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Excess Deaths Usa

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Last Updated: 02 July 2021

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General | Latest Info

Excess Mortality is a term used in epidemiology and Public Health that refers to the number of Deaths from all causes during a crisis above and beyond what we would expect to see under normal conditions. 1 in this case, were interested in how deaths during COVID - 19 pandemic compared to the average number of deaths over the same period in previous years. Excess Mortality is a more comprehensive measure of the total impact of pandemic on deaths than the confirmed COVID - 19 Death count alone. In addition to confirmed deaths, Excess Mortality capture COVID - 19 Deaths that were not correctly diagnosed and reported 2 as well as Deaths from other Causes that are attributable to overall crisis conditions. 3 Excess Mortality can be measured in several ways. The simplest way is to take the raw number of deaths observed in give period in 2020 - say Week 10, which ends on 8 March 4 - and subtract the average number of deaths in that week over previous years, for example, last five. While the raw number of deaths helps give the US a rough sense of scale, this measure has its shortcomings, including being less comparable across countries due to large differences in populations. 5 measure that is more comparable across countries is P - score, which calculates Excess Mortality As percentage difference between the number of weekly Deaths in 2020 and the average number of Deaths in the same week over the previous five years. For example, if a country had a P - score of 100% in give week in 2020, that would mean the death count for that week was 100% higher than - that is, double - average death count in the same week over the previous five years. The chart here shows excess mortality during the pandemic for all ages using P - score. 6 You can see that some countries - such as England & Wales 7 and Spain - suffer high levels of Excess Mortality, while others - such as Germany and Norway - experience much more modest increases in mortality. To see P - scores for other countries, click Add country on the chart. It is important to note that because P - scores in this chart combine all ages, they are impacted by differences in mortality risk by age and country age distributions. For example, countries with older populations - which have higher mortality risk, including From COVID - 19 - will tend to have higher All - age P - scores by default. When comparing countries, it is informative to look at P - scores for different age groups. The chart here shows P - scores broken down by two broad age groups: ages 15 - 64, which contain most of the working age population, and age 85 +, which has the highest mortality risk. 8 Two more age groups can also be selected by clicking Add country: ages 65 - 74 and ages 75 - 84. You can see that Spain suffers high levels of excess mortality even for its younger, working population aged 15 - 64, while Germany experiences relatively low levels of mortality even for its most vulnerable population age 85 +.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Figure Notes:

Mmwr Surveillance Summary 66: 1 - 8 finds that nonmetropolitan areas have significant numbers of potentially excess deaths from five leading causes of death. These figures accompany this report by presenting information on potentially excess deaths in nonmetropolitan and metropolitan areas at state level. They also add additional years of data and options for selecting different age ranges and benchmarks. Potentially excess deaths are defined in MMWR Surveillance Summary 66: 1 - 8 as deaths that exceed numbers that would be expected if death rates of States with lowest rates occur across all States. They are calculated by subtracting expected deaths for specific benchmarks from observed deaths. Dashboards allow selection of fixed benchmarks based on best performing States in a specific year and hold constant over time and floating benchmarks based on best performing States in each year and that changes from year to year. Refer to notes for additional information. Not all potentially excess deaths can be prevent; some areas might have characteristics that predispose them to higher rates of death. However, many potentially excess deaths might represent deaths that could be prevented through improved public health programs that support healthier behaviors and neighborhoods or better access to health care services. On the right side of Dashboard, options can be select. Not all options are available on all boards. Map or Bar graph Display of Numbers or Percents locality Year State Cause of Death Age Range type of Benchmark select Dashboard from the left side drop - down menu, then click on tap Update Dashboard to navigate through different graphics. Download dataset in CSV Format by clicking CSV Format link. Additional file formats are available for download for each dataset of data.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Technical Notes

Counts of deaths in most recent weeks were compared with historical trends to determine whether the number of deaths in recent weeks was significantly higher than expect, using Farrington surveillance algorithms. Surveillance package in R was used to implement Farrington algorithms, which use overdispersed Poisson to generalize linear models with spline terms to model trends in counts, accounting for seasonality. For each jurisdiction, model is used to generate a set of expect counts, and an upper bound threshold based on one - side 95% prediction interval of these expect counts is used to determine whether a significant increase in deaths has occur. Estimates of excess deaths are provided based on the observed number of deaths relative to two different thresholds. The lower end of the excess death estimate range is generated by comparing observed counts to the upper bound threshold, and the higher end of the excess death estimate range is generated by comparing observed count to the average expected number of deaths. Report counts were weighted to account for potential underreporting in most recent weeks. This method is useful in detecting when jurisdictions may have higher than expected numbers of deaths, but cannot be used to determine whether give jurisdiction has fewer deaths than expected given that data is provisional. Provisional counts of deaths are known to be incomplete, and the degree of completeness varies considerably by jurisdiction and time. Incomplete data in recent weeks can contribute to observed counts below threshold. Thus, estimates of excess deaths - numbers of deaths falling above threshold - may be underestimate. While report counts are weighted to account for potential underreporting in most recent weeks, true magnitude of underreporting is unknown. Therefore, weight counts of deaths may over - or underestimate the true number of deaths in give jurisdiction. A range of estimates of excess deaths is provided based on comparing observed numbers of deaths to two different thresholds, by week and jurisdiction: 1 average expected number of deaths, and 2 upper bound of 95% prediction interval of expected number of deaths. Negative values, where observed count fell below thresholds, were set to zero. Percent Excess was defined as the number of Excess deaths divided by threshold. The total number of excess deaths in each state was calculated by summing excess deaths in each week, from February 1 2020 to the present. Similarly, total number of Excess deaths in the US was calculated by summing the total numbers of Excess deaths across jurisdictions. Estimates of Excess deaths for the US overall were computed as the sum of jurisdiction - specific numbers of Excess deaths with negative values set to zero, and not directly estimated using Farrington surveillance algorithms.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Citation

Sars - CoV - 2, virus that caused coronavirus Disease 2019, was first identified in December 2019 in Wuhan, China, and has since spread worldwide. On March 11 2020, World Health Organization declared COVID - 19 pandemic. That same day, first confirmed COVID - 19 - associate fatality occurred in New York City. To identify confirm COVID - 19 - associated deaths, defined as those occurring in persons with laboratory - confirmed SARS - CoV - 2 infection, on March 13 2020, New York City Department of Health and Mental Hygiene initiated daily match between all deaths reported to DOHMH electronic vital registry system and laboratory - confirm cases of COVID - 19. Deaths for which COVID - 19, SARS - CoV - 2, or equivalent term are listed on the death certificate as immediate, underlying, or contributing cause of death, but that do not have laboratory - confirmation of COVID - 19 are classified as probable COVID - 19 - associate deaths. As of May 2, total of 13 831 laboratory - confirmed COVID - 19 - associate deaths, and 5 048 probable COVID - 19 - associate deaths were recorded in NYC. Counting only confirmed or probable COVID - 19 - associated deaths, however, likely underestimates the number of deaths attributable to the pandemic. Counting of confirmed and probable COVID - 19 - associate deaths might not include deaths among persons with SARS - CoV - 2 infection who do not access diagnostic testing, test falsely negative, or become infected after testing negative, die outside of a health care setting, or for whom COVID - 19 was not suspected by health care provider as cause of death. The counting of confirmed and probable COVID - 19 - associated deaths also does not include deaths that are not directly associated with SARS - CoV - 2 infection. The objective of this report is to provide an estimate of all - cause excess deaths that have occurred in NYC in the setting of widespread community transmission of SARS - CoV - 2. Excess deaths refer to the number of deaths above expected seasonal baseline levels, regardless of reported cause of death. Estimation of all - cause excess deaths is used as a nonspecific measure of the severity or impact of pandemics and public health emergencies. Reporting of excess deaths might provide a more accurate measure of the impact of pandemic. Dohmh has developed an electronic vital statistics reporting system that provides a near complete count of all deaths that occur in NYC. Rapid reporting of event of death using this electronic system allows timely surveillance of all deaths in NYC pending complete recording of demographics and International Classification of Diseases, Tenth Revision coding of cause of death information. To estimate excess deaths in NYC during the COVID - 19 pandemic, seasonal periodic regression model, as is routinely conducted for monitoring the impact of seasonal influenza, was used. Excess deaths were determined for the period March 11 - May 2 2020, using mortality data from period January 1 2015 - May 2 2020 and calculating as difference between seasonally expected baseline number and report number of all - cause deaths. Limitation of this approach is that it does not account for uncertainty in reporting lag or completeness of these provisional data.


Where deaths are far above normal

Counting deaths takes time and many states are weeks or months behind in reporting. These estimates from CDC are adjusted based on how mortality data has lagged in previous years. Even with this adjustment, it is possible they could underestimate the complete death toll if increased mortality is causing states to lag more than they have in the past or if states have changed their reporting systems. But comparing recent totals of deaths from all causes can provide a more complete picture of pandemic impact than tracking only deaths of people with confirmed diagnoses. Epidemiologists refer to fatalities in the gap between observed and normal numbers of deaths as excess deaths. From March 15 through Sept. 5, most recent date with reliable death statistics, estimated excess deaths were about 42 percent higher than the official coronavirus fatality count. If this pattern hold, it would put the current death toll at about 285 000 people. Many epidemiologists believe measuring excess deaths is the best way to assess the impact of viruses in real time. It shows how viruses are altering normal patterns of mortality. High numbers from coronavirus pandemic period undermine arguments that the virus is merely killing vulnerable people who would have died anyway. Our charts show weekly deaths above or below normal. They include weeks in which CDC estimates data to be at least 90 percent complete or estimate deaths are above expected death numbers. Because states vary somewhat in their speed in reporting deaths to the federal government, these state charts show death trends for slightly different time periods. Recent totals were compared with a simple model of expected deaths based on the number of deaths in the past three years, adjusted to account for trends over time, like population changes. Public health researchers use such methods to measure the impact of catastrophic events when official measures of mortality are flaw. Measuring excess deaths does not tell us precisely how each person die. Most of excess deaths in this period are because of the coronavirus itself. But it is also possible that deaths from other causes have risen too, as hospitals in some hot spots have become overwhelmed and people have been scar to seek care for ailments that are typically survivable. Some causes of death may be declining, as people stay inside more, drive less and limit their contact with others. Drug deaths have also risen an average of 13 percent so far this year over last year, according to preliminary mortality data collected by The New York Times, though much of this increase predates coronavirus pandemic and resulting social disruptions. Even in a normal year, it takes up to eight weeks for full death counts to be reported by CDC. But this is not a normal year, and it is possible that, because of the unusual number of recent deaths and stress they are placing on medical examiners and public health officials, totals will take even longer than usual to become complete.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Projecting from the past

To calculate excess deaths requires comparison to what would have occurred if COVID - 19 had not exist. Obviously, it's not possible to observe what didn't happen, but it is possible to estimate it using historical data. The Centers for Disease Control and Prevention do this using a statistical model, based on previous three years of mortality data, incorporating seasonal trends as well as adjustments for data - reporting delays. So, looking at what happened over the past three years, CDC projects what might have been. By using statistical model, they are also able to calculate uncertainty in their estimates. That allows statisticians like me to assess whether observed data looks unusual compared to projections. The number of excess deaths is the difference between model's projections and actual observations. Centers for Disease Control and Prevention also calculate an upper threshold for estimate number of deaths - that helps determine when the observed number of deaths is unusually high compared to historical trends. Clearly visible in graph of this data is spike in deaths beginning in mid - March 2020 and continuing to present. You can also see another period of excess deaths from December 2017 to January 2018, attributable to the unusually virulent flu strain that year. The magnitude of excess deaths in 2020 makes clear that COVID - 19 is much worse than influenza, even when compared to bad flu years like 2017 - 18, when an estimated 61 000 people in the US died of illness. The large spike in deaths in April 2020 corresponds to coronavirus outbreak in New York and the Northeast, after which the number of excess deaths decreased regularly and substantially until July, when it started to increase again. This current uptick in excess deaths is attributable to outbreaks in the South and West that have occurred since June.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

The data tell the story

Without once citing sources for statistic,sss President Donald Trump has complained to at least 20 times since early August about the media refusing to report his claim that the COVID - 19 pandemic has been far more deadly in Europe than in the United States. Reporters were right not to trust the President, because Americans have in fact died at a greater rate than Europeans since March, according to New Data provided to Intercept by Danish researchers WHO monitor Excess Mortality in Europe, and separate analysis of deaths during pandemic by Oxford University economists published on Tuesday. Excess Mortality is a measure used by epidemiologists to account for the real toll of pandemics by comparing the total number of deaths from all causes each week to the average number of deaths in a typical, non - pandemic year in that country or region. Trumps false claim about pandemics being worse in Europe has been central to his effort to deflect questions about why the US led the World in confirming COVID - 19 deaths since August 11, when he first claimed that Europe has experienced nearly 40 percent higher Excess Mortality rate than the United States during pandemic. He has made comparisons again and again in weeks since, but never offered any explanation of how statistics were calculate, or by whom, or why the percentage by which he claims the rise in deaths in Europe is higher than in the US keeps changing. The President has said four times that Europe has recorded 40 percent more deaths than the US. Hes say figure was 33 percent twice. He put the difference at 38 percent on one occasion. A week later, he said it was 24 percent twice. At ABC News town hall two weeks ago, Trump said the confirmed COVID - 19 death toll, showing the US is harder hit than any nation, should be ignored because, Theres chart that just came out a little while ago: excess mortality rate is compared to Europe, compared to other places, it about 25 percent better. In one case, it was over 60 percent better. He did not provide a chart. Four days after that, he said the gap with Europe was 30 percent. Last week, he said it was 30 percent Two More Times, and then switched again, telling rally - goers in Pennsylvania and Florida that reporters covering his campaign do want to tell you that Europe has had almost 50 percent greater excess mortality rate than the United States. Not only were all of the president's numbers wrong, but true figures on deaths from all causes during pandemic, compiled by researchers in Denmark and England, show that the US has done significantly worse than Europe, not better, at keeping its citizens alive during pandemic.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Blunt tool

Johns Hopkins University Coronavirus Resource Center keeps track OF COVID - 19 pandemic data report from most countries in the world. One common way to measure how countries are handling Coronavirus relative to one another is to compare their COVID - 19 mortality rates per 100 000 people. In that respect, US, at 57. 97 per 100 000, is doing better than Belgium, United Kingdom, Spain, Brazil, and Italy, with rates at 86. 78 62. 68 63. 34 60. 85, and 58. 85 respectively. On other hand, COVID - 19 mortality rates in Sweden, France, Canada, Germany, and South Korea currently stand at 57. 33 45. 93 24. 83 11. 26, and 0. 67 respectively. Another oft - cite statistic is that the US, with just 4 percent of the world's population, accounts for 24 percent OF the world's diagnosed COVID - 19 cases and 22 percent OF deaths attributed to the disease. Base on these figures, US has not been ALL that great at mitigating pandemic.S During an interview last week on BBC Newshour, President Trump's New Coronavirus epidemic adviser Dr. Scott Atlas more or less dismissed these figures as misleading and instead pointed to excess deaths as a better way to measure country's success in responding to Coronavirus. And he has a point, to some extent. A September 1 article in Nature notes that during outbreaks of disease, researchers need to quickly quickly quickly tally deaths rapidly. To do so, they usually turn to a blunt but reliable metric: excess mortality. It's comparison of expected deaths with ones that actually happen, and, to many scientists, it's most robust way to gauge the impact of pandemic, explained Nature. Using death data from 32 countries and four major cities, Nature article observe that by the end of July, diagnose COVID - 19 deaths across 32 countries and four major cities number 413 041, whereas the figure for total excess deaths stands at 593 344. A small proportion of excess deaths are an indirect result of conditions created by the impact of pandemicpeople missing cancer treatments or failing to go to emergency rooms during a heart attackrather than because of the virus itself. On the other hand, deaths may decline due to fewer traffic accidents and increased social distancing. At the beginning of his interview with Trump adviser Atlas, BBC Newshour presenter asked Atlas about his credentials and credibility. I am a total straight shooter, respond Atlas. I am a very direct, blunt speaker. I am not shy about saying the truth. I will never say something that I do not believe is correct, period. The Newshour interviewer then went on to point out that America's record is much worse than other countries, 4 percent of the world's population, quarter of confirmed COVID - 19 cases and deaths. As it happen, Atlas boss has made several similar assertions in the past month. At the August 11 White House press briefing, President assert, Europe has experienced a nearly 40 percent higher excess mortality rate than the United States.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Taking stock

More people in the United States are dying during the COVID - 19 pandemic, but not just because of coronavirus. One reason, experts say, is people with other ailments may not be seeking help. That conclusion is emerging from new research showing deaths are increasing from causes such as heart disease, stroke and diabetes - while emergency room visits for those conditions are down. One factor that could be contributing to the increase is that people are afraid to come in for care, says Dr. Steven Woolf, professor of family Medicine and population Health at Virginia Commonwealth University in Richmond. We need to assure them that the danger of not getting care is greater than the danger of getting exposed to viruses. Woolf led a study published on July 1 in JAMA that examined the number of deaths reported in the US in March and April, when pandemic began to take hold, compared with preceding years. Nationwide data show there were 87 000 excess deaths - that is, more than would have been expected during the two - month period - but only two - thirds of the total was attributed to COVID - 19. In 14 States, more than half of excess deaths were from causes other than COVID - 19. Moreover, JAMA study found huge increases in excess deaths from underlying causes such as diabetes, Heart Disease and Alzheimer's Disease in Massachusetts, Michigan, New Jersey, New York and Pennsylvania - five States, with most COVID - 19 deaths in March and April. New York City experienced the biggest jumps, including a 398% rise in heart disease deaths and a 356% increase in diabetes deaths. Other research underscores the findings. New study published in JAMA Internal Medicine analyzes data from March through May and calculated that 22% of excess deaths were not attributed to COVID - 19. Although data is still being gather, upward trends in other causes of death may contribute to excess deaths in some jurisdictions, Centers for Disease Control and Prevention say. Woolf says he is certain those trends are continuing, and offers two explanations. First is that COVID - 19 does contribute to many deaths even though it was not listed on death certificates and people may not have been tested for virus. We now know that viruses are not just a respiratory problem, he say. It causes other physical responses, such as damaging immune system, blood clotting and arrhythmias. It's possible some of these spikes were caused by COVID - 19 and doctors didn't realize it. Another factor, Woolf say, is some people may be avoiding or delaying treatment for medical conditions, as well as mental health or addiction problems. Cdc reported in late June that in 10 weeks after the pandemic was declared a National emergency on March 13, hospital emergency department visits declined by 23% for heart attacks, 20% for strokes and 10% for uncontrolled high blood sugar in people with diabetes. It seems like people are afraid of getting virus, or maybe they are afraid of adding to the burden on doctors and hospital,ss say Dr.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Looking back to look forward

When we look back at the coronavirus 2019 pandemic, many things will be evaluatedcases, mortality, long - term implications, number of tests, etc. Critical aspects of understanding how severe and impacting a pandemic is means also looking at damage it inflict, such as economic. One piece of this awareness is evaluating excess deaths associated with pandemic. Understanding mortality is tricky though, especially as testing availability poses a huge challenge in the early months of an outbreak. The mortality burden is not just those WHO have died due to COVID - 19, but also those WHO avoid seeking Medical Care due to fear, stress healthcare systems, or a number of other reasons. A new research study seeks to discuss this in JAMA Internal Medicine. A research team worked to understand all - cause mortality in the first few months of the COVID - 19 pandemic within the United States. Authors pull data due to any cause each week, then compare these estimates of excess deaths with reported numbers of deaths due to COVID - 19 in different States and evaluate the timing of these increases in relation to testing and pandemic intensity. Data regarding deaths due to influenza, pneumonia, and COVID - 19 was pulled from the National Center For Health Statistics and stratified by State and week. Observation period was March 1 through May 30, 2020. By estimating the number of deaths in the COVID - 19 free World, they then subtract the expected number of deaths each week from the observed number of deaths. Authors do include adjustments for reporting delays. After this work, their findings were quite eye - opening. 781000 deaths that occurred during study time were higher than expected during that time of year. During the study timeframe, there were 95235 deaths that were officially contributed to COVID - 19 and 122300 Excess deaths. The number of Excess all - cause deaths was 28% higher than those of COVID - 19 deaths. They note that, deaths officially attributed to COVID - 19 account for 78% of excess all - cause deaths, leaving 22% unattributed to COVID - 19. The proportion of excess deaths that were attributed to COVID - 19 varies between States and increases over time. In terms of mortality varying by state, researchers find that all - cause mortality actually increased by a 7 - fold increase from the baseline when the epidemic was at its peak in New York City. Other States had varying findingsCalifornia. Reported 4 046 COVID - 19 related deaths and 6 800 all - cause Excess deaths, meaning that 41% of Excess deaths were unattributed to COVID - 19. In two states currently experiencing massive spikes, authors note, Texas and Arizona had even wider gaps, with approximately 55% and 53% of Excess deaths unattributed to COVID - 19, respectively. Ultimately, these findings point to several things. First, monitoring excess deaths is an important piece in understanding the toll of the COVID - 19 pandemic and its rippling effects. Second, there are serious implications for testing capacity and availability. Third, As authors note that deaths due to any cause increased by 122000, which emphasizes that there is a larger burden of deaths that extends beyond COVID - 19.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Sources

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

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