The number of people reported to have died of contracting the novel coronavirus infection in the United States surpassed 100,000 this week, but an analysis of overall deaths during the pandemic shows that the nation probably reached the terrible milestone three weeks ago.
Between March 1 and May 9, the nation recorded an estimated 101,600 excess deaths, or deaths beyond the number that would normally be expected for that time of year, according to an analysis conducted for The Washington Post by a research team led by the Yale School of Public Health. That figure reflects about 26,000 more fatalities than were attributed to COVID-19 on death certificates during that period, according to federal data.
Those 26,000 fatalities were not necessarily caused directly by the virus. They could also include people who died as a result of the epidemic but not from the disease itself, such as those who were afraid to seek medical help for unrelated illnesses.
Increases or decreases in other categories of deaths, such as motor vehicle accidents, also affected the count.
Such "excess death" analyses are a standard tool used by epidemiologists to gauge the exact death toll of infectious-disease outbreaks and other widespread disasters.
The Yale-led team also used historical death data to estimate the expected number of deaths for each week this year, adjusting for such factors as seasonal variation and the intensity of flu epidemics. To calculate excess deaths, the researchers subtracted their estimate of expected deaths from the overall number of deaths reported by the National Center for Health Statistics.
The COVID-19 death toll, a key data point in shaping the public-health response to the pandemic, has become a political flashpoint. Allies of President Donald Trump have claimed that the government tally is inflated, contending that it includes people with other medical conditions who would have died with or without an infection.
The Yale-led analysis, however, suggests that the actual number of people who have died because of the pandemic is far greater than the official government death tallies. The researchers estimated that the number of excess deaths between March 1 and May 9 was most likely between 97,500 and 105,500.
"It's clear that the burden is quite a bit higher than reported totals," said Daniel Weinberger, professor of epidemiology from the same varsity who led the analysis.
Many Republican strongholds, including Alaska, South Dakota, and Utah, did not have an unusual number of overall deaths during the period covered by the analysis. The number of deaths in those states rarely rose above the expected ranges, instead were sometimes slightly below them, the researchers found.
In contrast, some of the nation's most populous blue and purple states -- including New York and New Jersey but also Maryland, Massachusetts, Michigan, and Illinois -- experienced staggering surges in deaths. In every one of those states, the spike surpassed the number of deaths attributed to covid-19 in official tallies. New York City had an estimated 6,500 excess deaths beyond those attributed to the virus, according to the analysis.
The state-by-state analysis further indicated that as testing has become more widely available, COVID-19 deaths have accounted for larger and larger percentages of the excess deaths. It also suggested that the gap between excess deaths and official COVID-19 tallies has been particularly pronounced in several states that currently have the least restrictive social distancing rules in place.
The number of excess deaths fell nationally in the weeks leading up to May 9 -- the last week for which data is complete enough to be reliable -- largely because of the easing of the pandemic in such hot spots as New York City and New Jersey.
For the most part, the states that continue to maintain especially restrictive social distancing rules are those that suffered the largest numbers of excess deaths. In many of those places, most nonessential businesses remain closed, bars and restaurants may not seat customers, and public gatherings are limited to 10 people or fewer, according to a Post review of state policies through Friday.
In states that have begun to lift restrictions, the picture of excess deaths through May 9 is more mixed. Deaths were within the normal range in many of those states, but they spiked in a handful of others, including Massachusetts, Colorado, Louisiana and Virginia, the analysis showed.
The states with the loosest restrictions are generally those in which the death toll through May 9 was not unusually high, according to the analysis.