COVID-19 by the Numbers: Mortality Rates in U.S. Decrease, Despite Uptick in Cases

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The number of excess deaths in the United States is trending downward despite autumn upticks in COVID-19 incidents.

For the first time since the COVID-19 epidemic began in the U.S., deaths have dropped below usual levels from prior years, according to data from the Centers for Disease Control and Prevention (CDC). The most recent data (from the week ending October 10) showed excess deaths only 0 and 2.9 percent higher than historic data. These figures are based on death certificates and analyzed by the National Center for Health Statistics within the CDC.

This is part of a recent downward trend in excess deaths. It suggests that, as scientists learn more about this disease, they are better equipped to intervene earlier and more effectively than when the pandemic began. Concomitantly, they are learning which repurposed therapies can mitigate the worst symptoms caused by the SARS-CoV-2 virus, and when they are best administered. Some new therapies also are in clinical trials. Consequently, COVID-19, while quite serious, is losing some of its sting.

A look at the data shows that excess deaths peaked the week ending April 11, with 35.6% to 40.6% more deaths than usual, then began a downward trajectory through June 20, when the incidence of COVID-19 rose in Sunbelt states after declining in the North and Northeast.

Nationally, the CDC says 207,882 of the total 2,270,323 deaths were related to COVID-19. Respiratory conditions, overwhelmingly, were the cause of death. Of deaths attributed to COVID-19, 94,396 involved pneumonia. Only 6,734 involved influenza. Overall, 53,397 of those COVID-19 and pneumonia relates deaths occurred among males, while only 40,995 occurred among female. The leading co-morbidities were hypertensive diseases (44,261), diabetes (33,603), and vascular and unspecified dementia (22,874).

The vast majority of deaths, including COVID-19-related deaths, occurred in an inpatient, healthcare setting. Here’s the breakdown:

  • Healthcare inpatient: 135,340
  • Nursing home or long-term care facility: 43,879
  • Home: 11,281
  • Healthcare outpatient or emergency room: 7,187
  • Hospice: 6,267
  • Other: 3,648
  • Healthcare setting, dead on arrival: 192
  • Unknown: 88

A downward trend continued for most age groups, too. Mortality rates for those 0 to 25, and those 45 to 64 were slightly below usual, while deaths for those 75 and older were slightly above usual, based on data between 2015 and 2019. Only the group aged 85 and older is experiencing a slight increase in mortality rates – from 17,243 in week 42 to 17,408 in week 43 (the week ending October 19.) The usual mortality rate for that group for the same week is 16,496.

CDC data shows that non-Hispanic white populations account for the majority of deaths related to COVID-19 – slightly more than 52% – but account for 60% of the U.S. population. The Hispanic population, meanwhile, experienced 21% of all COVID-19-related deaths, but accounts for 18.5% of the population. Non-Hispanic Blacks have a similar morality rate from COVID-19, but account for only 12.5% of the population.

This means, according to the CDC charts on race, Hispanic origin, and COVID-19, that Hispanics and Blacks have a disproportionally high percentage of deaths from COVID-19. The mortality rate for Asians and Whites, in contrast, is less than their percentage of the population.

Notably, the disparity in mortality rates for Hispanics is greatest among those 34 to 44, followed by 45 to 54. For Blacks, mortality disparity is greatest for those 24 and younger, and 55 to 64.

There are multiple reasons for these disparities, but they may be based in differences in underlying medical conditions among the races, according to Lisa Cooper, M.D., director of the Johns Hopkins Center for Health Equity.

“Existing racial disparities in the rates of chronic medical conditions increase the risk among ethnic minorities for serious complications of the novel coronavirus, and result in higher death rates,” Cooper said.

Living conditions, socioeconomic status and access to healthcare (and insurance) also play a role in exposure, transmission and ability to seek medical help.

Currently, the U.S. is in the midst of its third peak of COVID-19 cases, although the most recent data shows what optimistically could be the beginning of a decrease, according to data from Johns Hopkins University of Medicine’s Coronavirus Resource Center.

Within the U.S., Johns Hopkins’ seven-day moving average of new COVID-19 incidents reports sharp spikes in a few states, while most are modest and some are holding steady.

Its October 22 update showed the sharpest spikes in Wisconsin and North Dakota. Meanwhile, new incidents in Maine, Vermont, Washington, Oregon and New Hampshire are graphed as virtually flat lines, with no spikes, as the rates of increase hold steady. The remaining states show higher numbers of daily cases, but – for the most part – only moderate increases. Before states can begin a phased reopening, the federal government recommends two weeks of a downward trajectory.

Globally, India and Brazil report steep, steady decreases in reported incidents, while cases in the U.K., France, Spain, Russia – all among the most affected countries – are increasing. Yet, despite the increases, mortality rates appear to be falling there, too.

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