Disease-specific Excess Mortality During the COVID-19 Pandemic

An Analysis of Weekly US Death Data for 2020

Dongshan Zhu, PhD; Akihiko Ozaki, PhD; Salim S. Virani, PhD

Disclosures

Am J Public Health. 2021;111(8):1518-1522. 

In This Article

Results

Trajectories of disease-specific excess mortality data showed that at the country level (Figure 1), the excess deaths related to CVD and to influenza and respiratory diseases increased with the rise of excess deaths related to COVID-19 from week 12, and the first peak was at week 16. Compared with the baseline, the excess deaths from diabetes mellitus increased from week 12 to week 16, and it remained at about the same level after week 16. In addition, excess unclassified deaths in 2020 increased with time, and the more recent the week, the higher the number of deaths (Figure 1).

Figure 1.

Trajectories of Disease-Specific Excess Deaths: United States, 2020
Note. The dashed line represents the baseline.

At the level of the 4 states, we found that the trajectory of excess deaths from CVD was highly synchronous with the trajectory of excess deaths related to COVID-19, especially in California (Figure 2a) and Florida (Figure 2b). In New York (Figure 3a) and Texas (Figure 3b), the excess deaths related to COVID-19 rose again from week 46, whereas the excess deaths from CVD remained stable or even decreased, which might be caused by the lag in time of death certificate issuance in recent weeks. Other disease-specific excess mortality (excess deaths from diabetes, influenza, and cancer) remained stable over time, although there was a slightly increased trend of unclassified excess deaths in California. The weekly new cases of COVID-19 in the United States and the 4 states are plotted in Figure 4. New York was hit earlier by COVID-19 than the other 3 states (Figure 4).

Figure 2.

Trajectories of Disease-Specific Excess Deaths in (a) California and (b) Florida: 2020
Note. The dashed line represents the baseline.

Figure 3.

Trajectories of Disease-Specific Excess Deaths in (a) New York and (b) Texas: 2020
Note. The dashed line represents the baseline.

Figure 4.

Weekly New Cases of COVID-19 in (a) the United States and (b) California, Florida, New York, and Texas: 2020

After using the Oxford COVID-19 Government Response Tracker to trace governments' response to the COVID pandemic (Table A, available as a supplement to the online version of this article at http://www.ajph.org), we found that the 4 involved states all canceled public events in week 10 (March 11–12), implemented stay-at-home requirements in week 11 (March 15–21), and adopted restrictions on internal movement in week 12 (March 22–28).

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