- The U.S. has dodged a major wintertime Covid-19 surge as the pandemic continues to recede into the background. But the death toll is still growing.
- The U.S., which recently topped 1.1 million Covid-19 deaths since the pandemic began, continues to record several hundred more each day, death-certificate data show.
- The people who are dying remain old, often with underlying health issues such as heart and lung ailments, the data indicate.
A recent news article published in the Wall Street Journal intrigues Why the Covid-19 Death Toll in the U.S. Is Still Rising.
A lagging booster rate
These deaths are the consequence of a virus that continues to transmit easily, allowing it to reach vulnerable people, even though built-up immune protection from vaccines and prior infections have lowered the risks for most others, according to doctors and public-health experts. A lagging booster rate is also leaving vulnerable people exposed, they said.
“There are still susceptible individuals out there,” said Janet Hamilton, executive director at the Council of State and Territorial Epidemiologists.
The U.S. averaged about 400 deaths a day in a three-month span covering November through January, based on weekly Centers for Disease Control and Prevention counts of death certificates listing Covid-19 as the underlying or contributing cause. Data from the most recent weeks are incomplete.
There has been significant improvement: The country averaged roughly 1,700 deaths a day in the same period a year before. The same wintertime period two years ago was even worse: about 2,800 daily deaths.
The current pace, however, is still enough to keep Covid-19 among the major causes of death in the U.S. The disease ranked at No. 3 in 2020 and 2021, behind heart disease and cancer, and might rank there again in 2022.
Deaths caused by Covid are heavily concentrated among the elderly, an analysis of CDC data shows. In recent weeks people 75 years and older have represented about seven of every 10 Covid-19 deaths. This age group peaked at 64% of the total during the severe winter surge two years ago and tumbled as low as a one-third of deaths when the Delta variant struck in 2021.
Grant Egley, 90 years old, died from Covid complications on Jan. 7 after falling ill with the virus following a family Christmas gathering in Ohio. He was previously treated for a form of leukemia, but was otherwise fit and healthy and fully vaccinated and boosted, his daughters said.
The retired U.S. Department of Agriculture scientist was a former ultramarathoner who hit the treadmill at his daughter Catherine Waggoner’s house during the holiday gathering. He also remained mentally sharp, filling notebooks with ideas from philosophers and theologians and his own thoughts.
At 90 years, he was not finished
“We’re all in shock,” Ms. Waggoner said. Other family members, including her mother, also 90, recovered from infections they caught at the same time. “He was not ready to go; he was not finished.”
In a shift, Covid-19 is now listed on death certificates as a contributing cause of death, rather than the main cause, more than was the case during the pandemic’s early days. Physicians, coroners and medical examiners who fill out these documents are supposed to include Covid-19 when it played a meaningful role in a person’s death. In 2020 and 2021, the disease was the underlying cause about 90% of the time.
The portion of death certificates listing Covid-19 as a contributing cause has been above 30% since spring 2022, CDC data show. This pattern likely reflects Covid exacerbating other medical conditions, doctors said. Heart issues, lung ailments, cancers, diabetes and obesity are among common health issues that can complicate infections.
Some people “have enough comorbidities that any sort of shock to the system can upset the apple cart of the rest of their illnesses,” said Dr. Cameron Wolfe, an associate professor of infectious disease at Duke University School of Medicine.
Excess deaths—a measure of all deaths in the U.S. above expected levels, based on averages from before the pandemic—remain higher than the number of reported Covid deaths. This suggests the U.S. is likely undercounting its Covid deaths, though not as much as in the pandemic’s earliest months when the disease was new, said Robert Anderson, chief of the mortality statistics branch at the CDC’s National Center for Health Statistics.
This winter’s climb in non-Covid excess deaths is likely due in part to the active flu season, Dr. Anderson said. Drug overdose deaths have also surged during the pandemic, contributing to the excess counts.
Improving vaccination uptake
Improving vaccination uptake could help further reduce the Covid death toll, doctors said. Only 41% of the population age 65 and older has received a bivalent booster shot, CDC data show. And about 53% of residents in nursing homes, which Covid devastated before the initial vaccines were introduced, were recently up-to-date on their shots, according to the Centers for Medicare and Medicaid Services.
Though far below death rates from earlier in the pandemic, nursing homes were still reporting an average of about 270 Covid-19 deaths a week in the final three months of 2022, CMS data show.
Last month, agency Administrator Chiquita Brooks-LaSure wrote to the governors of several states with the lowest rates of resident vaccinations to raise awareness and offer help, an agency spokesman said. Among them were Arizona and Florida, the two lowest-ranked states in the most recent CMS data.
“Can we do better?” said Dr. Michael Stoto, a professor emeritus at Georgetown University and a statistician in epidemiology. “The answer is yes, absolutely.”
Did you subscribe to our daily Newsletter?
It’s Free! Click here to Subscribe