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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.2020.11787
The number of publicly reported deaths from coronavirus disease 2019 (COVID-19) may underestimate the pandemic’s death toll. Such estimates rely on provisional data that are often incomplete and may omit undocumented deaths from COVID-19. Moreover, restrictions imposed by the pandemic (eg, stay-at-home orders) could claim lives indirectly through delayed care for acute emergencies, exacerbations of chronic diseases, and psychological distress (eg, drug overdoses). This study estimated excess deaths in the early weeks of the pandemic and the relative contribution of COVID-19 and other causes.
Weekly death data for the 50 US states and the District of Columbia were obtained from the National Center for Health Statistics for January through April 2020 and the preceding 6 years (2014-2019).1,2 US totals excluded Connecticut and North Carolina because of missing data. The analysis included total deaths and deaths from COVID-19, influenza/pneumonia, heart disease, diabetes, and 10 other grouped causes (Supplement). Mortality rates for causes other than COVID-19 were available only for underlying causes. Death data with any mention of COVID-19 on the death certificate (as an underlying or contributing cause) were used to capture all deaths attributed to the virus. Population counts for calculating mortality rates were obtained from the US Census Bureau.3,4
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