COVID-19 research briefs: Another study assessing excess mortality in the United States attributed to the pandemic

Daily POEMs

Published: 2020-11-29 © 2020 John Wiley & Sons, Inc.

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Clinical question
What effect has COVID-19 had on mortality by age, race, and ethnicity in the United States between January 2020 and October 2020?

Bottom line
Since January 2020, the United States has experienced almost 300,000 more deaths than would otherwise have been expected. The largest percentage increases were seen among 25- to 44-year-old persons and among Hispanic persons. Only two-thirds of the excess deaths been classified as COVID-19 deaths, suggesting an undercounting of COVID-19 as a cause of death. (LOE = 2c)

Reference
Rossen LM, Branum AM, Ahmad FB, Sutton P, Anderson RN. Excess deaths associated with COVID-19, by age and race and ethnicity — United States, January 26–October 3, 2020. MMWR Morb Mortal Wkly Rep 2020;69(42):1522-1527.

Study design: Time series

Setting: Population-based

Synopsis
Research Brief #69: There have been several studies of the excess number of deaths in the United States during the COVID-19 pandemic. As of October 15, 2020, the Centers for Disease Control and Prevention estimates more than 216,000 Americans have died from COVID-19 — and reports that this is likely an underestimate. Measures of excess mortality have been used in previous pandemics and health disasters to mitigate the potential underestimation of mortality. These authors looked at weekly all-cause mortality rates going back several years to establish stable temporal trends. They also used data from the National Vital Statistics System to identify deaths caused by COVID-19. Between January 26, 2020, and October 3, 2020, the United States experienced 299,028 more deaths than what would historically have been expected. Two-thirds (66.2%) were attributed to COVID-19 and the rest were attributed to other causes. Since younger age groups have lower death rates, the authors also reported percent changes in excess mortality by age. Surprisingly, the greatest percentage increase occurred in those between 25 years and 44 years of age, with a 26.5% increase over expected deaths. For Americans aged 45 years to 64 years, 65 to 74, 75 to 84, and 85 or older, the percent increases in deaths were 14.4%, 24.1%, 21.5%, and 14.7%, respectively. Although the report does not adjust for socioeconomic status, the authors report the average percentage increase was largest for Hispanic persons (53.6%) and that deaths were 28.9% above average for non-Hispanic American Indian or Alaska Native persons, 32.9% above average for Black persons, 34.6% above average for those of other or unknown race or ethnicity, and 36.6% above average for Asian persons. For those interested, frequently updated data are available at: https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm.

Henry C. Barry, MD, MS
Professor
Michigan State University
East Lansing, MI

Copyright © 2020 John Wiley & Sons, Inc.