Just How Do Deaths Due to COVID-19 Stack Up?
Governance

Just How Do Deaths Due to COVID-19 Stack Up?

Coronavirus is now the #1 killer in New York, Brazil, and Peru; the #2 top cause of death in England; and #3 in Sweden

Image shows a handful of officials in whole-body protective gear standing in an empty stadium.
Arena do Gremio stadium before the Brasileiro Championshi in Porto Alegre, Brazil, on September 13, 2020. Brazil is one of the countries where COVID-19 is on track to become the #1 killer in 2020. REUTERS/Diego Vara

With all the ways that coronavirus has impacted how we live, it's no great venture to predict that the COVID-19 pandemic will be one of the top stories of the century when all is said and done. Already in 2020 it has changed society, infected tens of millions, directly claimed nearly a million lives globally—and perhaps many more indirectly by disrupting health systems and care—and changed how we collectively live our lives. By the end of 2020, some projections suggest that it may be responsible for several million deaths worldwide.

‘There is wide variation across regions’

As of September 14 more than 946,000 global deaths have been attributed to COVID-19, making it the twelfth leading cause of death worldwide so far in 2020 according to findings from the Institute for Health Metrics and Evaluation (IHME). This is based on the assumption that other causes of death have equal rates of occurrence throughout the year. There is wide variation across regions, however. On the high mortality end, COVID-19 already ranks as the second-leading cause of death in Latin America and the sixth leading cause in high-income countries. On the lower mortality end, COVID-19 ranks as the forty-first-leading cause sub-Saharan Africa, and the fifty-eighth-leading cause in Southeast Asia, East Asia, and Oceania

Where COVID-19 Sits Among the Global Leading Causes of Death

The expected number of deaths from coronavirus and other causes ranked through September 14, 2020

NOTE: the numbers of deaths caused by COVID-19 vary slightly between IHME and other widely used sources, like the Center for Systems Science and Engineering at Johns Hopkins University (JHU). While IHME uses the data from JHU for most locations, excess mortality estimates for several countries, like Peru and Ecuador, increase IHME’s counts.

>33,000

So far in 2020, COVID-19 was responsible for more than 33,000 deaths in New York State alone

COVID-19 has been the leading cause of death in some U.S. states (New York, New Jersey, Massachusetts), parts of Italy like Lombardia, and places in Latin America (Mexico City, Ecuador, Peru, and Chile). So far in 2020, COVID-19 was responsible for more than 33,000 deaths in New York State alone, nearly matching the number of deaths due to ischemic heart disease for the entire 2019 calendar year. In Peru, COVID-19 has already caused 12,000 more deaths than lower respiratory infections, the next leading cause of death, caused in the entire calendar year 2019. Even if no more COVID-19 deaths occurred in 2020, it would be the second leading cause of death in England, third leading cause of death in Sweden, and the fourth leading cause in Iran.

How COVID-19 Ranks as a Cause of Death—High-Income Countries

The expected number of deaths from coronavirus and other causes ranked through September 14, 2020

There are 170 total causes of death considered in the map below. Data are from the Institute for Health Metrics and Evaluation (IHME) COVID-19 dataset based primarily on deaths collected by the Johns Hopkins University dashboard. Deaths in China and Turkmenistan were not available. The map shows subnational administration level 1 in the United States, Mexico, Brazil, Italy, Pakistan, and India.

The image shows a map with countries colored according to how high COVID-19 ranks as a cause of death.
This map shows the ranking of COVID-19 as of Sept. 14, 2020 among all causes of death in the Global Burden of Disease study (rankings assume that all causes are evenly distributed through the year). IHME image

How Close Are We to the True Numbers?

Deaths that are officially caused by COVID-19 might be an underestimate of the true impact of the disease on all causes of mortality. Still, COVID-19 is likely responsible for about 2 percent of all deaths in 2020.

COVID-19's Cause of Death Ranking in Latin America/Caribbean

The expected number of deaths from coronavirus and other causes ranked through September 14, 2020

In the United States, COVID-19 is approaching 200,000 deaths as of this writing, nearly as many deaths as chronic obstructive pulmonary disease and stroke caused in all of 2019. COVID-19 has been responsible for more deaths than the next leading infectious cause of death, lower respiratory infections, a group of infections that include deaths due to influenza viruses and Streptococcus pneumonia bacteria.

In comparison, drug overdoses caused about 66,000 deaths in the United States in 2019 (about 47,000 due to opioid overdoses). Suicide and interpersonal violence caused about 67,000 deaths combined (including 23,000 firearm associated suicides and 13,000 interpersonal firearm deaths), and road traffic injuries caused about 41,000 deaths.

How COVID-19 Ranks as a Cause of Death in the United States

The expected number of deaths from coronavirus and other causes ranked through September 14, 2020

The bottom line is that just as much as the novel coronavirus has impacted how we live, the COVID-19 pandemic has also reshaped how people die. The impact of COVID-19 on mortality so far in 2020 has been extraordinary, but we do have the opportunity to affect the rest of 2020 and beyond.

‘We must not become inured to the scope of COVID-19 or succumb to defeatism’

In order to reduce deaths from COVID-19, we should look at other large-scale public health efforts that have reduced preventable causes of death, including around reducing tobacco smoking, vaccines for infectious diseases, and motor vehicle safety. The future is not set, and we must not become inured to the scope of COVID-19 or to succumb to defeatism. Collectively, as a global community, we must work together to prevent as many deaths as possible including protecting the most vulnerable members of society, by wearing masks, physically distancing when possible, and being thoughtful in how our actions affect those around us.

Picture shows the New York skyline seen from behind safety netting in an open construction atop a skyscraper looking across.
Lower Manhattan seen from the top of 77-story One Vanderbilt tower in midtown Manhattan in New York—a state which is on track to have enough COVID-19 deaths to make it the number one killer in 2020. REUTERS/Mike Segar

EDITOR’S NOTE: The author is employed by the University of Washington’s Institute for Health Metrics and Evaluation (IHME), which produced the COVID-19 forecasts described in this article. IHME collaborates with the Council on Foreign Relations on Think Global Health. All statements and views expressed in this article are solely those of the individual author and are not necessarily shared by their institution.

Christopher Troeger is a doctoral student at the University of Washington and a pre-doctoral research assistant at the University of Washington's Institute for Health Metrics and Evaluation (IHME).

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