According to the current statistics from the National Center for Health Statistics, the number of fatalities in the U.S. last year declined to 3,078,290 from 3,269,042 in 2022.¹  That number is very close to the pre-pandemic trendline.

Prior to the pandemic, the number of people who died in the U.S. was very consistent. From 1960-2019, the U.S. fatality rate (fatalities/1,000 population) was about 8.75. The rate ranged from a high of 9.5 to a low of 7.9. From 1970-2010, there was a slight downtrend in the rate. However, beginning in 2011, the rate began to reverse and started asteady increase. This was likely associated with an aging population and a slight decline in life expectancy. But the fatality rate jumped significantly during the pandemic. For 2020-2022, the rate averaged 10.2, about a 22% increase from before the pandemic.

The rate for 2023 was 9.1. In the ten years prior to the pandemic, the rate was increasing by about .08% per year. If there had been no pandemic and that trend would have continued, the rate last year would have been almost exactly 9.1. Of course, we only live on one timeline, so it is impossible to know what would have happened without a pandemic.

I think there are two conclusions we can likely draw from this data. First, the good news is the rate at which people are dying in America is pretty much back to normal. The bad news is that during 2020-2022, around 1.4 million more people died than we would have expected had there been no pandemic.

The CDC estimates that about 1.2 million died from COVID. Of course, there is some disagreement about whether COVID was the principal cause of death or only a contributing cause in many of these cases because so many who died from the disease had multiple co-morbidities. But regardless, there was undoubtedly an increase in fatalities that exceeded the number the disease itself caused.

I suspect that a detailed study would show that many of these fatalities were caused by unintended consequences of our reaction to the virus. We know that drug overdoses were up during the pandemic as depression soared. Also, certain chronic fatality drivers, like cardiovascular issues and cancer, were up due to a decline in routine early detection associated with the lockdowns. In less developed countries, collateral fatalities were almost certainly even higher. This UN report estimated that 43 million people in Africa were at risk of extreme famine because of the fallout from the pandemic in May 2022.

It is unquestionable that the pandemic exacted an enormous toll on our country and the entire world, and not just in the additional fatalities it caused. Much of the damage was attributable to the lethality and the transmissibility of the disease. But a great deal of the damage was also due to our reactions to it. Frequently, our leaders reacted on very imperfect information and that often lead to misguided polices where their “cures” that were worse than the disease. I have been reluctant to criticize actions that were taken in the heat of the moment, but hopefully the next time we face a similar crisis, our leaders will be somewhat more cognizant of the potential harm from the unintended consequences of policy decisions.

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Note 1 – The NCHS accumulates mortality data from each state, which in turn accumulate their data from the filing of death certificates by local governmental entities. There are frequently significant delays in death certificates. So, the 2023 fatalities will drift up some in coming months, but it is unlikely that those delays will significantly skew this data.

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