The new tally includes not only deaths known to have been directly caused by the coronavirus, but also roughly 100,000 fatalities that are indirectly related and would not have occurred if not for the virus.
The study, published by the Centers for Disease Control and Prevention, is an attempt to measure “excess deaths” — deaths from all causes that statistically exceed those normally occurring in a certain time period. The total included deaths from COVID-19, the illness caused by the coronavirus, that were misclassified or missed altogether.
Many experts believe this measure tracks the pandemic’s impact more accurately than the case fatality rate does, and they warn that the death toll may continue an inexorable climb if policies are not put in effect to contain the spread.
“This is one of several studies, and the bottom line is there are far more Americans dying from the pandemic than the news reports would suggest,” said Dr. Steve Woolf, director emeritus of the Center on Society and Health at Virginia Commonwealth University, whose own research recently reached similar conclusions about excess deaths.
“We’re likely to reach well over 400,000 excess deaths by the end of the year” if current trends continue, Woolf said.
Paul Sutton, deputy director of the division of vital statistics at the CDC and an author of the analysis, said the study had set out to gauge the number of deaths that “we would not have expected to see under normal circumstances.”
The results indicate that the pandemic “is having a tremendous and significant impact on death in the country, and it may extend well beyond those deaths that are directly classified as COVID deaths,” Dr. Sutton said.
The analysis highlights two disturbing trends. The researchers discovered a high percentage of excess deaths in an unexpected group: young adults in the prime of life. And the coronavirus has greatly raised deaths over all among people of color.
Although the pandemic has mostly killed older Americans, the greatest percentage increase in excess deaths has occurred among adults ages 25 to 44, the analysis found.
While the number of deaths among adults ages 45 to 64 increased by 15%, and by 24% among those ages 65 to 74, deaths increased 26.5% among those in their mid-20s to mid-40s, a group that includes millennials.
Among those in the youngest age group, under 25, deaths were 2% below average.
People of color also had large percentage increases in excess deaths, compared with previous years. Hispanics experienced a 54% increase, while Black people saw a 33% rise. Deaths were 29% above average for American Indians or Alaska Native people, and 37% above average for those of Asian descent.
By comparison, the figure for white Americans was 12%, according to the analysis.
The report reviewed deaths from Jan. 26 to Oct. 3, and used modeling to compare the weekly tallies with those of corresponding weeks in 2015-19.
The researchers estimated that 299,028 more people than expected died in the United States during that period, with 198,081 deaths attributable to COVID-19 and the rest to other causes.
That estimate is significantly higher than the 216,025 coronavirus deaths officially reported by the CDC as of Oct. 15. (The figure now is nearing 221,000, according to a database maintained by The New York Times.)
Other researchers have also found greater deaths overall during the pandemic. A study published July 1 in JAMA Internal Medicine reported that deaths from all causes in the United States increased by 122,000 from March 1 to May 30, a figure that was 28% higher than the deaths attributed solely to COVID-19 during that period.
Dr. Woolf’s study, published in the journal JAMA, examined the period from March 1 to April 25 and found that COVID-19 deaths represented only two-thirds of the excess deaths in the United States during that period.
In 14 states, including Texas and California, more than half of excess deaths were linked to underlying health conditions unrelated to COVID-19. Dr. Woolf discovered large increases in deaths from diabetes, heart disease, Alzheimer’s disease and cerebrovascular disease.
In New York City, for example, deaths from heart disease increased by 400%, and deaths from diabetes rose by 356%, Dr. Woolf’s analysis found.
In many cases, patients may have delayed seeking medical attention or going to the emergency room, either out of fear of contracting the virus or because medical care was not available. Substance abuse disorders and psychological stress may also be playing a role in excess deaths, he said.
Going forward, Woolf said, “It’s important for people who have these conditions to not delay or forgo medical care because of their fears of the virus.”
“In many cases, the danger of not getting care is much greater than the risk of exposure to the virus,” he said.