This isn't a figure I normally track, so I looked it up to get a relative sense of scale during a "normal" year. The CDC says it was 2,839,205 in the USA for 2018.
In case people are skipping the article. preliminary numbers suggest that the United States is on track to see more than 3.2 million deaths this year, or at least 400,000 more than in 2019.
Were the numbers consistent before this year (2020)? That would help indicate what the variance / increase this year was compared to the past, say, 5-10 years or so.
No. The article even says this; US deaths (unlike most other places) climb every year:
U.S. deaths increase most years, so some annual rise in fatalities is expected. But the 2020 numbers amount to a jump of about 15%, and could go higher once all the deaths from this month are counted.
One thing the article doesn't say is the size of the usual 'expected' increase, but if I recall correctly it's about 2%. So a 15% jump would be large.
The big question is why is the US so much more badly affected than other places. Sweden, which famously did very little, is on track to see a small increase of perhaps 2%-3% this year over 2018, or just a few thousand deaths, almost not noticeable on the scale of a country.
NB: 2019 in Sweden was the least deadly year for a decade which is one reason comparisons of Sweden vs Norway etc are misleading: the question is not "why did Sweden have higher deaths than Norway in 2020" because it would have done anyway, simply due to catching up from 2019. The question is "why is 2020 going to be a normal year in so many countries but not the USA"?
I think the idea that Sweden did very little has been overplayed. It didn’t do enough, and has suffered for it, but it did quite a lot, and the population was reasonably careful even where not forced.
This is somewhat different to the weird defiant “taking precautions is bad, we must deliberately do high risk things” attitude that seems common in the US.
Sweden quite obviously has not "suffered for it" by any reasonable definition of suffer. Look at the graph I linked to. That is not suffering, it's not even something that'd be noticed normally. 2020 will come in death-wise as basically a normal year for them.
With a population of 330 million and an average life expectancy of about 80 years, we can expect that number to keep climbing. We'd average over 4 million deaths per year maintaining a stable population with the current life expectancy.
I just don't think this is true as a generalization. It may be true of American culture today, but it doesn't follow from even the past 50 years of broader human innovation against death. Consider the number of lives saved from:
A reciprocal view is that all sci/tech advances which led to those saved lives has also led to urbanization (=> vastly accrued need for antibiotics), automobile (=> need for seatbelts and other automotive innovations)...
We may (or may not) be "more something" (for example "more happy", "more self-accomplished"...) thanks to all those advances.
Maybe not as much as we think, as AFAIK diabetes, obesity, depression/addiction and mental illness (for example) are also hitting hard among youngsters.
I will get beat up for speaking up on this topic, but you are right and its related to food based on my researching this topic in nih.gov. First world countries are experiencing the highest mortality rates because of eating garbage. Insulin resistance being at the root of most of your mentioned down-stream problems. There are also a lot more chemicals in foods now. Pesticides, fungicides, etc. leading to auto-immune problems, allergies, chronic low-grade inflammation, higher triglycerides, higher small dense particles in the LDL cholesterol. To find some of the studies backing this, use google and put in queries like "site:nih.gov insulin resistance" and other similar terms. Some of the studies contain graphs by country. The most fascinating studies are the ones that include cultures that are still hunter-gatherers. Most of them have no traces of cardio vascular disease, mental illness, obesity and certainly no diabetes.
GIGO (Garbage In, Garbage Out) rules. Add sleep (of dubious quality) deprivation, 'bad stress' (no real motivation, extreme noise and light, near-constant state of haste...), lack of exercise... feedback-boosting the destructive process we now see nearly everywhere in full swing.
Automotive deaths are another example of a failure, not success. Something like 40,000 deaths a year still. Add guns to the list as well. Covid isn’t the first mass killer we just kind of learn to live with and ignore.
The US is arguably a bit of an outlier on automotive deaths. In most highly developed countries these peaked in the 70s or so and fell sharply since (due to seatbelts, better car design, harsh anti-drink-driving rules, etc). The UK peaked at 8k per year in the late 60s, for instance, and fell to reliably under 2k by the last decade. The US peaked around the same time at 55k, but fell much more modestly to 38k.
Gun deaths, of course, are a very US thing; they don’t really register in most developed countries.
I think a lot of the problem is that it isn't familiar. People use intuitive reasoning, they don't see disease and death, it must not be a problem. But it spreads so fast that it's dangerous long before you see it (because it quickly gets to the point of being uncontrollable).
This too. Or just people's perceptions of "overwhelmed." I know people who don't think hospitals are having issues because "nobody is spilling out the door, so they still have room in hallways."
They went to a local hospital and looked through the window to make this judgement, as if the resource constraint was physical space in the building.
What threat? There is zero context to this "increase"; Did population stay the same, grow or shrink for this year? That gives entirely different context to this raw number.
Is that a major concern? Around me, the hospitals are at capacity for covid patients, but have reserved space for accidents, pregnancies, and other expected needs.
The cited reason:
'Lower patient volumes, canceled elective procedures and higher expenses tied to the pandemic have created a cash crunch for hospitals'
I wonder if the lockdown/stay at home order has something to do with it...
With the highest cost of idle hospital beds being in the intensive care (ICU), people talk as if whole sections of hospitals sit empty waiting for the day when they are needed. Occupancy in ICUs typically are close to full. If they are not the hospital closes more beds so that they remain near capacity.
So? The risk of that other person become seriously sick remain the same.
>And the hospitals are overwhelmed
If the hospital are overwhelmed, keep in mind that most hospital are not overwhelmed, then yes it need to be fixed, nobody said to do nothing, some that can be done:
"People Thought Covid-19 Was Relatively Harmless for Younger Adults. They Were Wrong."[1]
"New research shows that July may have been the deadliest month for young adults in modern American history."
The latest episode of This Week in Virology[2] covered this article and the Journal of the American Medial Association (JAMA) article it was based on.
"From March to July a total of 76,088 all-cause deaths occured in the US in adults from 25 to 44 years of age, which is about 12,000 more than you would expected (the expected number would be about 64,000) so 12,000 excess deaths. Among this age group there were 4,500 COVID-19 deaths recorded. That's 38% of the excess mortality. The idea is that that is due to COVID-19, and they go in to that further and say, yeah, that is probably what it was."
"The point is, as we're learning, anyone who says this group doesn't get infected, that group doesn't get sick, they're just wrong... the data shows that if you're between 25 and 44 you can die of COVID-19..."
"And that's only the deaths. There are a lot of people who got sick with this and still aren't quite well.. and that's not good either... you can get a mild infection and still get long-term COVID.. even if it's not mild or long-term, you could could still have a relatively short-term illness that puts you in the hospital, you don't die - you're really sick. And 4,500 people, that's more than we lost on 9/11. Just a little perspective. Just the deaths is still a huge number of people. And those are just the confirmed COVID deaths... that's 38% of the excess, and the article is basically - what's the rest of the excess? Because you don't expect that many people to die, and a significant portion of those are certainly going to be people who just didn't get a confirmed diagnosis of COVID-19 before they died."
Then they quote from the NYT article:
"In fact, July appears to have been the deadliest month among this age group in modern American history. Over the past 20 years, an average of 11,000 young American adults died each July. This year that number swelled to over 16,000."
"I don't think you can argue to us that that's not COVID-related. What else is going on? Nor can you say that "oh, it must be harmless in this age group", this is really having an effect."
"And this is not political, folks. This is the truth. This is science. This is the data. This is what we see."
Every death is a tragedy, but the vast majority of those younger COVID-19 patients who died had at least one serious co-morbid condition, such as obesity. For those under 50 with no co-morbid conditions the risk of death is extremely low.
Maybe cap sugar content in foods. Maybe try and reverse what the sugar industry did with it's "Fat is the enemy" campaigns. Fact is sugar is what leads to obesity, diabetes, etc. It causes people to overeat.
Or maybe just ban lobbying at all in congress and via PACs and Super Pacs, so that gov't can fix issues that matter based on real needs assessment not one cherry picked for them by special interests groups with lots of money to throw around.
These numbers do not add up with CDC statistics, which show that about 7000 people in that age group died from COVID over the whole year.
One mistake I see is to take the average of twenty years of deaths in that age group as baseline. The number of deaths from drug overdoses has steadily risen from 20,000 per year in 2000 to over 80,000 last year - with a sharp spike at the beginning of this year.
Edit: The paper that is cited in the introduction acknowledges that an increase opiate overdoses may be the underlying factor here. They only had data from 2018 to estimate its impact.
Someone over 70 is 270x as likely to die of COVID as someone under 50. For anyone under 50 without co-morbidity, then this is just a yearly flu — and destroying your economic future over the flu doesn’t make sense.
Having a blanket policy that ignores those differences is unrealistic.
That conversation has been going on since long before COVID-19. For example age is one factor in allocating scarce transplant organs. Other countries with socialized healthcare systems sometimes explicitly use Quality Adjusted Life Years (QALY) in deciding whether to pay for expensive treatments for elderly patients.
So is he. QALY analysis is used to allocate all treatment in places like the UK, realistically in other places too. Basically a very expensive treatment that is only expected to increase your lifespan by a few months if you're already very elderly may not get funded if there are other interventions with better cost/benefit ratios available in the queue. This obviously affects nearly 100% of the population in the sense that most people will make it to old age, and even the non-elderly are affected by getting treatment they otherwise might not have done.
Not saying that those 400K doesn't deserve to be saved, they are absolutely deserve the care but if you are doing it at the huge expense for other people then conversation is unavoidable.
You build in the assumption that policy responses to a pandemic will harm the economy, and then don't do any work to establish that policy responses in this pandemic have prioritized lives over the economy, or to demonstrate that policy responses that weren't used would have been similar, etc.
I think, clearly, that there is a debate to be had about the value of lives that are nearly at an end no matter what, and lives that are just hitting their prime.
Hey, good news. We have pretty strong evidence that our policy choices have been geared towards letting the elderly die.
(I'm talking about all the elderly that died if it isn't clear what evidence I'm referring to)
Of course, the awful thing is that controlling the virus in May (I mean actually doing it, not just having a pause) would have been better for the economy. But we are too stupid for that.
Wouldn't we generally expect any given year is the deadliest year on record? If we assume (1) the population strictly increases year on year and (2) deaths are proportional to population in a given year, then it would be true. Weaken these assumptions and it should still be true for the most part.
The article addresses this in the first few paragraphs:
> U.S. deaths increase most years, so some annual rise in fatalities is expected. But the 2020 numbers amount to a jump of about 15%, and could go higher once all the deaths from this month are counted.
> That would mark the largest single-year percentage leap since 1918, when tens of thousands of U.S. soldiers died in World War I and hundreds of thousands of Americans died in a flu pandemic. Deaths rose 46% that year, compared with 1917.
It walks back the significance of the title a bit, but that's different than addressing it. I'm not saying it's wrong, but I would expect far larger number of souls to die from one year to the next even if nothing significant occurred.
That also would be reflecting a significant (assumed-- possibly non-existent--see twblalock's reply below) reduction in the number of car crash fatalities we'd normally have if lockdowns weren't going on (There were 38,800 total in the US in 2019 [0]).
But data seems to be showing increased deaths due to overdoses & suicides due to those lockdowns, so it's hard to tell.
> Synthetic opioids (primarily illicitly manufactured fentanyl) appear to be the primary driver of the increases in overdose deaths, increasing 38.4 percent from the 12-month period leading up to June 2019 compared with the 12-month period leading up to May 2020. [1]
> Compared to the last three years (2017-2019), the number of suicide deaths was lower than average during the initial phase of the pandemic but, starting in July 2020, exceeded the past trend. The source of the increase was mainly female suicides, whose numbers increased by approximately 70% in October 2020. Suicides by young women (less than 40 years of age) almost doubled in October, with a 95.58% increase, compared to the same month in the past three years. The number of suicides among students was also notably higher in August and September 2020 than the corresponding numbers of past years. Our survey data indicated that the status of mental health among young women has been deteriorating in recent months, and also that young female workers were more likely than any other group to have experienced a job or income loss, suggesting adverse economic conditions surrounding some of these individuals. [2]
We don't have full car crash fatality numbers for 2020 yet, but during the first 6 months of the year, which is when the strictest lockdowns were in effect, deaths were actually up 1% compared to 2019: https://injuryfacts.nsc.org/motor-vehicle/overview/prelimina...
You can also see monthly estimates here from the same source: https://injuryfacts.nsc.org/motor-vehicle/overview/prelimina.... Overall, 2020 is not stacking up to be a better year for car accident deaths than 2019 was -- certainly not enough to make a big difference in the total number of deaths per year in the US.
"When you factor in an important aspect of that change, vehicle miles traveled (VMT), you actually see that more people died this year, on average, than last year. That's because VMT was down a dramatic 16.6 percent (or 264.2 billion miles) in the first six months of 2020, which pushed up the fatality rate per 100 million VMT, a metric the NHTSA uses to more accurately compare vehicle and road safety over time. Using this number, the NHTSA discovered that fatalities per 100 million VMT climbed to 1.25 in 2020, up from the 1.06 in 2019, despite the same three-year decrease that the agency saw with fatalities-per-VMT that it did with overall fatalities leading into this year."
I would guess then that the increased traffic from people ordering online instead of in person offsets the increase in driving to work/socializing etc.
Risk of fatality in an accident is proportional to speed of the vehicles involved. People driving to work are stuck in traffic pre-COVID while the roads are ripe for hitting 80 mph during lockdowns and WFH.
If you want to know if the impact of COVID you could look at a metric like excess mortality which there's pretty good data on, then compare the excess to the total mortality. Usually it's calculated so that any excess deaths is pretty rare which is what makes it a good metric.
With year on year increase in deaths I'm not sure I could convince myself it was significant unless I had a chart and a calculator in front of me. A year over year death increase, even a large one, seems like it would occur pretty often. Even a large increase in the increase doesn't sound like it would be significant -- wouldn't that be pretty sensitive to the shape of the population relative to age? And I'm not sure what that looks like off the top of my head. There's a lot to adjust for, and you need to be sure you're not just rolling dice at the end with the numbers.
My point is it's not really a good metric. There's plenty of reasons why it would jump around, and I'm not smart enough to adjust for all the necessary variables in my head. It's not obvious how much we should expect it to jump around. But maybe others here just know their US demographic data better than me.
I haven’t seen a QALY-based analysis of the fatality data. Odd, because our State is reporting underlying condition stats and age (by decade) and gender of death daily. Pretty easy to take expected years of life remaining, and quality of life given age and underlying conditions and estimate and come up with an estimate to first order of the “quality life years” lost due to COVID.
No one seems to be providing such a QALY estimate.
So, let’s do a quick one.
For 1917, the comparison year, let’s assume excess deaths were from combat and the Spanish Flu.
Combat skews young. So, say, 50 quality years per death.
I don’t see any age-specific bias or bias towards underlying conditions one way or another in Spanish Flu cases given this information. And a lot of cases of healthy adults dying, e.g. Australian miners.
The median age of COVID death in my county has been in the late 70s
Life expectancy tables for US suggest ten years of life remaining for folks in their late 70s. I’ve seen statistics that find degraded quality of life in the last 3 or 4 years of life.
Even without underlying conditions, that puts quality life years lost at 8. Underlying conditions predisposing to COVID death will only make it look worse, driving the 8 down to 7 or 6.
So, for 1917, 50 years lost in combat combined with 30 quality years lost to the “Spanish Flu”...IDK, let’s say 40 years lost per death.
For 2020, COVID excess deaths...6-8 quality years lost.
Even after quibbling with numbers, the quality years of life lost are a factor of 5 higher in 1917 as compared to 2020. Based on this, admittedly rough, “analysis”. (You get what you pay for.)
I really would like to see a formal QALY analysis of COVID, instead of the ones that many people have already done in their heads.
What about people that didn't die this year, but experienced a high degradation of life quality? What about people that experienced a 'low quality' year this year, being in ICUs for weeks?
A scientific analysis about years of life lost was done for COVID fatalities. It was in the press about half a year ago. It was a little over 10 years on average, even considering the preexisting conditions.
Linked article says in Sweden for COVID-19 you count QALY in months not years.
'The observed temporary excess mortality likely arises because people in vulnerable groups die weeks or months earlier than they would otherwise, due to the timing and severity of the unusual external event.'
I don't know about 2021, but at some point we'll see fewer deaths. Lots of people who would otherwise have died in that future year are dying this year.
If you're already 75 years old your life expectancy is roughly another 10 years (COVID deaths skew to the 70+ age bracket). So I'd expect the "deficit" in deaths to be spread out over at least 5-10 years. This might not be easily resolvable above typical year to year background fluctuations.
Probably we will see more than usual, from other causes that benefit from early detection such as cancer. People avoiding hospitals during the pandemic is probably going to have a bit of an aftereffect.
You're far more optimistic than I am. People can find many ways to mold statistics to fit their beliefs (or simply reject the numbers as a deep state conspiracy).
It won't be refusing to look; it will be asserting speculation as fact, e.g. saying that the excess deaths are from increased domestic abuse and suicide because of the lockdown.
EDIT: This is not in reference to comments here on HN. I wrote this before seeing any comments referencing those other causes of death, and those comments here on HN are not presenting speculation as fact.
This is so interesting to me. Facts are still important to those seeking truth. Sure, there are a lot of people seeking reassurance ahead of truth, but there are also simply a lot of people. Given that people now have more ability to make their opinions widely known, I suspect that truth and facts are just as relevant as ever, but that loud noises will be made by those who won't be doing anything relevant about it either way.
Our ability to judge the relative value of messages is proportional to our ability to reason about the sheer number of people with things to say. I think that wrapping one's mind around the enormity of 330 million people may be valuable towards honing in on not only what messages are important, but what movements simply aren't.
> Facts are still important to those seeking truth.
What about the people that don't want to seek truth?
> The aide said that guys like me were "in what we call the reality-based community," which he defined as people who "believe that solutions emerge from your judicious study of discernible reality." I nodded and murmured something about enlightenment principles and empiricism. He cut me off. "That's not the way the world really works anymore," he continued. "We're an empire now, and when we act, we create our own reality. And while you're studying that reality -- judiciously, as you will -- we'll act again, creating other new realities, which you can study too, and that's how things will sort out. We're history's actors . . . and you, all of you, will be left to just study what we do." [1]
Again, lots of people produce lots of opinions. If I'm understanding you correctly, the meme that "the deplorables" all think alike (and are thus wrong) doesn't have much merit after more than a cursory glance.
While I agree in a sense, it doesn't seem useful that people keep pointing out how facts don't matter. Not only is it debatable whether they ever were relevant, but I've heard this sort of phrase used too often in a way that is dismissive. No one even replied that COVID isn't real, or whatever nonsense, but you're already arguing against some nameless side of the COVID debate.
The pandemic, like everything else, must have its costs weighed against benefits, even if it involves people dying; for that reason alone, whether or not people think the pandemic restrictions are justified, the debate should be ongoing. It should never be considered a settled issue because the facts often come out long after it has passed. I'd be concerned if everyone agreed on anything in unison.
Heh! Facts are always relevant when you are debating in good faith. People who find facts not supporting their beliefs argue dishonesty that doesn't mean facts are not relevant.
You're speaking as if this article gives us certainty that the 400,000 extra deaths this year, compared to last year, are due to COVID. The article makes no such claim. Maybe that's not what you meant, though, because clearly there are things like drug overdoses, suicides, domestic violence, etc., that can also explain a lot of it as well. Tens of thousands of people die of fentanyl overdoses each year, and the number was growing up to this point, so it's not farfetched to consider that the COVID restrictions have resulted in more people taking addictive drugs or killing themselves out of desperation.
I’ve worked in four emergency departments in three states this year. All of them have been overwhelmed by patients with covid, and not patients with overdoses, suicides, or domestic violence. Granted the incidence of those non-covid pathologies are likely higher this year, but they are no-way elevated at the scale of covid-19. I haven’t seen, or heard from any colleagues, hospitals brimming with suicides and overdoses to the point where they are filling an entire icu with those patients, or having so many domestic violence cases that they have to shut down operating rooms and convert them into icu beds.
Thank you for helping in all these emergency rooms, and I’m sorry that some people are downplaying the virus’s effects on mortality in the USA in 2020.
People floating potential alternate explanations is not a downplaying COVID. It's trying to better understand the issue through open-minded inquiry, and giving people like the OP an opportunity to help inform people by sharing their reasoning and personal experience.
Equating the consideration of different theories with the rejection of one particular theory will discourage the kind of free discourse that makes society more informed.
I've heard this argument many times over. While it's certainly plausible, I've yet to see real statistics supporting the claim that there's been a significant rise in suicides / drug overdoses during the pandemic.
After doing some research on 2020 suicide rates, the only legitimate source I found suggested there was a decrease in suicide rate towards the beginning of the pandemic due to a "honeymoon pulling together" phase and no peer-reviewed data thereafter.
Half this country didn't care about drug addicts before. Now all of a sudden people care about drug addicts. They don't care though when it comes to cutting social programs or health care reform.
People didn't care when Wal-Mart decimated mainstreet and Amazon killed who was left. Now people are all about small business.
Sick of the hypocrisy. It's sad we can't take care of our own people in this country.
The devil's advocate could point out how trivial it would be to fudge these numbers. "Government releases data showing government is benevolent. Trust government."
Better yet, he might point out how absurd it is that we need to wait this long to identify a potentially statistically significant increase in deaths... during one of the worst pandemics in recorded history.
>With this statistic, the explanation for the huge annual increase can only be COVID.
Do you really think that the lockdown and its effect (the bankruptcy, unemployment, reduced social activity, delayed treatment of other illness, etc) could not cause increase in death ?
Not sure why you're downvoted. Your question is valid. That said, I've yet to find solid evidence that supports a substantial rise in suicide rates. The only source I found suggested the opposite: https://www.bmj.com/content/371/bmj.m4352
I didn't downvote, but it's probably because every time talk about covid related deaths comes up, there is someone that tries to downplay it, and almost always with the same line of reasoning.
Problem is it ignores all the actual reports of covid deaths, overwhelmed hospitals and lack of stats on significant increases (or at least significant enough to account for the extra deaths) from other causes. The implication is almost always something along the lines of Covid is just a flu, it's not that deadly and we shouldn't have taken the measures we have.
I see reports that hospital levels are fine, it's just that their dedicated covid areas are filling up. Or that nursing shortages are more to do with layoffs or hiring freezes by penny pinching executives. And reporting that covid deaths are vastly inflated from perverse incentives or political agendas or mandatory rules of which the nuance is lost in reporting.
Not saying any of this is true. Just saying I'm not exactly watching Alex Jones or Fox News and this is still the stuff I hear, and just because you hear a report about something doesn't mean it's the arbiter of truth and everyone else is wrong.
There are countries on the list here: https://www.euromomo.eu/graphs-and-maps/ that had lockdowns but have no significant excess mortality, so it’s at least possible.
There were other factors that differed in 2020 compared to other years, like the effects of the lockdowns: mass-bankrupties [1], social isolation for the elderly [2], an increase in drug-overdoses, a decline in access to quality-of-life enhancing services, etc.
Isolation in general is extremely deadly. [3]
My guess is that the effects of COVID on the US's 2020 mortality rate were much greater than the effects of the lockdown, but that is just a guess, not a scientifically validated conclusion.
Some of this is COVID, no doubt. Most of those deaths are people in their last decade (if not last few years) of life regardless. We had a baby boom in the 1950s. So we should be too surprised to have a death boom starting right about now.
https://www.cdc.gov/nchs/products/databriefs/db355.htm