Clinical Scorecard: Patterns of Excess Mortality from Non-COVID Causes in the United States: A Spatiotemporal Analysis from March to December 2020

At a Glance

Key Highlights

• Approximately 500,000 excess deaths occurred in the US in 2020; 70% attributed to COVID-19 and 28% to other causes.
• Increases observed in deaths from cardiovascular disease, diabetes, Alzheimer disease, liver disease, and homicide; decreases in cancer, influenza/pneumonia, chronic lower respiratory disease, and suicide.
• Regional variation noted, with disproportionate increases in homicide and motor vehicle accident deaths in the Great Lakes region and sustained cancer death reductions in Mideast and New England.

Guideline-Based Recommendations

Diagnosis

• Use detailed mortality data with ICD-10 coding to classify causes of death accurately.
• Monitor temporal and geographic trends in cause-specific mortality to identify excess deaths.

Management

• Address healthcare system disruptions to reduce excess deaths from cardiovascular disease, diabetes, and Alzheimer disease.
• Implement social and economic interventions to mitigate increases in homicide and liver disease deaths.

Monitoring & Follow-up

• Conduct spatiotemporal analyses of mortality data to detect shifts in cause-specific death patterns.
• Compare trends in non-COVID excess deaths with COVID-19 mortality to understand underlying mechanisms.

Risks

• Potential misclassification of COVID-19 deaths as other causes may affect mortality estimates.
• Social and economic stressors during the pandemic may increase risk of homicide and liver disease deaths.
• Healthcare disruptions may exacerbate chronic disease mortality.

Patient & Prescribing Data

General US population affected by pandemic-related excess mortality

Excess deaths from chronic diseases likely reflect healthcare access issues; addressing these may reduce mortality.

Clinical Best Practices

• Utilize comprehensive mortality surveillance systems integrating cause-specific data for timely public health response.
• Consider regional differences in excess mortality when planning interventions.
• Recognize the multifactorial causes of excess mortality beyond COVID-19 infection itself, including social determinants and healthcare disruptions.

References

• CDC Excess Deaths Data
• National Center for Health Statistics Mortality Data
• US Census Bureau Population Estimates