Early in the pandemic, a major storyline was the undercounting of coronavirus deaths, as testing struggled to keep pace with the number of people dying, leaving tens of thousands of deaths that were likely from covid attributed to more generic causes (in many cases, causes that were symptoms of covid).
The numbers haven’t caught up. But as testing has grown into abundance, the undercount has stopped growing at such a high rate, and as the total number of deaths has swelled, the undercount has grown smaller by comparison. Per The Economist’s excess death tracker, which compares the expected number of deaths pre-pandemic to the number of deaths during the pandemic over a given time and area, the total number of excess deaths in the United States—deaths beyond those that would have occurred based on trends from recent years—was roughly 550,000 from last March through February 5th, compared to the accepted count, over that period, of roughly 450,000 confirmed covid deaths. That leaves the undercount at 100,000—a massive, massive number of people, but also only a little more than a 20% miss, which is sizable but not something that affects our understanding of the cost by orders of magnitude.
It’s possible, of course, that some of these excess deaths were collateral—that people died because of trepidation about or difficulty of receiving medical care, etc. There will be studies upon studies around this, I’m sure, and it may be a decade or more before we get a great estimate of the pandemic’s true toll (especially as the lingering effects may last even if we can get covid down into flu-like mortality territory [or hopefully better]). For what it’s worth, “deaths of despair,” a category which includes suicides, drug overdoses, and alcohol-driven deaths like liver failure, likely doesn’t account for many collateral deaths. I haven’t seen data on drug and alcohol deaths, but the CDC has reported that suicides decreased from 2019 to 2020, and while there are myriad factors affecting the prevalence of suicide (and all causes of mortality), suicides would have had to more than double to account for even half the excess deaths.
This news about the undercount is good news. It’s good that the undercount isn’t bigger, because it means the total number of lives taken by the pandemic in this country isn’t bigger. Still, when the twelve-month total comes in and all the data’s been ironed out, it’s not unlikely that we’ll find the coronavirus took as many lives in a year as heart disease and cancer each take, making it one of the three leading causes of death in America for its peak twelve months and inflating the American death total for those twelve months by nearly a quarter.
