Excess Deaths During COVID-19, January–October 2020: By Age and Race

By October 15, 2020, the United States had reported 216,025 deaths from COVID-19. But official counts can miss deaths — limited testing, including after death, and incomplete death certificates both play a part. Excess deaths — all deaths above what would normally be expected for a given place and time — capture the pandemic's toll more completely, including deaths it caused indirectly. CDC's National Center for Health Statistics has published excess death estimates since April 2020; this report looks at January 26 to October 3, 2020.

Excess deaths in the United States, late January to early October 2020. Credit: Centers for Disease Control and Prevention.

How it was measured

Expected deaths were modeled from past patterns in provisional National Vital Statistics System data, accounting for seasons; recent weeks were weighted to allow for reporting delays. Weekly 2020 deaths by age and by race and ethnicity were compared with the average for the same weeks in 2015–2019. Deaths with COVID-19 listed as an underlying or contributing cause (ICD-10 code U07.1) were counted as COVID-19 deaths.

The toll

• About 299,028 more people died than expected from January 26 through October 3, 2020.
• 198,081 (66%) of those excess deaths were attributed to COVID-19.
• Excess deaths occurred every week from March onward, peaking in the weeks ending April 11 (40.4% above expected) and August 8 (23.5%).

Weekly deaths from all causes and excluding COVID-19, against the expected number. Credit: Centers for Disease Control and Prevention.

By age

Older people accounted for the most excess deaths — from about 841 among people under 25 to 94,646 among adults aged 75–84. But compared with past years, the largest increase was among adults aged 25–44: 26.5% above average. COVID-19 deaths shifted toward younger ages from May through August, though trends in other causes of death may also play a part.

Change in weekly deaths in 2020 compared with 2015–2019, by age group. Credit: Centers for Disease Control and Prevention.

By race and ethnicity

White people had the most excess deaths in number (171,491) but the smallest percentage increase; American Indian and Alaska Native people had the fewest in number (about 3,412). The disproportionate increases match known disparities in COVID-19 deaths.

Change in weekly deaths in 2020 compared with 2015–2019, by race and ethnicity. Credit: Centers for Disease Control and Prevention.

Limitations

• Provisional data lag; the most recent weeks are likely undercounted.
• Models carry uncertainty, and other methods may give different results; subgroup figures may not sum to totals published elsewhere.
• Comparing with past averages may underestimate expected deaths, given population growth, aging and rising causes such as drug overdoses.
• Some deaths from other causes — circulatory diseases, Alzheimer disease and dementia, respiratory diseases, all up in 2020 — may be misclassified COVID-19 deaths or deaths caused indirectly, for example by disrupted health care.

Why it matters

The findings show how many COVID-19 deaths may go uncounted and can guide efforts to prevent deaths directly and indirectly tied to the pandemic — including by limiting disruptions to health care — and to eliminate health inequities. At the time, CDC recommended masks, frequent handwashing and social distancing to prevent COVID-19.

Sources

Based on Rossen LM, Branum AM, Ahmad FB, Sutton P, Anderson RN, "Excess Deaths Associated with COVID-19, by Age and Race and Ethnicity — United States, January 26–October 3, 2020," Morbidity and Mortality Weekly Report 69(42), Centers for Disease Control and Prevention; a work of the United States government in the public domain. Original report.