COVID-19 Deaths Were Not Just Reclassified Deaths From Other Diseases and Conditions

The Journal of the American Medical Association (JAMA) has an interesting article out on the leading causes of death in the United States.* In the article, the authors include a table that tells a story of the COVID-19 pandemic so far in terms of death:

Note that the number of deaths from conditions other than COVID-19 remained well within their normal variation and/or trends. For example, Heart Disease remained at the top of the list and continued the upward trend from previous years. Cancer remained steady in the high 590 thousands. One category of death that showed a decrease after several years of increasing was Suicide. (Even as political pundits assured people that the consequence of lock-downs and the economic turndown would be an increase in suicides.)

Those numbers are also a good reminder that COVID-19 deaths are not “reclassified” deaths from other diseases or conditions, as some have said. If it were the case that heart attacks, strokes or complications from diabetes were being falsely — or dishonestly — classified as COVID-19 deaths, then those categories of deaths would have shown a decline in 2020 instead of an increase for all three. So either we had a massive jump in heart attacks, strokes, diabetes and influenza, so they could all account for the “reclassification” to COVID-19… Or, as the evidence and the science shows, COVID-19 really did account for over 345,000 deaths in 2020 in the United States. As the authors put it:

Most of the increase in deaths from 2019 to 2020 was directly attributed to COVID-19. However, increases were also noted for several other leading causes of death. These increases may indicate, to some extent, underreporting of COVID-19, ie, limited testing in the beginning of the pandemic may have resulted in underestimation of COVID-19 mortality. Increases in other leading causes, especially heart disease, Alzheimer disease, and diabetes, may also reflect disruptions in health care that hampered early detection and disease management. Increases in unintentional injury deaths in 2020 were largely driven by drug overdose deaths. Final mortality data will help determine the effect of the pandemic on concurrent trends in drug overdose deaths.

Ahmad FB, Anderson RN. The Leading Causes of Death in the US for 2020. JAMA. Published online March 31, 2021. doi:10.1001/jama.2021.5469

Author: René F. Najera, DrPH

I am the editor of the History of Vaccines site, an online project by the College of Physicians of Philadelphia. All opinions expressed on these blog posts are not necessarily those of the College or any of my employers. Check out my professional profile on LinkedIn: https://www.linkedin.com/in/renenajera Feel free to follow me on Twitter: @EpiRen