Study investigates non-COVID-19 deaths during the pandemic

Researchers have identified increases in deaths during the pandemic compared with previous years. Although this is not surprising in itself, many of these excess deaths are not due to COVID-19. The authors of a new study took a look at the demographics of this increase.

Researchers have identified the number of excess non-COVID-19 deaths during the first 3 months of the pandemic. In addition, they have linked these deaths to particular demographics.

The research, which appears in the journal Public Health, makes evident the need to understand exactly why these deaths are occurring to help reduce their number as the pandemic continues.

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Excess deaths

The COVID-19 pandemic is an international crisis because of the risk of death associated with the disease, particularly for vulnerable groups. Deaths have exceeded 1.3 million globally, with older people and those with certain underlying health conditions most at risk.

However, the pandemic has also profoundly disrupted the way our societies work, largely due to the emergency measures that governments across the world have introduced.

This disruption has, in itself, put people’s lives at risk. For example, during the pandemic’s local peaks, many hospitals have been overwhelmed by the number of people requiring critical care beds. This increased demand has reduced access for people with other critical care needs not relating to COVID-19, potentially increasing their risk of death.

Researchers in the United Kingdom have also predicted that the suspension or reduction of cancer services due to the pandemic will result in “[s]ubstantial increases in the number of avoidable cancer deaths.”

Prof. Sheldon H. Jacobson, a professor at the Carle Illinois School of Medicine, and Dr. Janet Jokela, the head of the department of internal medicine and acting regional dean of the University of Illinois College of Medicine at Urbana, have now quantified these deaths in the United States.

According to Prof. Jacobson:

“We know that the pandemic is selectively taking lives. It also seems to be causing ancillary deaths that are not directly caused by COVID-19 but are a consequence of the fact that we have COVID-19 in our society, in our healthcare system, in our jobs, in our lives. We’re trying to capture those effects as data.”

Analyzing CDC data

To investigate, Prof. Jacobson and Dr. Jokela looked at data from the Centers for Disease Control and Prevention (CDC) covering March 1 to May 30, 2020 — the first 3 months of the U.S.’s response to the emerging pandemic.

In addition to COVID-19 deaths, these data include all-cause deaths. They also contain information on the age and sex of those who died.

By combining CDC mortality data from 2018 with 2019 population estimates, the researchers were able to estimate 2019 deaths. They then used these as a benchmark against which to measure excess deaths during March–May this year.

Significant increases

The researchers found that there was a significant increase in the deaths of males between the ages of 15 and 54 years and of females between the ages of 25 and 44 years.

“Although we don’t know why, deaths increased to a greater degree than expected,” says Dr. Jokela. “As someone who has spent their career in medicine and public health, this concerns me.”

“The concern is that excess deaths will continue to occur during the pandemic, whether it’s because people are delaying care for other conditions or because some COVID-19 deaths are going undetected. This is a phenomenon that requires ongoing monitoring and investigation.”

Interestingly, Prof. Jacobson and Dr. Jokela found that among females between the ages of 5 and 14, there was a reduction in excess deaths compared with previous years.

According to Prof. Jacobson: “The only explanation we can come up with is that if you look at the deaths that occur in that age group, the preponderance of them are accidents. Thus, the shutdowns in much of the country appear to have had a protective effect on young girls.”

Prof. Jacobson and Dr. Jokela intend to continue their analysis as the CDC release more data, with the aim of covering the whole of 2020.

To help with this, they encourage public health agencies to make data relating to both COVID-19 and non-COVID-19 deaths available so that researchers can identify and respond to underlying trends.

“Is it because people are neglecting routine medical exams? Are they delaying treatment for other conditions, such as cancer or heart disease? Are mental health issues going unaddressed? Information about the causes of death in different age groups would be very useful because then we can look at the appropriate countermeasures to reduce preventable deaths,” says Prof. Jacobson.

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