An article appearing online on March 31, 2021 on the JAMA Network analyzed recent vital statistics data from the National Center for Health Statistics (NCHS) National Vital Statistics System (NVSS) and reported: “Provisional estimates indicate a 17.7% increase in the number of deaths in 2020 (the increase in the age-adjusted rate was 15.9%) compared with 2019, with increases in many leading causes of death. The provisional leading cause-of-death rankings for 2020 indicate that COVID-19 was the third leading cause of death in the US behind heart disease and cancer.”
“The provisional number of deaths occurring in the US among US residents in 2020 was 3,358,814, an increase of 503,976 (17.7%) from 2,854,838 in 2019. Historic trends in mortality show seasonality in the number of deaths throughout the year, with the number of deaths higher in the winter and lower in the summer … death counts by week from 2015 to 2019 followed a normal seasonal pattern, with higher average death counts in weeks 1 through 10 (n = 58,366) and weeks 35 through 52 (n = 52,892) than in weeks 25 through 34 (n = 50,227). In contrast, increased deaths in 2020 occurred in 3 distinct waves that peaked during weeks 15 (n = 78,917), 30 (n = 64,057), and 52 (n = 80,656), with only the latter wave aligning with historic seasonal patterns.”
“[I]n 2020, there were notable changes in the number and ranking of deaths compared with 2019. COVID-19 was the third leading cause of death in 2020, with an estimated 345 ,323 deaths, and was largely responsible for the substantial increase in total deaths from 2019 to 2020. Substantial increases from 2019 to 2020 also occurred for several other leading causes. Heart disease deaths increased by 4.8%, the largest increase in heart disease deaths since 2012. Increases in deaths also occurred for unintentional injury (11.1%), Alzheimer disease (9.8%), and diabetes (15.4%). Influenza and pneumonia deaths in 2020 increased by 7.5%, although the number of deaths was lower in 2020 than in 2017 and 2018. From 2019 to 2020, deaths due to chronic lower respiratory disease declined by 3.4% and suicide deaths declined by 5.6%.”
“Most of the increase in deaths from 2019 to 2020 was directly attributed to COVID-19. However, increases were also noted for several other leading causes of death. These increases may indicate, to some extent, underreporting of COVID-19, ie, limited testing in the beginning of the pandemic may have resulted in underestimation of COVID-19 mortality. Increases in other leading causes, especially heart disease, Alzheimer disease, and diabetes, may also reflect disruptions in health care that hampered early detection and disease management. Increases in unintentional injury deaths in 2020 were largely driven by drug overdose deaths. Final mortality data will help determine the effect of the pandemic on concurrent trends in drug overdose deaths.”
“Early estimates of life expectancy at birth, based on provisional data for January to June 2020, show historic declines not seen since World War II (1942-1943). The effects of the pandemic are likely to continue through 2021 as well because COVID-19 has already caused more than 100 000 deaths this year. However, the effects of COVID-19 on mortality trends may be mitigated in 2021 given better detection and treatment options as well as increasing natural and vaccine-related immunity.”
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