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The Toll of COVID-19

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME

Everyone dies eventually. But exactly when did a person die and from what cause? How many deaths were attributable to that cause? These straightforward questions can be challenging to answer, and their answers reveal only part of the effects of a disease on a family, community, and nation, as is the case with deaths from the coronavirus disease 2019 (COVID-19) pandemic.

Countries began systematically to record deaths and such events as births and marriages at least since the Registration Act of 1854 in Scotland. The US National Center for Health Statistics (NCHS), within the Centers for Disease Control and Prevention (CDC), operates the National Vital Statistics System (NVSS) for the US. The NVSS compiles data supplied by the 50 states, 2 cities (New York City and Washington, DC), and 5 US territories, each of which has legal responsibility for registering births, deaths, and other vital statistics within their jurisdictions. These jurisdictions vary in the timeliness of their submissions to the NVSS, and it takes time to process, code, and tabulate these data. At any moment in time, therefore, the NVSS death counts are incomplete, especially over the most recent couple of weeks, and the lag, depending on jurisdiction and cause of death, can be as long as 8 weeks. For this reason, some universities, media, and other organizations have taken up the task of tabulating current COVID-19 death counts by counties and states and summing those to provide more current, national tallies that are familiar from daily news reports.

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Article Information

Corresponding Author: Harvey V. Fineberg, MD, PhD, Gordon and Betty Moore Foundation, 1661 Page Mill Rd, Palo Alto, CA 94304 (harvey.fineberg@moore.org).

Published Online: October 12, 2020. doi:10.1001/jama.2020.20019

Conflict of Interest Disclosures: None reported.

References
1.
Centers for Disease Control and Prevention. Daily updates of totals by week and state: provisional death counts for coronavirus disease 2019 (COVID-19). Accessed September 22, 2020. https://www.cdc.gov/nchs/nvss/vsrr/COVID19/index.htm
2.
Yan  H , Fox  M , Gunbrecht  J . CDC official affirms coronavirus deaths really are coronavirus deaths. CNN. Accessed September 22, 2020. https://www.cnn.com/2020/09/02/health/us-coronavirus-wednesday/index.html
3.
McGinnis  JM , Foege  WH .  Actual causes of death in the United States.   JAMA. 1993;270(18):2207-2212. doi:10.1001/jama.1993.03510180077038PubMedGoogle ScholarCrossref
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Woolf  SH , Chapman  DA , Sabo  RT , Weinberger  DM , Hill  L , Taylor  DDH .  Excess deaths from COVID-19 and other causes, March-July 2020.   JAMA. Published online October 12, 2020. doi:10.1001/jama.2020.19545Google Scholar
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Viglione  G .  How many people has the coronavirus killed?   Nature. 2020;585(7823):22-24. doi:10.1038/d41586-020-02497-wPubMedGoogle ScholarCrossref
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Centers for Disease Control and Prevention. COVID-19 hospitalization and death by race/ethnicity. Accessed September 22, 2020. https://www.cdc.gov/coronavirus/2019-ncov/covid-data/investigations-discovery/hospitalization-death-by-race-ethnicity.html
7.
Cooper  LA , Williams  DR .  Excess deaths from COVID-19, community bereavement, and restorative justice for communities of color.   JAMA. Published online October 12, 2020. doi:10.1001/jama.2020.19567Google Scholar
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Institute for Health Metrics and Evaluation. Global Burden of Disease history. Accessed September 22, 2020. http://www.healthdata.org/gbd/about/history
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Simon  NM , Saxe  GN , Marmar  CR .  Mental health disorders related to COVID-19–related deaths.   JAMA. Published online October 12, 2020. doi:10.1001/jama.2020.19632Google Scholar
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AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

  • 1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
  • 1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
  • 1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
  • 1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
  • 1.00 credit toward the CME [and Self-Assessment requirements] of the American Board of Surgery’s Continuous Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.

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