The number of U.S. Covid-19 deaths recorded in 2021 has surpassed the toll in 2020, according to federal data and Johns Hopkins University, demonstrating the virus’s persistent menace.
The total number of reported deaths linked to the disease topped 770,800 on Saturday, Johns Hopkins data show. This puts the pandemic-long total at more than twice the 385,343 Covid-19 deaths recorded last year, according to the most recent death-certificate data from the Centers for Disease Control and Prevention.
Covid-19 has proven to be an enduring threat even in some of the most vaccinated places, many of which are confronting outbreaks again now, as the world prepares to live with and manage the disease for the long term. In Europe, parts of Austria, Germany and the Netherlands have imposed new restrictions in recent days after Covid-19 cases rose and hospitals came under strain.
The 2021 U.S. death toll caught some doctors by surprise. They had expected vaccinations and precautionary measures like social distancing and scaled-down public events to curb the spread of infections and minimize severe cases. But lower-than-expected immunization rates as well as fatigue with precautionary measures like masks allowed the highly contagious Delta variant to spread, largely among the unvaccinated, epidemiologists say.
“Heading into this year, we knew what we needed to do, but it was a failure of getting it done,” said Abraar Karan, an infectious-diseases doctor at Stanford University.
Among missteps, Dr. Karan said, public-health officials failed to effectively communicate that the purpose of vaccines is to protect against severe cases of Covid-19 rather than to prevent the spread of infection entirely, which may have led some to doubt the effectiveness of the shots. Authorities also failed to use testing to effectively prevent super-spreader events, Dr. Karan said.
Joey Rodriguez, a high school soccer coach in Arlington, Texas, died from Covid-19 complications in October. The 44-year-old father of three was fully vaccinated but had a rare immune-system condition that made him more vulnerable to infections.
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He fell ill in August with what seemed like a sinus infection, his wife, Lena Rodriguez, said. When he died after weeks of intubation, some of his friends who had harbored doubts about the severity of the pandemic and the importance of vaccines changed their minds about the risks of Covid-19 and began to take a more cautious approach to the disease, she said.
“It definitely opened a lot of eyes that this pandemic is very real,” Ms. Rodriguez said.
The Journal calculated when the number of known Covid-19 deaths in 2021 surpassed 2020’s figure by using Johns Hopkins and CDC data. The Johns Hopkins numbers reflect a near-real-time count from states, but can lag behind when deaths actually occurred. CDC death-certificate data don’t track the changing pandemic as quickly, but do reflect the actual day of death.
The CDC’s count for 2020 may grow with further revisions. These records are also close to showing more deaths in 2021.
Comparing the two pandemic years is imperfect because the first coronavirus-related deaths in the U.S. weren’t recorded until February 2020, while 2021 began in the grips of a wintertime surge. During just one week in January, the U.S. recorded a peak of nearly 26,000 Covid-19 deaths, CDC data show.
CDC data also indicate there was a larger undercount of Covid-19 deaths in 2020, when the disease was newer and a scarcity of tests made confirming some infections difficult. A Wall Street Journal analysis of CDC data shows about 54% of roughly 875,000 excess deaths the agency attributes to the pandemic came last year.
“Early in the pandemic we would have been missing more,” said Robert Anderson, chief of the mortality statistics branch at the CDC’s National Center for Health Statistics.
Another major difference between the years: Vaccines were in development in 2020, and in arms in 2021. About 59% of the U.S. population is fully vaccinated, according to the CDC, and some 17% have received booster shots. Studies indicate the vaccines are highly effective at preventing severe disease, though they are slightly less effective against Delta, and authorities are urging all adults to get booster shots to bolster waning immunity.
“The vaccine is not a panacea,” said Ana Bento, an epidemiologist at Indiana University-Bloomington. Dr. Bento was the co-author of an August study in the journal Health Affairs that argued that nearly 140,000 U.S. Covid-19 deaths between the beginning of 2021 and the end of May could have been prevented by vaccinating a larger portion of the population.
After heavily affecting coastal states last year, the virus hit hard in the Deep South this year, often spreading quickly through populations with low vaccine uptake, according to health officials.
States hit hard early on in the Northeast had some of the highest Covid-19 death rates per 100,000 residents in 2020, led by New Jersey, CDC data show. New York ranked fourth, behind the Dakotas. Southern states—Mississippi, Alabama, Tennessee and Florida—have had the highest rates this year.
Vermont has the lowest Covid-19 death rate per 100,000 people since the pandemic began, although the state is in a continuing surge. Vermont also has the most fully vaccinated population among the states, at 72%. Mississippi, closer to the bottom of the list with about 47% fully vaccinated, has the nation’s highest death rate since the pandemic began.
“What we’ve been through was not inevitable, and where we go from here is not inevitable,” said Thomas Dobbs, Mississippi’s state health officer, during a recent roundtable discussion of Covid-19 hosted by state officials and streamed on Facebook.
Deaths remain concentrated in older people, CDC data show, but younger people make up a higher portion of the total now because older people including nursing-home residents are among the most widely vaccinated. While 81% of Covid-19 deaths hit people ages 65 and up last year, that group represents about 69% of this year’s deaths.
Deaths among younger people are rarer, but the 20,563 deaths among people under 45 this year are more than double the deaths in this group last year.
“There are plenty of what we call the young invincibles who just didn’t get around to getting a vaccine,” said Olveen Carrasquillo, chief of the internal medicine division at the University of Miami’s Miller School of Medicine, “and a lot of meetings with family where they say, ‘Oh he’s so stubborn, we told him to get vaccinated, but he wouldn’t.’”
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