Well hello there! Another month has flown right by, and it’s time for another US excess mortality update. I’ve actually spent my week arguing about Portugal’s death counts (substance use related, not COVID related), but that’s a story for another post.
It’s been quite the month, and I was interested to look back and realize that when I first started doing these posts in August, the estimates for excess mortality put us at between 595,688 and 758,749 excess deaths since 2/1/2020. As of the most recent data release earlier this week, the US is now somewhere between 791,202 and 962,125. The 1 million mark is getting pretty close. If you have questions about these numbers, see prior posts.
Excess Mortality in 20-50 year olds
After my last post, bluecat57 left me a few comments about the concerns about excess mortality specifically in the younger adult age ranges. These are concerning deaths because 1. They are on the rise and 2. There is debate where they are coming from. It will be a while until all the data is in, but here’s the US trend for deaths through the end of September:

So basically during the pandemic we gained about 600ish extra deaths in the 25-44 year old age range, with a sudden jump in July of this year that took us to about 1800 extra deaths every week over baseline.
One of the links went to a clip of someone speculating on the reasons for these deaths, with several possible explanations. One explanation is that this is COVID. One is that something else is killing young people. One was that the vaccines were killing younger adults. Now this was an interesting claim, as the timeframe doesn’t entirely match up. July was on the later side for most people getting vaccinated, but perhaps the claim is there’s a delay. I decided to take a look at my 3 states I go back to: Massachusetts, Arizona and Tennessee. These are interesting states because they are in 3 totally different areas of the country, and have very different vaccination rates. In Arizona, 53.7% of the population is fully vaccinated. In Massachusetts, 70.3% and in Tennessee it’s 48.8%. That’s of the total population (kids excluded until recently) so we can assume that translates in to a somewhat higher number for this slice of the population. So how are these states doing? Here you go:

Starting around May of 2020, Arizona and Tennessee show gains here, whereas Massachusetts does not. Per the state report, around 80% of 25-44 year olds in Massachusetts are vaccinated, and we do not see much of a gain (if any) in young person deaths. As someone in that age group, it is of course relieving to see that my risk of death is basically unchanged since 2019. In Arizona and Tennessee, there are points where your risk of death was 1.5-2x as likely.
It seems unlikely the vaccines are causing these deaths, when we see bigger spikes in more unvaccinated populations than in largely vaccinated ones. I wanted to compare these to the overall deaths in each state, so here is that:

Interesting that each spike in overall mortality correlates to a similar spike in 25-44 deaths except the initial Massachusetts spike. This backs up the theory that the very first COVID spike hit nursing homes hard, and that has not been as much of a problem since then. I was also interested to note that despite COVID appearing fairly seasonal, death rates for Arizona and Tennessee exceed those of Massachusetts last winter.
So basically, I think it’s unlikely that vaccines are playing a role. I would speculate many of these are COVID deaths, or something else potentially related to COVID. As far as I’m aware, Massachusetts had the toughest lockdowns/restrictions of the 3 states (though lockdowns have been done in MA for over a year, unless you count mask mandates as lockdowns) so I’d suspect it’s not lockdown related either. Let me know if you have evidence Tennessee or Arizona were tougher though, as I obviously know my own state better than those two.
Excess Mortality Over Average Updates
Okay, so here’s the visual:

Who moved the most this month? Not a lot of major changes
| State | Excess Deaths Above Average/Million 2/1/20-11/10/21 (change from 10/6) | Change from 10/6 rank |
|---|---|---|
| Mississippi | 4784 (+160) | No change |
| Alabama | 4325 (+325) | No change |
| Louisiana | 4086 (+286) | No change |
| Arkansas | 4086 (+303) | No change |
| DC | 3946 (+201) | No change |
| Arizona | 3846 (+251) | No change |
| Tennessee | 3803 (+422) | +1 |
| Florida | 3655 (+290) | +1 |
| South Carolina | 3588 (+135) | -2 |
| Nevada | 3480(+324) | +1 |
Of note, New York fell off the top ten list entirely, and currently sites at #17. It’s good to see the top states slowing down though, it’s been a tough go of it.
Most of the states with the biggest gains this month actually did not make the top 10. The top 5 gainers were Idaho (#32, +596), Puerto Rico (#31, +563), Montana (#13, +535), Kentucky (#12, +516) and Wyoming (#36, +500).
Excess Mortality Over Upper Bound by State
Graphical representation here:

Okay, here’s the top 10 list:
| State | Excess Deaths/Million Over Upper Bound (change from 10/6) | Change from 10/6 rank |
|---|---|---|
| Mississippi | 3362 (+60) | No change |
| Alabama | 3280 (+276) | No change |
| Florida | 2912 (+265) | +1 |
| Arizona | 2860 (+201) | -1 |
| Arkansas | 2829 (+236) | +1 |
| Louisiana | 2810 (+324) | +1 |
| Texas | 2793 (+244) | +1 |
| Tennessee | 2784 (+361) | +3 |
| New York | 2760 (+60) | -4 |
| Georgia | 2599 (+280) | +2 |
Again, not a lot of motion except for NY running off the list. This seems fairly consistent with a falling peak: states simply aren’t adding huge numbers at the moment. The biggest changes are again (mostly) coming in states that have actually had lower pandemic numbers up until now: Idaho (#29, +521), Puerto Rico (#40, +496), Kentucky (#15, +457), Montana (#23, +396), Tennessee (#8, +361).
Again, given the nature of COVIDs seasonal interaction here, I’m going to continue to keep this updated for at least Dec/Jan/Feb. With acquired immunity and vaccines going on, it’s hard to know if we’ll see a substantial 4th (or 5th, depending how you count) wave of deaths in the US. Stay healthy everyone!














