2 infections and deaths to the Centers for Disease Control and Prevention (CDC).
As of May 29, 2021, the ending date for data collection in the Lancet study, the CDC COVID Data Tracker had reported 589,526 COVID-19 deaths. On the same date, the National Vital Statistics System (NVSS) had aggregated a slightly lower figure of 582,135 COVID-19 deaths, accounting for some lag time with filing death certificates.
Estimates of excess deaths allow assessment of the “burden of mortality potentially related to the COVID-19 pandemic,” either directly from COVID-19 or with the disease as a contributing factor. It is typically calculated by calculating the difference between the observed number of deaths in a specific time and the expected number of deaths for the same period compared to recent historical trends.
However, as the authors of the study note, excess deaths cannot distinguish COVID-19 deaths that were “misclassified” from deaths that occurred because of avoiding emergency care due to fear of accessing health care systems, hospital overcrowding, interruption, and disruption of treatments, or even from a drug overdose, for that matter.
When deaths are reported to the National Vital Statistics System (NVSS), a death certificate is issued, providing information on the deceased’s demographics, place and date of death, events leading to the individual’s death from which a single underlying cause of death is selected. If additional contributing factors are deemed pertinent, these may be included if due diligence is taken.
However, to classify these cause-specific deaths based on standardized codes can take several weeks, if not months. Additionally, many COVID-19 related deaths may be underestimated because infected individuals may not have sought medical care. Or when they did, the virus was no longer detectable. Other factors include lack of testing availability or improper specimen collections that may have led to a missed diagnosis of COVID-19 related fatality.
Even if a patient is diagnosed with COVID-19 and is hospitalized, often they linger for weeks before they succumb, leading to an incorrect attribution “to a cause other than COVID-19 because of the time between identification and death.” In many cases, SARS-CoV-2 infections can exacerbate chronic medical conditions or cause massive infections, heart or kidney failure, and the death certificate incorrectly omits COVID-19 as a causative factor. Ultimately what is or is not written on the death certificate is final.
In conducting their study, the authors explained, “To better quantify and estimate the number of excess deaths [due to COVID-19] that were not captured as COVID-19 deaths or unrecognized on death certificates, we developed a regression model, using 2020-2021 all-cause mortality data reported to NVSS and SARS-CoV-2 viral surveillance data for six age groups across 50 states, New York City, and the District of Columbia.”
To estimate “COVID-19-attributable unrecognized deaths” among all the excess deaths that did not have COVID-19 listed as a cause of death, all death certificates that annotated COVID-19 as contributing to or causing death were subtracted from the excess deaths before conducting their regression analysis. This avoids double counting and reducing the potential underestimation.
Their analysis found 184,477 unrecognized deaths between March 8, 2020, and May 29, 2021, a period of almost 15 months, with a range estimate between 172,810 to 196,035 deaths. When these figures are then added back to the COVID-19 deaths reported through death certificates, the authors estimated the actual death toll from COVID-19 through the end of May 2021 at 766,611, with a range of 754,944 to 778,170. In simple terms, more than three-quarters of a million people who did not have to die.
More unrecognized deaths had occurred early in the pandemic. Not surprisingly, April 2020 had the most significant figure with 36,850 deaths (20 percent) when the first wave of infections crashed into the United States, establishing the country as the epicenter of the pandemic for almost an entire year. December 2020 and January 2021 were the next highest, with the devastating winter surge coinciding with the holidays. Also, 151,592 deaths (82 percent) occurred in individuals 65 years and older. Though people over 65 make up only 18 percent of the population, they represent more than 80 percent of all deaths from COVID-19.
The US Department of Health and Human Services (HHS) divides the country into ten regions. Region Four includes Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, and Tennessee, and had the most significant number of unrecognized deaths, with just over 44,000 accounting for almost 24 percent of all such deaths. Regions Five and Six secured second and third place, which includes the upper Midwest and South/Southwest. However, the most considerable per capita rate of unrecognized deaths fell on Region Seven, which includes Iowa, Kansas, Missouri, and Nebraska.
The study also analyzed the data according to reported COVID-19 deaths and total COVID-19 attributable deaths, and the reader is encouraged to review these data. What it demonstrates concretely is the massive loss of life that the ruling elite have allowed to befall the population in the hopes of staving off any economic repercussions. The enormous rise in the Wall Street financial indices and the accumulation of obscene wealth in the hands of the financial aristocrats correspond to the misery and death that has befallen the population.
Every means to stave off a human catastrophe from the ravages of the virus exists on a social scale. In no uncertain terms, given the advancement in technology, in medical expertise, in resources, and capacity to distribute them to the population, that the pandemic has been allowed to create the singularly most deadly event in the United States’ modern history is a damning indictment of the capitalist system.