New JAMA reports highlight ‘striking’ number of deaths from COVID-19, says Virginia Tech biostatistics expert

Two new reports published Monday in the Journal of the American Medical Association suggest a stark reality: from March 1 – August 1, 2020, just over 1.3 million people died in the United States from all causes, an estimated 20 percent increase over the number that would have be expected for the time period.

Those 225,530 additional U.S. fatalities are referred to as “excess deaths” because they represent the gap between what has been observed so far in the country, and the statistical expectation based on previous years’ totals.

Ron Fricker, a biostatistician and expert in disease surveillance at Virginia Tech, says it is the accounting of these excess deaths that provide one of the most reliable measures of the pandemic’s toll in America thus far.

“Because some question how COVID-related deaths in the U.S. are counted, assessing the number of excess deaths provides a less controversial and less questionable assessment of the effects of the pandemic on mortality,” Fricker said. “And it’s not subtle: in a plot of weekly mortality in the U.S., 2020 stands out for the striking increase in the number of deaths.”

The new estimates were published in JAMA via two research letters and an editorial:

• Excess Deaths From COVID-19 and Other Causes, March-July 2020 (Woolf et al)
• COVID-19 and Excess All-Cause Mortality in the US and 18 Comparison Countries (Bilinski et al)
• Excess Deaths and the Great Pandemic of 2020 (Bauchner et al)

Fricker was not involved in the updated articles.

About 67 percent of the excess fatalities were directly attributable to COVID-19, the authors conclude in one of the JAMA research letters, while noting that some other deaths attributed to different causes likely were also related to the pandemic in general due to myriad societal disruptions from the global health crisis.

 [More: Find additional Virginia Tech expertise related to COVID-19 here.] 

“As the JAMA articles make clear, in spite of some of the rhetoric, the United States has lagged behind most of the rest of the world in effectively combating the pandemic,” Fricker said. “Indeed, as Bilinski and Emanuel show, the U.S. is in a group of ‘high mortality’ countries and, in fact, at the upper end even among those countries.”

Writing in The Conversation in August, Fricker previously noted that the number of deaths in the United States through July 2020 was 8 to 12 percent higher than it would have been if the coronavirus pandemic had never happened. “That’s at least 164,937 deaths above the number expected for the first seven months of the year — 16,183 more than the number attributed to COVID-19 thus far for that period — and it could be as high as 204,691,” he wrote.

Experts are still examining what’s causing the number of excess deaths to exceed the number officially attributable to COVID-19.

“What’s behind that discrepancy is not yet clear,” Fricker wrote in The Conversation, citing a previous research letter from the spring by Woolf et al, one of the teams that updated their findings in this week’s JAMA. “COVID-19 deaths could be being undercounted, or the pandemic could also be causing increases in other types of death. It’s probably some of both.”

Even so, Fricker said: “It doesn’t take a sophisticated statistical model to see that the coronavirus pandemic is causing substantially more deaths than would have otherwise occurred.”

About Fricker

Ron Fricker is a professor of statistics at Virginia Tech with research focused on the performance of various statistical methods for use in disease surveillance, and statistical process control methodologies more generally. He is the co-author of “Monitoring the Health of Populations by Tracking Disease Outbreaks: Saving Humanity from the Next Plague,” which was published earlier in 2020. View his bio.

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