Home / Health / US deaths in coronavirus during the first weeks of the pandemic exceeded the official number

US deaths in coronavirus during the first weeks of the pandemic exceeded the official number



Excess

death

minus

covid-19

Covid-19

death

reported

Right then

Excessive deaths is death

of what is historical

is expected for this period.

Sources: Overall death data come from the National Center for Health Statistics, covid-19 death bills come from state health departments and compiled by The Washington Post, and estimates of expected deaths come from the Yale School of Public Health’s modeling unit.

Excess

death

minus

covid-19

Covid-19

death

reported

Right then

Excessive deaths is death

of what is historical

is expected for this period.

Sources: Sources: Overall death data come from the National Center for Health Statistics, covid-19 death count comes from state health departments and compiled by The Washington Post, and estimates of expected deaths come from the Yale School of Public Health’s Modeling Unit.

Excessive deaths

except

reported

covid-19

Covid-19

death

reported

Right then

Excessive deaths is death

of what is historical

is expected for this period.

Sources: Overall death data come from the National Center for Health Statistics, covid-19 death bills come from state health departments and compiled by The Washington Post, and estimates of expected deaths come from the Yale School of Public Health’s modeling unit.

Excessive deaths

except

reported

covid-19

Covid-19

death

reported

Right then

Excessive deaths is death

of what is historical

is expected for this period.

Sources: Overall death data come from the National Center for Health Statistics, covid-19 death bills come from state health departments and compiled by The Washington Post, and estimates of expected deaths come from the Yale School of Public Health’s modeling unit.

During the first few weeks of the coronavirus epidemic, the United States recorded an estimated 15,400 deaths, nearly twice as many publicly attributed to covid-19 at that time, according to an analysis of federal data conducted by The Washington Post by a research group led by Yale School or Public Health.

The excess deaths – the number beyond what would normally be expected for that time of year – occurred during March and until April 4, a time when 8,128 coronavirus deaths were reported.

The excess death rate is not necessarily due directly to covid-19, the disease caused by coronavirus. They may include people who died because of the epidemic but not because of the disease, such as those who were afraid to seek medical treatment for independent diseases, as well as a number of deaths that are part of the usual variation in death rates. The bill is also affected by increases or decreases in other categories of deaths, such as suicide, homicide and motor vehicle accidents.

But in all pandemics, mortality is higher than normal for researchers trying to understand the disease fully.

The Yale analysis estimates for the first time surplus deaths, both nationally and in each state, during these five weeks. By relying on data released by the National Center for Health Statistics (NCHS) on Friday, the analysis paints a picture of unusually high mortality that will come into sharper picture as more data becomes available.

The analysis calculates excess deaths by using a model to estimate how many people would probably have died from the pandemic and then subtracted the number from the total deaths reported by NCHS.

The analysis suggests that the deaths announced in the weeks leading up to April 4, based on reports from state public health departments, failed to capture the full effects of the pandemic. The incomplete figures were widely cited at a time when many states were making critical decisions to close down companies and take other measures to prevent the spread of the virus.

The analysis also suggests that the deaths from the pandemic are significantly higher than reported, says Daniel Weinberger, Yale professor of epidemiology and leader of the research team. As of Sunday, more than 54,000 people had been killed by the new coronavirus, according to figures reported by state health departments and compiled by The Post.

“It’s really important to get the right numbers to inform decision-makers so they can understand how the epidemic is developing and how difficult it is in different places,” Weinberger said.

The national number also shapes the public’s perception of how serious the disease is, and therefore how necessary it is to continue social distancing despite economic disruptions. The figure has political implications for President Trump, who originally played down the threat of the virus and whose administration failed to speed up covid-19 testing, allowing the virus to spread undetected for weeks.

Some of Trump’s advocates have argued that covid-19 death tolls are inflated because they may include people who died with the disease but not from it.

“The death toll is kept by everyone, really as a pretty direct metric to assess the competence of the federal response,” said Jeremy Konyndyk, a former USAID official who helped lead the US response to the Ebola outbreak and other international disasters under Obama -administrationen.

The problem of underestimating coronavirus deaths is not unique to this pandemic or the United States. In many countries, inadequate testing is a major obstacle to understanding the extent of the pandemic.

In the US, public health experts say that reporting delays, along with the fact that almost every state initially counted only cases where the coronavirus was confirmed by a test, contributed to an incomplete picture of deaths in the early weeks.

NCHS recently began holding its own summary of covid-19 deaths, separate from the speakers based on states’ reports to the Centers for Disease Control and Prevention.

NCHS’s summary, based on death certificates, attempts to correct for reporting delays and includes cases that lacked a laboratory confirmation of coronavirus. But even NCH’s covid-19 death total from the first few weeks – 10,505 as of Sunday – is just two-thirds of the surplus in the Yale estimate.

No jurisdiction has been as aggressive as New York City, the US epidemic when revising its deaths from the first few weeks. As of Saturday, the city had added 2,424 deaths from covid-19 to those numbers, driving the total from that period up to 5,085. The newly added deaths were almost equally split between cases confirmed by laboratory tests and cases deemed “probable” death of covid-19 only based on symptoms and exposure.

At least 6,300 deaths

from March to April 4

At least 6,300 deaths

from March to April 4

At least 6,300 deaths

from March to April 4

At least 6,300 deaths

from March to April 4

At least 6,300 deaths

from March to April 4

Covid-19

death

from

excess

death

* Covid-19 reported deaths exceed surplus estimates

All figures are for March through April 4. New York City and Washington have since updated their figures for this period.

Covid-19 deaths

as% of the excess

death

Covid-19 reported

deaths exceed

surplus estimates

All figures are for March through April 4. New York City and Washington have since updated their figures for this period.

Covid-19 deaths in%

of overdose

Covid-19 reported deaths exceed surplus estimates

All figures are for March through April 4. New York City and Washington have since updated their figures for this period.

Covid-19 deaths in%

of overdose

Covid-19 reported deaths exceed surplus

All figures are for March through April 4. New York City and Washington have since updated their figures for this period.

The revisions brought the covid-19 sum for New York City closer to the Yale analysis’s estimate of 6,300 overdose cases during that period.

A handful of states have also begun to report likely deaths in recent days, generally by adding them to current speeches rather than publicly revising figures from recent weeks. Most states have not added probable deaths. For example, the state of New York, unlike New York City, does not.

The Yale analysis estimates that excluding New York City had about 1,700 more New York state residents than expected died as of April 4 – far more than the 1022 counted as covid-19 deaths.

Governor Andrew M. Cuomo (D) acknowledged at a news conference last week that his state summary is “not an exact total number of deaths, in my opinion.”

“That number is going to go up,” he said. “These deaths are just hospital admissions or deaths in nursing homes. It does not have what is called death at home. “

The family of Long Island resident Adrian Sokoloff says they believe he is one of the indefinite. The retired owner of a pet production company, he had just celebrated his 99th birthday when he began showing symptoms of covid-19 on March 19, said his daughter Karen Sokoloff. His family said his pulmonologist diagnosed him with covid-19 because of nailing fever and coughing – and because two of his caregivers had come with chills and lost his taste buds, a clear sign of the virus.

Sokoloff’s children had decided not to take him to a hospital for fear that he would die there alone. They couldn’t get him tested for covid-19 at home.

On March 29, he died at home in Sands Point, N. Y. His death certificate reads, “congestive heart failure,” according to his daughter.

She says her father’s death should be reflected in the death of covid-19 and fears that an artificially low number would allow some states to reopen their economies prematurely. “You have to have the information to make an intelligent decision, and if you don’t count the number of people who died from it, you don’t make an intelligent decision,” she said.

In New Jersey, another severely affected state, 9,854 people died during the period covered by the analysis – about 2,200 more than expected, according to Yale estimates. Of these, however, only 846 deaths were counted as covid-19.

Marco Navarro, an EMT who works in three northern New Jersey cities, said he could go two to three weeks before the pandemic without seeing a cardiac arrest or call that required his team to perform CPR. Now it happens two or three times a day.

No one knows why. Does the virus attack the heart? Causes of blood clots heart problems? Are people afraid that they will be affected by the virus in a hospital that ignores their symptoms and stays at home until it’s too late, as many doctors have concluded?

“I don’t really have an answer,” said Navarro, who works in Union City and sometimes in Jersey City and North Bergen.

Interviews and 911 call data from other cities also indicate an increase in the number of people dying at home, a circumstance that makes them less likely to be tested for coronavirus or included in the official death tolls. For example, the updates New York City has made in its covid-19 death tolls include hundreds of such deaths at home.

In mid-April, the Chicago Fire Department ambulance doctor saw about four times as many calls as usual where the patient is beyond resuscitation and pronounced death at the scene, spokesman Larry Langford said. There are usually about four such cases; now, a few days, there are more than 20. In Detroit, as ProPublica has reported, 911 call data shows that the number of calls coded “dead person observed” spiked in the first 10 days of April.

But in dozens of states, the Yale analysis shows that the reported number of total deaths is either unchanged or even down compared to historical patterns.

In some states, the epidemic began later and spread less rapidly, killing few people in early April. Relatively small numbers of deaths from covid-19 may have been offset by reductions in car accident deaths or other such traumatic events that are less likely when people are sequestered in their homes.

Roads in reporting total deaths may also play a role, Weinberger said. Although the federal government’s preliminary death count until April 4 is more complete than the number in recent weeks, it remains incomplete and the number of total deaths is likely to continue to increase in the coming months as states report further deaths from those weeks. The number of total deaths across the country and in each state will not be felt with confidence until at least a year from now, Weinberger said.

In Washington, the first state to fight a large-scale outbreak, 310 people were originally reported to have died from the virus as of April 4. The state has since published data showing that in fact almost 600 people had died of covid- 19 from that date. Because of the state’s relatively robust test and contact tracking infrastructure, experts say, the number of death counts for covid-19 there is likely to be more accurate than in other states.

The total number of deaths in Washington during those weeks increased by only about 100 above the number that would normally be expected, according to the Yale analysis. This may be partly because fewer people have died on the roads. Stately, there have been 34 fatal collisions in March and April so far – about half of the usual number for this time of year, according to data from 2018 and 2019.

There are signs that traffic fatalities are declining more. Data collected by ESO, a company that provides software for about one-third of EMS services across the country, shows a sharp decline in calls for motor vehicle accidents when home orders have taken hold.

Crime patterns also change in some places. Miami did not report a single murder of seven weeks and six days, from mid-February to mid-April, police say. The last time the city was free of murder at that time was 1957.

Government Ron DeSantis (R) has been pushing to lift restrictions in Florida as soon as possible to reopen the economy. According to the Yale estimate, the state had only a small number of overdoses at the beginning of April, about 200, and that number is almost equal to the official covid 19th century.

“We expect there to be some level of underestimation,” said Natalie Dean, a professor of biostatistics at the University of Florida. “Obviously we don’t have deaths.”

In Louisiana, the Yale analysis seems to counter what can be expected based on news headlines.

The state holds one of the worst coronavirus outbreaks in the country after more than 1 million people gathered for Mardi Gras celebrations in New Orleans in February. However, the analysis estimates that even though 408 people were reported to have died of covid-19 by April 4, Louisiana had slightly fewer deaths overall than normal over the previous five weeks. According to Yale team estimates, Louisiana has recently been among the slower states to report deaths.

Joe Kanter, an assistant state health officer for the Louisiana Department of Health, confirmed that by the end of March, the state had not yet seen an increase in deaths overall compared to previous years. He said he believes Louisiana’s count of 19 is as close as possible and pointed out that last week the state began reporting probable deaths in addition to those confirmed by laboratory tests.

But some officials in that state say the coronavirus death will be higher than what is currently known, according to emails from Columbia University’s Brown Institute for Media Innovation shared with The Post.

In an email on April 4, New Orleans Health Director Jennifer Avegno noted a spike in paramedic’s reports of deaths on the scene and of cardiac arrest requiring advanced life support, including heart pressure. The number of such reports in March was 24 percent higher than it had been in March 2019.

“Therefore, I would probably add about 15% to the known death,” she wrote to two city officials. “But no city or state will take this into account or report it, so I don’t think we should either. We should only assume that the deaths are about 15% more than we can count, but do not include them in official modeling, because we will never really know. “

In a telephone interview on Thursday, Avegno said she is worried about elected officials across the country reopening cities and states based on what she believes are a subset of covid-19 cases and deaths.

“I’m worried that the numbers give them a false sense of security that they can communicate to the public,” she said. “They may think the number of cases is more limited but they are not testing enough to know.”

Lenny Bernstein, Lenny Bronner, Jacqueline Dupree, Aaron Steckelberg and Reis Thebault contributed to this report.

Methodology

A research group led by the Yale School of Public Health used historical data on all deaths between 2015 and early 2020, published by the National Center for Health Statistics (NCHS), to model the number of deaths normally expected each week from March 1 to April 4. The estimate takes into account seasonal variations, the intensity of influenza epidemics and the expected increase in deaths due to the total population increase.

Details of the team’s statistical approach that calculates the season’s basic deaths can be found in an article published online on the repression server with Rxiv. The method used for this analysis differs in that researchers did not attempt to correct delays in data reporting, as they did for their previous article. Instead, the analysis for The Post relied solely on reported deaths, a more conservative strategy for estimating overdose.

The number of total deaths in the United States and for each state was obtained from provisional death data published weekly by NCHS, part of the Centers for Disease Control and Prevention. Figures for Connecticut, North Carolina and District were not updated, and these jurisdictions are not included in this analysis.

This information is collected from state health departments, which report deaths at different rates. It usually takes about three weeks for the death data to stabilize, but even then they are still incomplete. As a result, as of April 4, the number of total deaths is expected to continue to increase as states continue to report additional data to NCHS.

The number of excess deaths was calculated by subtracting the expected season’s baseline from the number of deaths. Since the season’s baseline is an estimate, there is some uncertainty associated with the overdose figure of 15,400. Based on only the deaths reported so far, there is a 90 percent chance that the actual number of overdoses is greater than 12,000 and a 70 percent chance of it being greater than 14,000. (There is a 2.5 percent chance that the actual number of overdose cases is lower than 10,000 and an equal chance that it is higher than 20,000.)

The death toll for covid-19 as of April 4 comes from figures reported by state public health departments and compiled by The Post.


Source link