COVID and Drug Overdoses Contributed to Highest US Death Toll

Carolyn Crist

April 13, 2022

Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

The U.S. recorded its highest death total ever in 2021, with new data showing that COVID-19 deaths and drug overdoses contributed to the number.

The CDC updated its provisional death tally for 2021, which showed there were 3.465 million deaths from all causes last year. That's about 75,000 more than the record-setting total in 2020.

Early last year, public health and population experts believed the second year of the pandemic wouldn't be as deadly as the first year of the pandemic, partly due to vaccines becoming available.

"We were wrong, unfortunately," Noreen Goldman, DSc, a researcher in demography and epidemiology at Princeton University, told The Associated Press.

The main reason for the increase in deaths in 2021 was COVID-19, the AP reported, as new coronavirus variants spread and some Americans declined to get vaccinated. More than 460,000 Americans died due to the coronavirus last year, as compared to about 385,000 in 2020.

Death rates also rose for certain chronic diseases, according to the AP, possibly due to delays in diagnosis and treatment. Early data shows that death rates rose for cancer, diabetes, chronic liver disease, and stroke as well.

Another major cause was drug overdose deaths. The CDC's data through October 2021 suggests that the U.S. had at least 105,000 overdose deaths last year – up from 93,000 the year before.

In particular, overdose deaths jumped dramatically among teens ages 14-18, according to a study published Tuesday in The Journal of the American Medical Association.

Adolescent overdose deaths were constant for most of the last decade, at about 500 per year. But in 2020, they nearly doubled to 954, and in 2021, the total likely hit 1,150, the researchers estimated.

The teen overdose deaths are about 1% of the U.S. total, the AP reported, though adolescents had a greater relative increase than the overall population. The researchers said the increase was due to counterfeit pills that look like oxycodone or Xanax tablets but contain fentanyl, a deadly synthetic opioid.

Although the total number of U.S. deaths is expected to increase year over year as the population grows, 2020 and 2021 had unexpected jumps in death numbers and rates due to the pandemic, according to the AP.

National death trends tend to affect calculations for life expectancy, and the numbers for 2020 and 2021 have dropped life expectancy averages for the U.S. The CDC's life expectancy estimate for 2020 was about 77 years, which is more than 1.5 years lower than in 2019.

The CDC hasn't reported its calculation for 2021, but other researchers have estimated that life expectancy will drop another 5 or 6 months, the AP reported. That would shift the average back to where it was about 20 years ago.

Sources

The Associated Press: "COVID-19, overdoses pushed US to highest death total ever."

CDC: "Provisional Death Counts for Coronavirus Disease 2019 (COVID-19)."

The Journal of the American Medical Association: "Trends in Drug Overdose Deaths Among US Adolescents, January 2010 to June 2021."

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