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“Notable increases” were seen in deaths in March and early April, the team led by the Yale School of Public Health found. This was especially true in New York and New Jersey, states affected by the pandemic.
The study was first reported by the Washington Post.
Using data from the Centers for Disease Control and Prevention, the team found about 15,000 excess deaths from March 1 to April 4. During the same time, states reported 8,000 deaths from Covid-19. “That’s almost double,” Dan Weinberger, who studies the epidemiology of infectious diseases at Yale, told CNN.
The team was unable to show whether the increase in deaths was due to the coronavirus, Weinberger said. But there are strong indications that they were. For example, the team also analyzed data on doctor visits.
“What we see is that in many states, you see an increase in flu-like illness, and then, a week or two later, you see an increase in deaths from pneumonia and influenza,” Weinberger said. “It provides some confirmation that what we are seeing is related to the coronavirus.”
Furthermore, in specially affected states like New York and New Jersey, where the coronavirus is known to have spread widely and infected many people, the overall deaths were far higher than would normally be expected in March.
“In New York City, this discrepancy was even more severe, with three to four times more deaths from all causes than pneumonia and the flu,” the team wrote.
Some states, like New York, seemed to keep up with Covid-19 deaths. The state report of deaths in the pandemic closely tracked what the Yale team found. But others do not.
The new coronavirus causes respiratory illness, and presumably deaths would be listed among the regular reports of deaths and illnesses from pneumonia and influenza. But doctors are increasingly reporting other, sometimes fatal, symptoms of Covid-19, including strokes, kidney failure, and heart damage.
Patients who are already weakened by pre-existing conditions like diabetes, cancer, and heart disease may have had a death listed as due to one of those causes, rather than coronavirus.
Furthermore, it is possible that coronavirus blockages have led to a below-average mortality rate. For example, if fewer people were driving, traffic deaths could be expected to decrease, Weinberger said.
So Weinberger’s team looked at deaths from pneumonia and influenza, and deaths from all causes.
“We decided to look at all pneumonia deaths, or all deaths overall, and see how those numbers were changing,” Weinberger said.
The CDC tracks pneumonia and influenza deaths by week, and compares them to a death baseline to control for the annual seasonal flu epidemic. Separately, the National Center for Health Statistics, part of the CDC, maintains data on all reported deaths.
The Yale-led team subtracted the expected number of deaths for each week from the total number of deaths actually reported, and counted the extra as Covid deaths.
“Many states experienced a noticeable increase in the proportion of total deaths from P&I (pneumonia and influenza) from mid-March to March 28 compared to what would be expected depending on the time of year and influenza activity “the team wrote in their report
Weinberger’s team found evidence that people were dying as states struggled to find out if the virus had reached their regions. “In some states, such as Florida and Georgia, the increase in deaths from pneumonia and influenza preceded the widespread adoption of tests for the new coronavirus by several weeks,” they wrote.
The researchers said their work shows that it may be more accurate to estimate Covid deaths, rather than trying to count each and every positive test.
“Given the lack of adequate evidence and the geographic variability in the intensity of the evidence, this type of monitoring provides key information about the severity of the epidemic in different geographic regions,” they wrote.
“It also provides some indication of the extent to which viral evidence of deaths associated with COVID-19 is missing directly or indirectly.”
Some public health experts have said that Covid-19 was almost certainly spreading in the United States in January and perhaps as early as December, long before the United States reported the first official death. Some state and local health officials are returning to see if the people who died in January and February may have been infected with coronavirus.
