Excess Deaths in 2020 Spiked 23% Due to COVID-19; Black Population Among Hardest Hit

The 2020 increase is the largest since 1918 — when, in the midst of World War I, hundreds of thousands of people died from Spanish influenza. 

It's grim news. But not altogether shocking given the dire pandemic from which the country is slowly emerging.

The rate of excess deaths in the U.S. — which are deaths above the number that would be expected based on averages from the previous five years — is usually consistent, fluctuating 1% to 2% from year to year. But from March 1, 2020, to Jan. 2, 2021, excess deaths rose a staggering 23% nationally, fueled by COVID-19 and deaths from other causes, with regions experiencing surges at different times, according to a Virginia Commonwealth University study. 

According to CDC data, the 2020 increase is the largest since 1918 — when, in the midst of World War I, hundreds of thousands of people died from Spanish influenza. 

  • Black Americans had the highest excess death rates per capita of any racial or ethnic group in 2020. The percentage of excess deaths among Blacks (16.9%) exceeded their share of the U.S. population (12.5%). 
  • COVID-19 was responsible for 72% of excess deaths. But some of the excess death not attributed to COVID-19 may actually have been from COVID-19, even if the virus was not listed on the death certificates due to reporting issues.  
  • Surges in excess deaths varied in the United States. States in the northeast, such as New York and New Jersey, were among the first hit by the pandemic. The pandemic in those states peaked in April and returned rapidly to baseline within eight weeks because restrictions put in place. But the increase in excess deaths lasted significantly longer in other states that lifted restrictions early and were hit hard later in the year.
  • Mississippi, New Jersey, New York, Arizona, Alabama, Louisiana, South Dakota, New Mexico, North Dakota and Ohio were the 10 states with the highest per capita rate of excess deaths.
  • Death rates from heart disease, Alzheimer's disease and diabetes, also increased during surges.

"COVID-19 accounted for roughly 72% of the excess deaths we're calculating, and that's similar to what our earlier studies showed. There is a sizable gap between the number of publicly reported COVID-19 deaths and the sum total of excess deaths the country has actually experienced," said Steven Woolf, M.D., the study's lead author.

Woolf said the number of deaths among Black Americans was consistent with the evidence about COVID-19 but, "also indicates that excess deaths from some conditions other than COVID-19 are also occurring at higher rates in the African American population."