Coronavirus Deaths — Our Disagreement About Total Deaths Isn’t Really About the Total Deaths

Political News


Emergency medical service workers transport a patient to Roseland Community Hospital in Chicago, Ill., April 7, 2020. (Joshua Lott/Reuters)

Perhaps we shouldn’t be surprised to see poll results suggesting significant numbers of Americans think the official numbers for the death toll are overestimating or underestimating the real number of fatalities from the coronavirus. Each side has at least one compelling argument in their favor.

For the overcount side, some jurisdictions are counting “suspected” coronavirus deaths in their official counts. At one point, the state of Pennsylvania removed 200 “probable” deaths from their tally, about as close as any state official will ever come to resurrecting the dead. Separately, it is fair to wonder if the deaths of those, say, 85 or older with preexisting health issues really ought to be counted alongside those (thankfully rarer) victims dying in their thirties. Did the virus really kill that person? Or was it mostly driven by the preexisting heart disease, diabetes, lifelong smoking habit, and so on?

For the undercount side, the overall total of American deaths from all causes has skyrocketed since the virus hit, and that increase is considerably higher than the official number of coronavirus deaths. That jump probably reflects a combination of other factors — such as people avoiding hospitals for fear of catching the virus may be slower to call for help with signs of a heart attack or stroke — and a number of undercounted deaths. (With so many people stuck at home, it’s not a surge of car accidents.) Today, New York announced more than 1,700 previously undisclosed coronavirus deaths in nursing homes around the state. Yesterday, those people every bit as dead, but not in the official count.

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We have factors leading to overcount, and factors leading to undercount, but those factors probably don’t balance out equally.

One of the reasons the death count has turned into such a point of controversy is that it has turned into a proxy argument about reopening society. Pointing to a high death toll is seen as an inherent argument against loosening any of the rules about lockdowns, business closures, and social distancing.

What if I told you . . . that there is going to be a heartbreakingly high death toll from the coronavirus and its consequences, no matter what path we choose from here on out? And that the choice before elected officials, business leaders, and ordinary citizens is not to find the option that won’t increase the number of deaths, but that will increase the number of deaths the slowest?

The United States has been enduring between 1,153 and 2,683 deaths per day since April 1. There are 26 days left in May. If we have only 1,000 deaths per day from now until June 1, we’re going to hit the painful threshold of 100,000 deaths by the end of the month.

If we have 1,500 deaths per day from now until June 1, we’re going to have about 109,000 deaths by the end of May.

If we have 2,000 deaths per day from now until June 1, we’re going to have about 122,000 deaths by the end of May.

That Johns Hopkins Bloomberg School of Public Health model that created such a stir in the past twenty-four hours warned the United States could be suffering more than 3,000 deaths each day by the end of the month. The closer each day is to that tally, the closer we get to ending May with 150,000 or so deaths.

Hopefully, the death rate will start to steadily and continuously decline soon. (A lot of weeks, there is a cyclical decline of reported deaths on the weekends.) Remdesivir is going to help some. Blood plasma therapy might be another good avenue of treatment. The Food and Drug Administration says that as of April 19, there are 72 active trials of therapeutic agents and another 211 development programs for therapeutic agents in the planning stages. Our doctors and nurses know how to fight this better. But as we open society, the number of infections is inevitably going to increase.

It doesn’t help that some not-so-sharp observers point to charts of the number of cases and number of deaths continuously climbing to support whatever argument they want to make. While many who catch SARS-CoV-2 will recover, they will still be counted in the case total; “cases” and “active cases” are different measurements. “Total number of cases” is always going to go up until there’s a vaccine or herd immunity, and then it will level off. Meanwhile, the death toll is only going to go up, unless the State of Pennsylvania really does discover the power to resurrect the dead.


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