There Has Been an Increase in Other Causes of Deaths, Not Just Coronavirus – The New York Times

This chart shows deaths above normal in New York and New Jersey. The percentages are shares of total excess deaths from March 15 to May 2.

New York and New Jersey have had more than 44,000 deaths above normal from mid-March to May, according to analysis of data from the C.D.C. While Covid-19 is the leading cause of these excess deaths, more people have also died from other causes like heart disease, diabetes and Alzheimer’s disease in recent weeks than for the same period in previous years.

Public health experts have said that many of these additional deaths from other causes may be undercounts or misdiagnoses of Covid-19, or indirectly linked to the pandemic otherwise.

Here is a breakdown of excess deaths in the two states, which together account for more than 40 percent of the official coronavirus death toll in the United States. All numbers in the accompanying charts are rounded down, either to the nearest hundred, or if below 100, to the nearest 10. Totals for the three areas are rounded down from the exact sum.

Covid-19 makes up more than 60 percent of excess deaths so far.

According to the C.D.C., about 30,500 deaths were directly attributed to Covid-19 from March 15 to May 2, the period for which the most recent comprehensive data is available. About half of those deaths were in New York City alone.

Deaths from Covid-19

But more deaths have also been caused by conditions that are common comorbidities with Covid-19.

Heart disease — the leading cause of death in the United States — saw a large surge in excess deaths over the same time. In New York City, deaths from heart disease were nearly three times the normal.

Deaths from heart disease

About 800 deaths above normal have been attributed to diabetes. Research has shown that people with diabetes and heart disease are particularly vulnerable if they contract Covid-19.

Deaths from diabetes

“I would assume that a group of these are potentially undiagnosed Covid patients,” said Thomas McGinn, an author of a study about clinical characteristics of patients with Covid-19 in the New York City area.

It’s also possible that some patients with chronic illnesses, like heart disease and diabetes, may have chosen to stay home rather than risk exposure to the coronavirus by going to the hospital. Many doctors have reported a decrease in hospital visits for heart attack and stroke.

“If I had diabetes, and it was barely manageable, and I had some episode that may normally require me to get urgent care … do I want to stay home and manage my diabetes, or do I want to go into a hospital and potentially contract Covid?” said Melody Goodman, a biostatistics professor at New York University.

The pandemic’s strain on the health care system is also forcing some to delay or forgo treatment for illnesses not related to Covid-19.

Some respiratory illnesses that were Covid-19 could have been misdiagnosed.

Deaths from the flu, pneumonia and other respiratory diseases may also have been miscategorized as Covid-19, especially earlier during the pandemic, when coronavirus tests were hard to get, Dr. Goodman said. Chest X-rays from the virus and pneumonia look especially similar, for example.

Deaths from flu and pneumonia

The C.D.C. data shows flu deaths peaking much later than normal this season. Usually, the peak is in January and February; this year, deaths attributed to the flu spiked in March and April, around the same time as the peak of the coronavirus pandemic.

“As you look at mortality rates as you move through February into March, anything documented as flu, you have to wonder is it truly viral-tested flu or just people thinking it was flu when maybe that was all Covid?” Dr. McGinn said.

Deaths from other respiratory diseases were also about 50 percent higher than normal.

Deaths from chronic lower respiratory diseases

Deaths from other respiratory diseases

More older people died of Alzheimer’s disease than normal.

Deaths from Alzheimer’s disease, a common cause of death among the elderly, were more than 60 percent above normal during the same time period.

Deaths from Alzheimer’s disease

“I imagine that the care for people with Alzheimer’s is being complicated by the epidemic, particularly given that this has ripped through certain nursing homes, and that could be affecting the level of care that’s being given,” said Robert Anderson, chief of the mortality statistics branch at the C.D.C.’s National Center for Health Statistics

Deaths from other causes have also spiked.

Deaths from other causes — including Parkinson’s disease, dementia and coronaviruses other than Covid-19 — are more than 25 percent above normal for this time. Deaths that are pending investigation are also included here.

Deaths from other causes

The C.D.C. will ask states if some of the generic coronavirus deaths are indeed Covid-19, Dr. Anderson said.

Determining how a person died can be subjective to a degree, so it’s hard to say exactly how many of the excess deaths might be directly or indirectly linked to Covid-19.

“There’s no completely objective way to do this,” Dr. Anderson said. “Even with autopsy, the cause of death may not be entirely apparent.”