State Level Excess Mortality Updates – Oct 6th, 2021

I can’t believe another month has gone by, but here we are! I am back to update state level excess mortality data from the CDC website, pulled on 06OCT21. See previous posts for more details about this data.

First up though, here’s an interesting gif someone made that shows the spread of COVID cases over time by region. Definitely shows some interesting seasonality, and also some interesting data anomalies.

Excess Mortality – How bad has it been?

As I’ve talked to a few people about state level data over the past few months, one of the things I’ve noticed is that some people’s perceptions of the pandemic do not match their individual state. I started wondering if this has anything to do with when the peak excess mortality is, and how long the states spend at high levels of excess mortality. Using the same CDC data I’ve been using, I decided to pull the number of weeks each state has a mortality rate >50% above their average. The data goes back to 2017, so we can see that this phenomena only happened three times between January of 2017 and March 28th, 2020: once to Puerto Rico in September 2017 (Hurricane Maria), and twice in Wyoming (October 2018 and January 2020). I’m not totally clear what happened those weeks.

So this happened 3 times in a little over 3 years. How often has it occurred since the end of March 2020? A total of 363 times in 45 states. The only 5 states that haven’t reached that level since the pandemic began are Alaska, Hawaii, Maine, New Hampshire and Oregon. The US as a whole spent 6 weeks in that range, with 25 states exceeding the national average. Here are those states, and how many weeks they spent at that level (so far):

State# of weeks at >50% excess mortality
Texas19
Mississippi17
DC16
Alabama, Arizona14
Nevada, North Dakota13
Oklahoma12
Georgia, Louisiana, Montana, South Dakota, Tennessee10
Arkansas, California, Florida, 9
Indiana, New Mexico, New York City (city only)8
Iowa, Michigan, New Jersey, Pennsylvania, New York (excluding city7

Just a note on NYC vs NY: only one of those weeks wasn’t overlapping. If we raise the bar and look at only states that have at least one week where they had DOUBLE the number of deaths they usually do, we find only 9 states have hit that bar:

State# of weeks at >100% excess mortality
New York City (city only)7
New Jersey, South Dakota5
California, Connecticut, Massachusetts3
Florida, New York (excluding city), North Dakota2
DC1

Another note on NYC vs NY: the 2 weeks for NY are also in the 7 week stretch for NYC. Not clear why the CDC reports these separately.

Excess Mortality Over Average Updates

First up, here’s the whole US. It’s worth noting that when I did this graph a month ago, the lowest value was 554 excess deaths/million. Now it’s 739 excess deaths/million. The brightest red a month ago was 4107/million, now it’s 4624/million. The greens and the reds mean more than before:

So who were the top movers this month? Let’s see:

StateExcess Deaths Above Average/Million 2/1/20-10/6/21 (change from 9/8)Change from 9/8 rank
Mississippi4624 (+516)No change
Alabama4000 (+559)+1
Louisiana3801 (+534)+3
Arkansas3404 (+379)No change
DC3749 (+97)-3
Arizona3597 (+251)-1
South Carolina3453 (+326)No change
Tennessee3381 (+326)+3
Florida3365 (+538)+3
New York3177 (+91)-2

Note: the NY data here is all of NY, state and city combined. Seems incredible that New York may actually fall out of the top 10 for excess mortality since the pandemic started. To note: there were 4 states that saw substantial gains but are not yet at top 10 level. These were: Georgia (+471, 14th place), Oklahoma (+442, 13th place), Peurto Rico (+407, 37th place) and Kentucky (+390, 17th place).

Excess Mortality Over Upper Bound by State

Okay, here are the states that most exceeded 2 standard deviations from the mean mortality:

And now the top 10:
StateExcess Deaths Over Upper Bound (change from 9/8)Change from 9/8 rank
Mississippi3302 (+443)No change
Alabama3004 (+502)+1
Arizona2659 (+210)+1
Florida2647 (+499)+5
New York2646 (+56)-3
Arkansas2582 (+324)No change
Louisiana2574 (+449)+3
Texas2549 (+345)-1
South Carolina2471 (+280)-1
New Jersey2452 (+52)-5

To note, there are again 4 states who had a top 10 gain in excess mortality, but didn’t make the overall top 10. These are: Tennessee (+483, 11th place), Georgia (+420, 12th place), Oklahoma (+380, 14th place), Kentucky (+327, 21st place).

As always, let me know if there are any questions and I’ll be back in a few weeks! Given seasonality, I’m going to try to keep this up monthly. I’d also ideally like to see if some states start to regress at all. There is a lot of commentary that COVID mostly killed people who were going to die anyway, but so far that is not what we are seeing. If that’s true, at some point some states excess mortality should start to decrease below the norm. So far I’m only seeing slight decreases for Connecticut, Rhode Island and Minnesota, but those are small and could be adjustments.

7 thoughts on “State Level Excess Mortality Updates – Oct 6th, 2021

  1. “Perspective isn’t news.” I believe that is original to me, Thee Frugal Curmudgeon

    I appreciate the work that it takes to put these numbers together. But without ALL of the information, it is hard to apply it to MY life.

    Real-World Intelligence Hardcover – 1991 by Herbert E. Meyer
    Explains that there is a difference between data and intelligence. Data are numbers, intelligence is how you apply those to your business.

    The media uses percentages when they want to TELL a story instead of reporting THE story.

    I did a quick calculation for your “brightest red month”. Unless I have the wrong numbers, in 2018 Mississippi had a mortality rate of 1%. In that brightest red month, their mortality rate was 1.5%. People dying is BAD, but that higher RATE isn’t nearly as dramatic when put in that perspective. The population of Mississippi is approx. 3 million.

    That means, if you live in Mississippi, you have a 98.5% of LIVING to next month.

    I applaud your attempt to put things a bit more into perspective.
    “some people’s perceptions of the pandemic do not match their individual state”
    Maybe my perspective on death is a bit warped. I just don’t worry about it.

    We are nearly two years into the plandemic and until August, I had not personally known (as in I could pick them out of a crowd) anyone that had died with covid. Since then, I know of 4 people that have died. I probably could have only picked out two of them, but I knew their spouses by sight.

    On the flip side, early last year during a veterinarian visit, our vet relayed the story of many people she knew that had lost family members. One family had lost FIVE. Of course, none of the dead’s demographics were reported. Dying is bad, but there is a BIG difference between a 90-year old dying and a 9-year old.

    So, is THE story that there really has been “excess mortality” over the past year? I’m not going to credit covid with those deaths. In at least two of the cases I know of personally, it was the TREATMENT (CDC protocol despite family requesting alternate treatments) that the families blame for the deaths. How about I claim, “50% of deaths are caused by hospital treatment.”?

    OH!!! and YOU are someone who might be able to answer this question for me.

    Of all of the covid related deaths, how many of those were hospitalized at some point for covid? (Not sure if that is correctly worded. Ask, and I’ll try to clarify.)

    My guess is nearly 100%. As in well over 90%.

    PS – Here in South Carolina we often say, “Thank God for Mississippi.” Usually, as it relates to BAD statistics and the student scores on standardized testing.

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    • Always good to see you, Frugal Curmudgeon! Still love the name.

      You get in to some good questions here, that I will attempt to answer somewhat in order. First, agree on the media. I’ve seen people swap between raw numbers and percentages in the same story, clearly trying to make a point by using one or the other. That is part of why I’m attempting to do these calculations, to try to use the same metrics every time and give people a sense of how things are moving. Well to be fair I actually started just doing it for myself and a few others via email, then thought it might be an interesting post series. I think flipping around how you look at the data too often can absolutely lead to skewing. There are arguments to be made for various methods, but picking one and sticking with it has its merits.

      Your comments about Mississippi’s mortality rate and subsequent ones about how it impacts you personally got me thinking in an interesting direction. You are right that Mississippi has about a 1% mortality rate, though I got that for the whole year. I downloaded the deaths by state/age file and it appears Mississippi had a little over 31k deaths/year average from 2015-2019. So 99% of the people alive in Mississippi on January 1st, 2019 were still alive on December 31st, 2019.

      However, we know that 1% death rate is not evenly distributed throughout the population. As you mention, a 9 year old and 90 year old are not comparable. Your chance of making it through any given year varies heavily based on your age, so we’d expect the increase in mortality to be different across the age groups. 

      Using the data file and populations I found here, I decided to look at how each age group did in Mississippi through the end of 2020. 2021 isn’t done yet so I didn’t do that. Comments don’t let me table format, but the numbers are average yearly deaths 2015-2019/deaths in 2020/% of subgroup that died historically/% of subgroup that died in 2020:
      Under 25 years – 769.8, 859, 0.08%, 0.09%
      25-44 years – 1720.8, 2421, 0.23%, 0.32%
      45-64 years – 7231.2, 8867, 0.96%, 1.17%
      65-74 years – 6548.4, 8893, 1.59%, 2.16%
      75-84 years – 7480, 9646, 5.45%, 7.03%
      85 years and older – 7530, 9174, 15.03%, 18.32%

      These are not high numbers overall, until you get to the 75+ range. However, that’s why I’m interested in following mortality yearly. Small increases in percentages for one year don’t make a huge difference, but if we see these increases for multiple years, they can compound. For example, that small uptick in the 65-74 year old category leads to an extra 4600 deaths if we have it for 2 years in a row.

      And I think that’s what I’m interested in. I’ve gotten away from talking COVID deaths in particular, because I do think different states count differently. If the mortality dips back down and we see fewer people dying in subsequent years, we can establish that some of these deaths may have been “borrowed”. However, if the rate never dips back down, then we know that something unusual has happened.

      To your question about hospitalizations pre-COVID death: I actually don’t know! I’d imagine it’s incredibly high though. Most people call an ambulance when someone starts to get very sick, so unless you have some sort of long illness/warning/pre-planning, most people will die in a hospital. I know my sister said they found a lot of people dead in their homes during the initial wave of the pandemic (she’s in Alaska), but with the shortage of tests at the time it wasn’t always clear what was a COVID death and what might have been a person avoiding the hospital while having chest pain or something. That’s another reason I like to look at excess mortality rather than COVID deaths. Sometimes we just don’t know.

      I think there’s a lot of good questions to look in to here, and I think we’ll be studying them for years to come. However, in the moment I think these conversations are better if we are all working from clear and transparent data. To take your hypothetical, if someone’s theory is that 50% of deaths are caused by hospital treatment, we’d still have to look at why Mississippi’s hospital treatment was so much worse than, say Kansas (similar population, about 8k fewer deaths in 2020 and 2021). “Did Kansas hospitals treat differently than Mississippi hospitals” is a valid question! However I think people need to be clear on who is doing (relatively) well and who is doing (relatively) poorly to be able to make fair comparisons.

      Quite frankly I get exhausted by the fixation on Florida (which really seems to be more about Desantis), New York (where most media people live), California (again, where people who run media live) and Texas (again, political). Not everyone is from there! If you think your state is doing something well/poorly, compare it to another state of similar size and see how they’re doing! That’s how statisticians are going to comb through this all later, I’m just getting ahead of myself :).

      But now I’ve gone on long enough. Now let’s see if this comment is too long for WordPress to take it!

      Liked by 1 person

  2. Very interesting. Again, thank you.

    Your mention of treatments and Alaska reminded me that over the last couple of days I’ve heard two different stories about “treatments”.

    One was a Freakonomics podcast, which I now can’t find, about how a delay in treatment is critical in heart attacks and cardiac arrest (I never knew they were different.) (Found it, one of the first episodes of Freakonomics, MD podcast.) (You may also like the “Inside the Breakthrough” podcast. It is medical oriented.)

    The host is an MD/PhD in Economics. The episode reported on a study they did to find out if Marathons were deadly. Yes, those running marathons that block access to emergency rooms and delay ambulances. The conclusion, spoiler alert, yes as much as 13% more deadly.

    The other was an article or something else I saw today (I have usually opened over 100 tabs before I finish my morning coffee. I’m a mile wide and an inch deep.), that due to the resistance to vaccine mandates, emergency services are understaffed and response times are going up. And yet government and businesses are STILL terminating employees. I’m almost ready to believe they ARE trying to kill off a good portion of the population. Some ambulances were taking over 30 minutes to respond. That Freakonomics podcast said minutes if not seconds count in heart situations, so I’m guessing that it may make more sense to send a hearse in some situations rather than an ambulance.

    I hope all is well with you and yours.

    Like

    • Oh man, you just brought me back to my days working in the ER on “Marathon Monday”. I can absolutely see those making a difference. Also, I am impressed with the 100 tabs. I get distracted after just a few.

      That’s a good point about ambulance delays, I hope somebody is tracking where shortages are occurring to see if this makes a difference. I know recently my old ER friends were upset because an anti-vaxx protest blocked the doors to their hospital and was also delaying care. I will say my bias is to be anti-federal mandates, as I think individual regional assessment is important. That is of course part of why I keep harping on state data. Not everyone has experienced this pandemic the same way, both for death/illness counts, and the way their governors/local officials handled things. National media (of any persuasion) obviously makes more money if they highlight things that will drive views, but many of those stories will be cherry picked and not reflective of a region’s reality.

      Political decisions aside, I actually got interested in excess mortality data in part because of the death of the father of an acquaintance of mine. He (the father) got COVID, recovered, then died of a stroke 2 months later. The son wondered if COVID helped hasten the stroke or made him more vulnerable to it. It struck me that’s the sort of question we simply can’t answer with anecdotes. The father was in his 80s so a stroke was not an odd occurrence. We simply can’t know if this was bad luck or if there was something causal without looking at a larger number of people. This is part of why I am cautioning people not to overgeneralize their own experience. I think some data won’t come perfectly clear for a while yet, after most people have moved on. I like to follow stories for longer than the media does, sometimes you get some interesting truth later when things have calmed down.

      Also, thanks for the podcast recommendations! I had cut back considerably on podcasts at the start of the pandemic, but I’m getting back in to them. That “Inside the Breakthrough” looks fascinating!

      Like

  3. Never underestimate the stupidity of humans.

    Last words before meeting warthog — ‘I wonder if we can pet him’

    Lines like that are why I’m a mile wide and an inch deep. I can’t resist. Good thing I almost never watch the videos. One blog I visit, every time I watch the video I wake up a couple of hours later after watching a dozen more.

    Like

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