Many deaths that had previously been attributed to natural causes during the first months of the Covid pandemic may actually have been because of the virus.
More than one million deaths during the first 30 months of the pandemic were reported from other natural causes, like disease and chronic conditions, according to the National Institute on Aging. Previous studies found that the excess deaths were higher than reported Covid deaths, but most investigated extra deaths from all causes.
Now, researchers say the timing of these deaths suggests they could have been unrecognized fatalities or indirectly linked to pandemic-related disruptions in health care and in other fields.
A study funded by the institute revealed there were approximately 1.2 million more natural-cause deaths than expected from March 2020 to August 2022 across 3,127 US counties.
Of those deaths, nearly 163,000 did not have a Covid notation on their death certificates.
Using data from the Centers for Disease Control and Prevention, the researchers found the largest gaps between the excess deaths and Covid deaths were in the rural West and South.
Increases in cases were often correlated with rises in excess natural-cause deaths, the institute said.
“The correlation between COVID-19 deaths and excess natural-cause deaths suggests that health care delays and social and economic impacts of the pandemic were not the main reasons for these excess deaths,” it explained.
In areas where there was a greater number of excess deaths assigned to natural causes, there may have been more unrecognized Covid deaths because of a lack of testing, less experienced death investigators, and more deaths occurring outside of medical facilities.
The study, published in the journal PNAS, found New England and mid-Atlantic metropolitan counties had fewer excess natural-cause deaths compared to reported Covid deaths. That’s possibly because of declines in other causes of death due to Covid prevention policies, different death reporting standards, or a greater ability to work from home in more economically privileged counties.
However, there were some limitations to the findings. For example, there’s an inability to know for certain if excess natural-cause deaths were due to unrecognized Covid cases or were related to other disruptions from the pandemic. Death counts for 2022 are also still provisional.
“Future research should differentiate unrecognized COVID-19 deaths from other causes and examine the differences based on individual factors, such as age, gender, race, and socioeconomic status, as well as access to health insurance and primary care,” the institute said.
“Overall, this study helps improve understanding of the pandemic’s true impact and may guide better public health responses and improvements in death investigation systems.”
