One issue with the previous analysis is that it applies only to deaths that were purely coincidental to Covid infections. Another set of deaths, it might be argued, that overly inflate the total death toll of Covid are those deaths in which Covid did, in fact, act as the proximate cause, but which were deaths of very weak or sickly old people who were probably going to die anyway--in a matter of days, weeks, or months.
For these deaths, the timing issue would not arise. In fact, these deaths would technically still be attributable to Covid, since it was Covid that, so to speak, pushed these people over the edge. So the previous analysis would not be able to separate out these deaths from other Covid deaths, whereas really the deaths *should* be more attributed to the extreme age or weakness of the people who died.
I don't think there's any question that deaths of this kind occurred and were included in the official Covid tally. Can we get some sort of estimate, however, on the magnitude of this effect?
Average Death Rates
Here, it is good to look at the average yearly death rates. In the United States, these vary from year to year, but not by a whole lot. They are also relatively constant throughout the year aside from a yearly noticeable peak during flu season.
Given the relative stability of this yearly average death rate in the U.S., we should be able to eliminate at least some of these types of deaths of the extremely weak. The hypothesis is that these people would have died soon anyway without Covid, and it just happened to be Covid that was the last straw. If this were the case, then we should see that these deaths, though included in the official Covid death tally, would *not* have increased the total deaths that occurred in the year above the yearly average. In other words, suppose 300,000 people are supposed to have died from Covid in 2020, but half of those people were people who were most likely going to die that year anyway. We should then expect the total number of deaths from all causes in 2020 to have risen above the average only by 150,000, not by 300,000.
This analysis has been done (and continues to be done) by the CDC on an ongoing basis. The report may be found here:
Currently, the CDC is estimating that since Covid began, we have had an average of about 760,000 excess deaths above what is statistically expected given recent history. Meanwhile, the official Covid death count is only at about 620,000 (for the time period at which the CDC data on that page was most recently updated). This means that there seems to be an *excess* of deaths resulting from Covid, *above* what the official tally reveals--something on the order of 20% or so.
Other Analyses
The CDC is not alone in coming to this conclusion. The Wall Street Journal has done several excellent statistical analyses of U.S. and world data on excess deaths more than once and has come to similar conclusions (though with slightly higher estimates for the underreporting of Covid-19 deaths at 35%):
Yet other statistical analyses have put the toll even higher: Estimation of excess mortality due to COVID-19 by the IHME puts the real toll of Covid in the U.S. at about 57% higher than the official tally based on excess deaths.
What Explains the Extra Deaths?
So why would there be more deaths from Covid than actually reported? The first explanation some people might want to gravitate towards is: social measures taken to halt Covid have had bad side effects on the population. For example, people who *should* have gone to the hospital with a heart condition were afraid to and hence died at home rather than being treated as they would otherwise have been.
The problem with this theory is that if you look at the graph of excess deaths, they very clearly track exactly with Covid infections--as Covid cases go up, the excess deaths go up, and as they go down, the excess deaths go down. The excess deaths do *not* track with the rigor of societal restrictions, which were most strict in the very earliest phase of the pandemic, but eased off before the Summer '20 surge and were even more eased just before the disastrous Fall / Winter '20 season.
Therefore plausible reasons to explain these excess deaths have to find a cause that's correlated with Covid infections. I have three theories that I would like to propose:
- In regions in which medical resources became strained due to Covid outbreaks, care of other patients suffered as well due to total lack of resources.
- Many people who died from Covid were the elderly, in nursing homes, and with other comorbidities. It's quite possible that many of those people died in such a way that their comorbidities were blamed rather than Covid, but that their deaths would not have happened for more than a year without Covid. (My opinion is that this represents the bulk of the difference between official tally and actual death toll).
- As I have pointed out several times, Covid has a significant second method of killing people, which is attacking the heart. We know for sure that Covid is to blame for at least a few heart attacks that otherwise came out of the blue, even in people who were otherwise only very mildly sick from Covid or even completely asymptomatic. Myocarditis has been found associated with Covid in otherwise healthy people who were asymptomatic at extremely high rates: up to 25% in one study of athletes with Covid.
It is quite possible that a number of people over the past year have dropped dead from heart attacks directly caused by Covid, but without that cause ever having been discovered. In fact, I believe we have some indirect evidence of this in studies which have shown that reports of heart attacks have inexplicitly risen in regions with high Covid occurrences.
What Do these Excess Deaths Mean?
That large number of deaths have indubitably occurred since Covid began and have been rising and falling largely in step with the rise and fall of Covid infections makes it exceedingly difficult for the theory that the official death tally for Covid is an overstatement. It makes it essentially impossible to claim that most of these people who died were on death's door already. To continue to maintain that the official death tally is a gross overstatement requires some other explanation, which I have not yet heard and which I can't even imagine currently.
This does not mean, however, that the death tally can't be put into a certain amount of perspective. While the people who died were certainly not all on death's door, nevertheless most of them have been quite old and vulnerable in other ways. It *is* quite possible that many and possibly the majority of them had only 3-5 years left anyway, or maybe 10 at the outside. Given the age of the primary victims of Covid, this is something that is necessarily true.
If you wanted to be morbidly precise and weigh out everyone's life in a balance, then it is possible to take the age and comorbidity statistics that we have and figure out what the approximate toll of Covid has been in terms of total man-years of life lost. This would certainly be a legitimate way to minimize the impact of Covid, though a rather ghoulish one, in my opinion.
If you were to do that, however, it would only then be fair to add into the balance the serious illness as well. There are many vulnerable people who were sickened by Covid and did *not* die, but nevertheless were left with significant, long lasting recoveries and put into a permanently weakened state: weaker heart, shredded lungs. These people are not counted yet on Covid's death toll, but have *certainly* lost total years of their life due to their battle with Covid. This will be a harder toll to add up than just the people who died, but *if* you go down the route of counting years of life lost, then you certainly need to add those future lost years in as well.
Conclusion
It is not possible to maintain that the official death toll for Covid is vastly overstated. By virtue of coincidental deaths, it might be as much as 10% overstated, but by virtue of excess deaths we observe, it is very likely to be something like 20% *under*-stated. It *is* true that the majority of these deaths were elderly or otherwise vulnerable people, and you can make of that fact what you want based on how much value you place on the lives of the elderly.
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