| |
Total Deaths In US Have Exceeded The Expected Level For 80 Consecutive
Weeks
Excess Deaths Are
Declining But Not Yet “Normal”
When will life return
to the normal, prepandemic level of risk? This a question which has
been on everyone’s mind during the COVID-19 pandemic. One possible
measure to use in making this determination about normalcy is the
weekly number of excess deaths obtained by comparing the
observed number of deaths to the expected number based on an average
number of deaths that occurred each week in the years before COVID-19.
In theory, when the percentage of excess deaths (the number of excess
deaths divided by the expected number) falls to zero, then risk has
returned to “normal” prepandemic levels.
Previous waves
In each of the three
previous waves of COVID cases and deaths since early 2020, the numbers
of weekly deaths have dropped from their peaks but remained well above
the expected number, according to data maintained by the Centers for
Disease Control and Prevention. There
has been an
unbroken pattern of deaths above the expected average level for at
least 80 consecutive weeks. At the time of the peak number of cases
and deaths in the third wave in early January 2021, approximately one
half of all deaths were excess deaths when compared to the average
number in the years immediately before COVID.
Fourth wave
In the current fourth
wave of the COVID-19 pandemic, the peak number of cases occurred in
late August and early September 2021. According to CDC, the number of
excess deaths has decreased from 71,828 for the week of September 4,
2021 to 61,188 for the week of October 2, 2021. (Table 1). The percent
excess deaths has decreased from 37.8% to 14.5% over the same five
week period. Data from more recent weeks in October are still
incomplete as of this writing. While there are advantages to using
excess deaths as a measure of the burden of mortality because it is
not subject to the level of testing for for COVID-19, a disadvantage
is the delay in the completeness of reporting.
Excess non-COVID
deaths
Interestingly, the
number of excess non-COVID-19 deaths not directly attributable to
COVID has also been elevated above the expected number during parts of
the earlier waves and during the fourth wave. However, these non-COVID
deaths have now returned to the expected level and even below as of
the week of October 2, 2021. (Table 2).
Significance
In media interviews,
epidemiologists have expressed uncertainty about how low the current
downward trend will go or if another wave will occur this winter. If
deaths decline to expected levels, and remain that way for several
weeks, this pattern could be interpreted as signaling a return to a
normal level of prepandemic risk. However, because COVID-19 is a new
cause of death, and may remain endemic even if not epidemic, baseline
or expected levels of mortality risk may have to be revised upward. In
short, returning to “normal” may require a new definition of normal.
■
[Data below adapted from CDC]
|
TABLE 1 - Excess Deaths from all causes
during COVID-19 pandemic |
|
Week of |
Expected |
Observed |
Excess |
Percent Excess |
|
Sept 4 |
52,111 |
71,828 |
19,717 |
37.8 |
|
Sept 11 |
52,453 |
71,291 |
18,838 |
35.9 |
|
Sept 18 |
52,800 |
70,215 |
17,515 |
33.0 |
|
Sept 25 |
52,869 |
66,794 |
13,925 |
26.3 |
|
Oct 2 |
53,459 |
61,188 |
7,729 |
14.5 |
|
TABLE 2 - Excess Deaths from all causes
excluding COVID-19 during COVID-19 pandemic |
|
Week of |
Expected |
Observed |
Excess |
Percent Excess |
|
Sept 4 |
52,111 |
56,170 |
4,059 |
7.8 |
|
Sept 11 |
52,453 |
56,004 |
3,551 |
6.8 |
|
Sept 18 |
52,800 |
55,379 |
2,579 |
4.9 |
|
Sept 25 |
52,869 |
53,397 |
528 |
1.0 |
|
Oct 2 |
53,459 |
50,303 |
(-3,156) |
0.0 |
|
|