Charts Paint a Grim Picture Two Years Into the Coronavirus Pandemic

Lambert here: People aren’t masking, so the pandemic is no more. Everything is fine.

By Louis Jacobson, PolitiFact. Originally published at Kaiser Health News.

The coronavirus pandemic is now stretching into its third year, a grim milestone that calls for another look at the human toll of covid-19, and the unsteady progress in containing it.

The charts below tell various aspects of the story, from the deadly force of the disease and its disparate impact to the signs of political polarization and the United States’ struggle to marshal an effective response.

Covid rocketed up the list of leading killers in the U.S. like nothing in recent memory. The closest analogue was HIV and AIDS, which ranked among the top 10 causes of death from 1990 to 1996. But even HIV/AIDS never reached higher than eighth on that list.

By contrast, covid shot up to third in 2020, its first year of existence, covering only about nine months of the pandemic. Only heart disease and cancer killed more Americans that year.

“The leading causes of death are relatively stable over long periods of time, so this is a very striking result,” said Dr. William Schaffner, a professor of preventive medicine and health policy at Vanderbilt University.

Covid generally hit people of color harder, a pattern experts trace back to historical disparities in income, geography, medical access, and educational attainment.

“This tells us something about our society — it’s a kind report card,” Schaffner said. Studies have shown that illness and prevention are even more strongly correlated with educational background than with income.

“There was some effort to correct the disparities,” said Arthur Caplan, a professor of bioethics at New York University’s Grossman School of Medicine. “But these were band-aids on a system that remains broken.”

Older people tend to be more vulnerable to disease than younger people, because of weaker immune systems and underlying health problems. That’s been especially true with covid.

“Many other infections affect the very young and the very old disproportionately, but covid-19 stands out in being so age-dependent,” said Dr. Monica Gandhi, a professor of medicine at the University of California-San Francisco. “Children were remarkably spared from severe disease in the U.S., as they were worldwide.”

Deaths among older Americans, however, were especially widespread in the early days of the pandemic due to the close contact of seniors living in nursing homes.

“Some will argue that [the] old are frail anyway, but I find that morally repugnant,” Caplan said. The deaths of so many older people “makes me extremely sad.”

The good news, experts say, is that older Americans were the most likely to get vaccinated, with a 91% full vaccination rate for those between ages 65 and 74. This almost certainly prevented many deaths among older people as the pandemic ground on, Schaffner said.

Although the pandemic has had its peaks and valleys, due to largely seasonal factors and the emergence of new variants, it has continued to produce deaths at a fairly steady rate since its beginning two years ago.

The pandemic is “impressive in how it just keeps going,” Schaffner said.

The slow grind is “why we’re exhausted,” Caplan said. “It’s like we can’t make a significant dent, no matter what we do.”

There have been five distinct peaks: the initial one in April 2020, a summer spike in August 2020, a winter spike in January 2021, the initial outbreak of the delta variant in September 2021, and the omicron surge in January 2022.

The on-off nature of the pandemic “has led to a lot of the confusion and grumpiness,” Schaffner said. Caplan compared it to the exhaustion of the American public when hearing body counts during the Vietnam War.

Once a natural disaster like a hurricane or a tornado has passed, Schaffner added, it’s gone and people can rebuild. With covid, it’s just been a matter of time before the next wave arrives. The coronavirus also affected the whole world, unlike a localized disaster.

Such factors “stretched the capacity of the public health system and our governance,” Schaffner said.

Not surprisingly, the number of deaths in each state was heavily dependent on the size of the state’s population. California and Texas each lost more than 80,000 people to covid, while Vermont lost 546.

But once you adjust for population, distinct differences emerge in how various states fared during the pandemic.

The seven states with the worst death rates include densely populated New Jersey, an affluent, educated Northeast state, and Arizona, a fairly diverse Southwestern state. The other five are Southern states that rank among the 11 states with the lowest levels of educational attainment and median income: Mississippi, Alabama, Louisiana, Tennessee, and West Virginia.

Among the states with the lowest death rates, Hawaii and Alaska (and, to an extent, Vermont and Maine) are isolated and may have had an easier time keeping the virus out.

“For all the grumbling you hear about federal mandates and enforcement, you can’t help but look at this list and see that the pandemic has been handled state by state,” Caplan said.

The world’s performance in battling covid is analogous to the United States’: Some places did it well, and others did not.

And in the international context, the United States’ record was not so hot.

When comparing death rates around the world, it’s clear how much worse the U.S. has fared than other wealthy industrialized nations.

The countries that have a higher death rate than the U.S. are largely medium-size and middle-income. The industrialized Western nations that are the United States’ closest peers all managed to do better, including the United Kingdom, France, Germany, Italy, and Canada.

Meanwhile, other affluent countries did far better than the U.S. did, including Japan, South Korea, and Taiwan (which have more experience with airborne diseases and greater public tolerance for masking), and two island nations: Australia and New Zealand.

In general, Schaffner said, countries that performed better than the U.S. tended to have “sustained, single-source, science-based communication. They communicated well with their populations and explained and justified why they were doing what what they werethey were doing.”

It’s impossible to look at the United States’ response to covid without factoring in the extent to which it became politicized. Almost from the beginning, basic communications about the severity of the disease and how to combat its spread broke down along partisan lines. The way Americans responded also followed a partisan pattern.

Most states that voted for Joe Biden for president in 2020 had above-average vaccination rates. Most states that voted for Donald Trump in 2020 had below-average rates.

Among the outliers in that pattern were Arizona, Nevada, Michigan, and Georgia, which supported Biden but had below-average vaccination rates. All four had very tight races in 2020; and Trump won three of them in 2016. The outliers on the other side were Florida and Utah, which supported Trump but had higher-than-average vaccination rates. 

Efforts to promote vaccination as advancing the common good “got beaten back by arguments about autonomy and individual freedom,” Caplan said.

The rejection of vaccines by many Americans helped bring down U.S. vaccination rates compared with other countries as well.

The U.S. full-vaccination rate of just under 66% was higher than the world average of about 54%, but not especially impressive considering the United States’ wealth and the fact it was producing many of the key vaccines in the first place. Essentially every other high-income country has vaccinated a higher share of its residents than the U.S. has.

The fact that the United States has both a lower rate of full vaccination and a higher death rate than other high-income countries “makes me wonder how we might have done as a country if our pandemic response had not been so politicized and polarized,” said Brooke Nichols, an infectious-disease mathematical modeler at Boston University.

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About Lambert Strether

Readers, I have had a correspondent characterize my views as realistic cynical. Let me briefly explain them. I believe in universal programs that provide concrete material benefits, especially to the working class. Medicare for All is the prime example, but tuition-free college and a Post Office Bank also fall under this heading. So do a Jobs Guarantee and a Debt Jubilee. Clearly, neither liberal Democrats nor conservative Republicans can deliver on such programs, because the two are different flavors of neoliberalism (“Because markets”). I don’t much care about the “ism” that delivers the benefits, although whichever one does have to put common humanity first, as opposed to markets. Could be a second FDR saving capitalism, democratic socialism leashing and collaring it, or communism razing it. I don’t much care, as long as the benefits are delivered. To me, the key issue — and this is why Medicare for All is always first with me — is the tens of thousands of excess “deaths from despair,” as described by the Case-Deaton study, and other recent studies. That enormous body count makes Medicare for All, at the very least, a moral and strategic imperative. And that level of suffering and organic damage makes the concerns of identity politics — even the worthy fight to help the refugees Bush, Obama, and Clinton’s wars created — bright shiny objects by comparison. Hence my frustration with the news flow — currently in my view the swirling intersection of two, separate Shock Doctrine campaigns, one by the Administration, and the other by out-of-power liberals and their allies in the State and in the press — a news flow that constantly forces me to focus on matters that I regard as of secondary importance to the excess deaths. What kind of political economy is it that halts or even reverses the increases in life expectancy that civilized societies have achieved? I am also very hopeful that the continuing destruction of both party establishments will open the space for voices supporting programs similar to those I have listed; let’s call such voices “the left.” Volatility creates opportunity, especially if the Democrat establishment, which puts markets first and opposes all such programs, isn’t allowed to get back into the saddle. Eyes on the prize! I love the tactical level, and secretly love even the horse race, since I’ve been blogging about it daily for fourteen years, but everything I write has this perspective at the back of it.

25 comments

  1. Roger Blakely

    Great summary of the current situation.

    Workers with jobs facing the public are facing a nightmare situation. There is the widespread perception that pandemic is over. However, there is plenty of SARS-CoV-2 to be inhaled in all indoor public spaces. Some people are genetically more vulnerable to SARS-CoV-2 than others. If people are not wearing respirators and goggles in indoor public spaces, they are going to get sick, feel sick all of the time, and go through cycle after cycle of infection.

    At the same time, no one is wearing masks. Employers are putting pressure on employees not to wear masks in an effort to maintain a happy atmosphere. Certainly employers are not putting their employees in respirators and goggles. Employers now feel free to discipline employees for missing work for being sick. Employees who are genetically vulnerable to the virus are living through an impossible situation.

    1. anon y'mouse

      If people are not wearing respirators and goggles in indoor public spaces, they are going to get sick, feel sick all of the time, and go through cycle after cycle of infection.

      that was exactly my experience working front-facing positions pre-covid. there were many years where i would have so many colds that i thought i had developed strep throat.

      and all of the right-side idiots who think one has direct control over their immune system don’t take into account constant stress of customer facing employees that derives from not only their work, but their precarity and their status, not to mention irregular hours. it doesn’t matter how well they eat at home nor exercise. this is why i despise “wellness” as it has been forced upon us—it seems to presume that one can choose not to be stressed out if they just work on it a little. you know, keep an affirmation journal and meditate a bit. that and eating five vegetables a day and you’re golden!

    2. BeliTsari

      In addition MANY precariate were ESSENTIAL (the new black, Latinx or refugee) so uninsured, without sick pay, childcare, jammed into mass transit and malnourished. They’d no PPE. “Their” party was a corrupt corporation, feeding them to FIRE, PhARMA & Private Equity ravished hospitals that killed ~83% of the cursorily intubated, harvested homes & indentured chronically PASC workers into 1099 virtual share-cropping gigs. Now, we’re just debilitating their kids with MIS-C, autoimmune or inflammatory damage for a lifetime of servitude.

      https://www.cidrap.umn.edu/news-perspective/2022/03/news-scan-mar-02-2022

  2. The Rev Kev

    Quite a good article this though with a caveat. In today’s Línks there is an article called ‘Adverse Reactions to COVID Vaccines I Have Come Across’ which highlights all those people damaged or even killed by reactions to those vaccines and the reports coming out of Pfizer before the Ukrainian war were disturbing enough. So when I saw that top chart called ‘COVID-19 was the third-leading cause of death in the U.S. in 2020’, I seriously began to wonder whereabouts vaccine-deaths would rate if we knew what the actual numbers are.

    1. Arizona Slim

      Shhhh! Reverend, you’re not supposed to talk about that stuff!

      And heaven forbid if we were ever to discuss early treatment, which may include a certain drug that must not be mentioned.

      BTW, I was trying to post a couple of recent NC stories in YouTube comments, and, man, their censors are good. They really don’t like any discussion of adverse reactions over at the Toob.

      1. Joseph DeSimone

        Exactly! Plus the COVID-19 hospitalization and deaths statistics are highly skewed due to the CDC’s directive to change the criteria for “what is a COVID patient” as well as “what is a COVID death.” Also, the hospitals were financially incentivized to report the inflated numbers. The numbers are greatly inflated. Sad.

    2. Wysiwig

      Yes and US is majority overweight and 40% obese. The CDC said 78% of Covid hospitalizations are in the overweight or obese. Countries with over half the population overweight, such as the US and UK, have had a 10x worse Covid outcome.

    3. Terry

      Sorry, but that is a scientifically illiterate assertion. The literature is clear that the adverse reactions, and especially deaths, are vanishingly small — per capita, compared to other historical vaccines, and particularly when compared to the lives saved by said vaccines. It’s always the same distortions and analytically impoverished delusional nonsense from vaxx deniers. Any educated person still flogging such drivel should be ashamed of themselves by now, given the overwhelming and diverse evidence of these vaccines’ safety and efficacy — from objective scientific sources all around the world, not just the CDC (the favorite obsession/scapegoat of the benighted).

      1. Yves Smith

        That is complete bullshit. One of my friends has three children in their 30s. One has had a near cessation of her periods. Another has had her autoimmune disease symptoms go from infrequent and mild to near-constant and moderate to severe. Two medical professors wanted to get data on menstrual-related side effects. They thought if they got 5,000 respondents that would be a great result (from a study perspective). In less than a week, their query on Facebook got over 100,000 responses. Yours truly is in NYC to have a medical procedure. My sonogram reports attributes the abnormality I am having treated to the vaccine. That means this isn’t the first time they’ve seen this.

  3. Mikerw0

    One quibble and one anecdotal observation…

    The quibble: I don’t think people are saying it’s over. I think they are saying it’s time to just live with it as they are burnt out. They are giving up. Not saying this is a rational, well thought through position, but in the absence of useful guidance from our “leaders” it is understandable. There is an analogy here in dieting. People can’t stick to dieting as sustaining denial doesn’t work, which is how it is perceived.

    Anecdotally, in our circles, which are people who actually are very careful (mask, vaccinated, etc.) there are more COVID cases than at any time. As most are being determined by home testing I suspect that they are not being reported and the statistics are understating how prevalent COVID is.

  4. PlutoniumKun

    A big question mark for me is how accurately post covid deaths will be measured and monitored. I know of two deaths – one a cardiac arrest and one from blood clotting, both of people who had recently recovered from covid. In neither case was it recorded as a covid death, but the first was possible and the second was a probable (according to doctors I talked to). Both fairly young people. Just this week, Shane Warne, the Australian cricketer died of a heart attack 6 months after a serious covid infection. I worry that we will see a very significant number of people dying over the next few years who will not appear in any statistics – and it could be a long time before there is a clear signal in overall death rates. There seems to be a very strong incentive for health authorities – in particular those who have advocated the lifting of restrictions – to downgrade these deaths.

    1. vao

      Classification of death causes can be fudged, but two other aspects cannot:

      1) The mortality increase (currently “excess mortality”, possibly becoming the new normal mortality rate in the future) and the resulting decrease in life expectancy. This cannot be disguised, only not be talked about — except that funny, visible changes might be happening with premiums for life insurance.

      2) Higher morbidity rates (because of repeated bouts of Covid affecting a large fraction of the population) will cause a significant increase in health insurance premiums — for all those countries that rely upon insurance as the basis of their health service (e.g. USA, Switzerland, Netherlands) or as a complement to a national healthcare system (e.g. France). Healthcare insurance premiums tend to rise year after year, but I expect a marked acceleration from this year onwards.

  5. dcblogger

    DC had one of the lowest death rates, in spite of the fact that it is a densely populated city. I attribute this to the high rate of vaccination and the high rate of mask compliance. Maskholes are almost unknown in DC, and this has saved a lot of lives. Also, DC is a Democratic town and nobody cares what Faux News thinks.

    1. 1 Kings

      Maybe most of DC having Single Payer Insurance, um. the US Govt, has something to do with it.

    2. Terry

      Excellent point about the cultural compliance factors in DC. Appalling how many lives were needlessly lost in red states and enclaves because of the militant politicization of science and reality.

  6. Janice

    Any stats out there about the particulars of COVID-19 deaths, is Omicron is not primarily attacking the lungs?

  7. tiebie66

    Covid generally hit people of color harder, a pattern experts trace back to historical disparities in income, geography, medical access, and educational attainment. “This tells us something about our society — it’s a kind report card,” Schaffner said. Studies have shown that illness and prevention are even more strongly correlated with educational background than with income.

    These sort of things drive me crazy. “… historical disparities in income, geography, medical access, and educational attainment” do not necessarily follow despite the best tracing efforts of the experts. People of color might get hit harder in the northern hemisphere due to a lack of Vitamin D. See the role of Vitamin D3 (Pre-infection 25-hydroxyvitamin D3 levels and association with severity of COVID-19 illness; https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC8812897/). I wish someone might do a Principal Component Analysis to show how much of the variance could be apportioned to the different factors involved. Perhaps Vitamin D3 deficiency is by far the most important factor.

    1. marku52

      Agreed. I think it insane that our ‘health” authorities haven’ even given simple guidance like “take 2000IU of D and 500mg of C every day” Low D levels have been correlated with poor covid outcomes since the early days of the epidemic. Even Fauci admits to taking D.

      Why not this simple advocacy? All I can figure is, they just don’t care, and no Big Pharma money in it.

      That simple explanation covers a lot of ground across early treatment as well.

      1. Anthony G Stegman

        Another reason: Just as it is easier and quicker to take a magic pill in order to lose weight, rather than exercising regularly and having a balanced diet it is also easier and quicker to take a jab rather than making the time consuming effort to maintain a healthy immune system. Americans like things quick and easy. Perhaps the powers that be know this and so they push the quick and easy (and highly profitable) solutions.

    2. Anthony G Stegman

      This is anecdotal so you may take it with a grain of salt. During the past year I have been frequently riding BART to San Francisco. What I have noticed is a significant portion of the African-American and Latin riders either not wearing masks at all (despite it being required on mass transit) or wearing the masks improperly. I won’t hazard a guess as for the reasons for this.

  8. Copeland

    Does it appear that there seems to be at least some correlation between high vax and low deaths?

    See Canada, Denmark, Australia and New Zealand, 4 of the top 10 high vax nations are also low death nations.

    On the other end, only one, India, out of the top 10 low vax nations is also among the low death nations.

    I know, the data, what can we believe?

    1. Yves Smith

      I’m not certain how useful the official death count is. The US, as Lambert has taken to regularly pointing out in Water Cooler, has taken to classifying Covid hospitalizations after a certain period of time as “post Covid” even though it’s clearly Covid. I assume that is to minimize the official Covid death count.

      That’s why a lot of experts have also looked at excess deaths.

      A confounding factor is Australia and New Zealand went for eradication, with some success, for much longer than just about anywhere ex China and Vietnam. So their low numbers can’t be attributed solely to vaccinations.

  9. britzklieg

    Politifact?

    Really?

    The vaccinated are smart, rich and voted Biden. The un-vaccinated are uneducated, poor and voted Trump.

    “Almost from the beginning, basic communications about the severity of the disease and how to combat its spread broke down along partisan lines. The way Americans responded also followed a partisan pattern.”

    I remember the bi-partisan dismissal of masks as being important form the very beginning, not the “almost” beginning. Trump, Cuomo, DeSantis, DeBlasio, Pelosi, Fauci etc. and many others.

    This essay is a prime example of the polarization and politicization it purports to criticize.

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