Excess death is probably the best COVID metric to track
Without a doubt, there are a large number of excess deaths this year.
If you are unsure how to make sense of the number of daily positive coronavirus tests (are they false positives, who is being tested, what about asymptomatic people?), if you are suspicious about the number of COVID deaths reported (are people dying from COVID or just with COVID, is it just old people who were going to die anyway, are the death certificates legit?), or if you have other questions about how bad COVID really is, I get it. It is so hard to know what to believe at all these days and to make sense of the world. And the majority of people are not living this personally.
Measured values become hard to interpret without context and perspective. We need a comparison (also known as a control). For example, over 600,000 people die from heart disease every year in the United States, just under 600,000 die from cancers, and about 160,000 die from accidents. Those are consistent and consistently the top three cause of death. A total of about 2.8 million people each year die from all causes. That’s about 50,000 — 60,000 people each week, and about 7,000 — 8,000 a day. This is perspective.
I believe the best metric of COVID’s toll is excess deaths. If you look at the typical, expected number of people to die — from all causes — based on years past, and compare that to this year, we can see if there are deaths in excess of the average. A number of total people dying above the expected number is deemed excess deaths.
Without a doubt, there are a large number of excess deaths this year. According to the CDC data linked above, and in Figure 1, accessed on November 1, the “total predicted number of excess deaths since 2/1/2020 across the United States is 236,480–318,355.” This would mean the current estimate of 236,000 deaths due to coronavirus is close, and maybe even an underestimate. Figure 2 below shows the comparison of excess deaths including (blue) and excluding (green) COVID. Even without COVID, there are a few weeks this year with excess deaths. This may be evidence of the other things going on as a result of COVID.
Excess deaths is probably the best metric because it is objective, leaves little room for manipulation or lying, and doesn’t require much trust in the system, or health officials, or politicians, or media. You are only asked to believe that the total number of people dying from any cause is not being made up.
Excess deaths captures all the higher-order consequences of COVID and the rest of 2020, both beneficial and negative. For example, maybe the number of traffic accident deaths has decreased due to people driving less and maybe iatrogenesis has gone down. But maybe the number of suicides have increased due to more mental health issues, and the number of people dying from other causes is higher because they are not seeking treatment. I’m only speculating in these examples. But that’s the point. In addition to actual COVID deaths, there are effects from COVID and our response to it that will all be picked up by excess deaths. Don’t be fooled by measures and analyses that try to isolate one factor away from all the others. Everything is connected.
Of course there are other negative outcomes from the disease besides death. These are all much harder to track and measure, especially now while we are in the midst of it. There are long haulers, people with lingering medical difficulties, quietly suffering at home. Also, we don’t yet know the truly long-term effects of contracting the coronavirus, if there are any, and we may not know for years or decades. And there is surely suffering from economic, political, social, and psychological outcomes of the disease and our response to the virus that don’t show up as deaths. But I still believe excess deaths is one of the best metrics, and one we should be reporting and following more closely.
