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Cardiology

Excess Deaths From COVID-19 and Other Causes, March-July 2020

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME
JAMA
Published Online: October 12, 2020
Research Letter
Steven H. Woolf, MD, MPH1;
Derek A. Chapman, PhD1;
Roy T. Sabo, PhD2;
Daniel M. Weinberger, PhD3;
Latoya Hill, MPH1;
DaShaunda D. H. Taylor, MPH1
Author Affiliations
  • 1Center on Society and Health, Virginia Commonwealth University School of Medicine, Richmond
  • 2Department of Biostatistics, Virginia Commonwealth University School of Medicine, Richmond
  • 3Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut
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Excess Death Rate During the COVID-19 Pandemic By US State, March-July 2020
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Excess Deaths During the Coronavirus Pandemic
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Previous studies of excess deaths (the gap between observed and expected deaths) during the coronavirus disease 2019 (COVID-19) pandemic found that publicly reported COVID-19 deaths underestimated the full death toll, which includes documented and undocumented deaths from the virus and non–COVID-19 deaths caused by disruptions from the pandemic.1,2 A previous analysis found that COVID-19 was cited in only 65% of excess deaths in the first weeks of the pandemic (March-April 2020); deaths from non–COVID-19 causes (eg, Alzheimer disease, diabetes, heart disease) increased sharply in 5 states with the most COVID-19 deaths.1 This study updates through August 1, 2020, the estimate of excess deaths and explores temporal relationships with state reopenings (lifting of coronavirus restrictions).

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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.

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Cardiology Dementia and Cognitive Impairment Geriatrics Neurology Population Health Coronavirus (COVID-19)
Article Information

Accepted for Publication: September 15, 2020.

Corresponding Author: Steven H. Woolf, MD, MPH, Center on Society and Health, Department of Family Medicine and Population Health, Virginia Commonwealth University School of Medicine, 830 E Main St, Ste 5035, Richmond, VA 23298-0212 (steven.woolf@vcuhealth.org).

Published Online: October 12, 2020. doi:10.1001/jama.2020.19545

Author Contributions: Drs Woolf and Chapman had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Woolf, Chapman, Sabo, Weinberger.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Woolf, Sabo.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: All authors.

Administrative, technical, or material support: Chapman.

Supervision: Woolf, Chapman.

Conflict of Interest Disclosures: Dr Weinberger reported receiving personal fees from Pfizer, Merck, Affinivax, and GlaxoSmithKline outside the submitted work and being the principal investigator for a research grant from Pfizer to Yale University. No other disclosures were reported.

Funding/Support: Drs Woolf and Chapman and Ms Hill received partial funding from grant UL1TR002649 from the National Center for Advancing Translational Sciences. Drs Woolf and Chapman also received partial funding from grant R01AG055481 from the National Institute on Aging. Dr Weinberger was funded by grant R01AI137093 from the National Institute of Allergy and Infectious Diseases.

Role of the Funder/Sponsor: The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Additional Contributions: We thank Cassandra Ellison, MFA, art director for the Virginia Commonwealth University Center on Society and Health, for her assistance with graphic design; she was not compensated beyond her salary.

References
1.
Woolf  SH , Chapman  DA , Sabo  RT , Weinberger  DM , Hill  L .  Excess deaths from COVID-19 and other causes, March-April 2020.   JAMA. 2020;324(5):510-513. doi:10.1001/jama.2020.11787PubMedGoogle ScholarCrossref
2.
Weinberger  DM , Chen  J , Cohen  T ,  et al.  Estimation of excess deaths associated with the COVID-19 pandemic in the United States, March to May 2020.   JAMA Intern Med. Published online July 1, 2020. doi:10.1001/jamainternmed.2020.3391PubMedGoogle Scholar
3.
Centers for Disease Control and Prevention. Weekly counts of deaths by state and select causes, 2014-2018. Accessed June 10, 2020. https://data.cdc.gov/NCHS/Weekly-Counts-of-Deaths-by-State-and-Select-Causes/3yf8-kanr
4.
Centers for Disease Control and Prevention. Weekly counts of deaths by state and select causes, 2019-2020. Accessed September 9, 2020. https://data.cdc.gov/NCHS/Weekly-Counts-of-Deaths-by-State-and-Select-Causes/muzy-jte6
5.
US Census Bureau. American Community Survey: table B01003. Accessed May 15, 2020. https://data.census.gov/cedsci/table?q=b01003&g=0100000US.04000.001&tid=ACSDT1Y2018.B01003
6.
Lee JC, Mervosh S, Harvey B, Matthews AL. See how all 50 states are reopening (and closing again). New York Times. Accessed September 11, 2020. https://www.nytimes.com/interactive/2020/us/states-reopen-map-coronavirus.html
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 CME points in the American Board of Surgery’s (ABS) Continuing 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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