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40,000+ excess deaths in 2020, and other things we learned from California death data

How deadly was 2020?

Newly published mortality data from the California Department of Public Health suggests that over 40,000 more people died in California last year than would have been expected before the coronavirus infected millions of people around the state.

The dramatic 15% increase in deaths over the average of the previous three years is significantly more than the nearly 26,000 deaths that state health officials attributed to COVID-19 as of the end of the year.

That number will ultimately grow, because COVID-19 deaths are determined carefully by public health departments, coroners and medical examiners and can take weeks or even months to be reflected in the publicly reported death tally. But even without much detail, we can clearly see the impact of the pandemic by looking at data on all deaths that happened in California last year, and we can learn a lot by comparing those deaths to recent years.

How many more died each day in 2020?

40,538 more people died in 2020 than the average of the previous three years.

That represents a sobering 111 more deaths each day, on average, than normal.

In reality, those deaths mostly happened later in the year, when the virus was spreading more widely.

Excess deaths, the number of deaths above what could be predicted using historical data, are notable since April, with a swell in July and August, and again in November and December. More than 7,000 excess deaths were reported in December, the highest of any month. As the chart below shows, it was also much higher than the normal yearly spike in deaths driven by the flu every winter.

Overall 310,701 people died in California in 2020 from all causes, according to the most recent data published by the state on Jan. 24.

2020’s leading killer?

The state groups deaths into a handful of broad categories. In 2020, the “other” category, which included coronavirus, became the leading cause of death, growing nearly 80% from the 2017-2019 average to more than 86,000 in 2020. The “other” category includes COVID-19 deaths, deaths other viruses and infections, many genetic diseases, and all deaths that don’t fit into the other categories. In all three previous years, heart disease was the leading cause of death, followed by cancer.

The second biggest proportional change was for suicides, which were surprisingly down more than 15% in 2020, despite concerns from mental health experts about a possible increase due to the psychological impact of social distancing and lockdowns.

Flu deaths were also down, not a surprise since social distancing helps stop the spread of the influenza virus, and more flu vaccines were administered in 2020 than recent years.

Alzheimer’s deaths increased, a significant 10%, possibly a predictable outcome that many experts warned of when lockdowns limited therapeutic and life-sustaining social interactions for many elderly people with Alzheimer’s and dementia, especially in nursing homes.

Disproportionate pain for Latinos

The data show that Latinx deaths increased 37% in 2020 from the average of the three previous years. That number represents nearly 20,000 additional Latinx resident deaths over the year.

Epidemiologists and public health researchers are starting to look at even more detailed death data. A research letter published in December by the The Journal of the American Medical Association found that “per capita excess mortality was highest among people aged 65 years and older, men, Black and Latino residents, and those without a college degree.”

Yea-Hung Chen, an epidemiologist at the University of California-San Francisco, and co-author of the paper, said the results of the analysis were “sobering.”

He and his colleagues wanted to see how policies, like the early shelter-in-place order, affected different groups. “During the early shutdown period you see excess deaths decline,” Chen said, “but you don’t see it declining among Latinos.” The authors posit that “reflects the risk of COVID-19 death faced by low-wage, essential workers and their social networks owing to occupational exposure, crowded housing, and inadequate access to testing or treatments.

“We were definitely surprised by the extent of the disparities,” Chen said.

After California’s shelter-in-place order, the researchers found that “Latino residents, and those without a high school degree/GED had the greatest increase in excess per capita mortality,” and excess death rates for those groups more than tripled after reopening.

Deaths of Black people in California increased by 19% — nearly 4,000 additional deaths compared to previous years; 22.7% more Asian people died in 2020 or 6,000 excess deaths.

White (non-Hispanic) Californians had the smallest increase in deaths of any group, with a 5.6% climb in 2020. Though the increase was the smallest proportionally, 9,000 more White residents died than in recent years.

When it comes to skeptics of the severity of the pandemic, Chen says the data on excess deaths make it clear. “There’s no fancy math here,” he said, “It’s clear as day.”


Source: Orange County Register

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