An estimate of how many Americans have died from each COVID variant

An estimate of how many Americans have died from each COVID variant thumbnail

Since the winter of 2020, new coronavirus variants have shaped the COVID-19 pandemic, each of which led to sharp increases in case counts, and eventually, deaths, in the United States.

These case spikes are apparent in retrospect. It is difficult to determine the exact death toll for each variant. A new report has been released ahead of peer review by a team of epidemiologists from Yale University and Public Citizen. It provides a basic estimate for each variant’s death rate.

“A significant portion, almost half and growing, have died after SARS-CoV-2’s ancestral strain was replaced by variants,” says Jo Walker, a Yale graduate student and lead author of the report. Of the more than a million Americans who had died of COVID-19 as of early May, variants killed 460,000.

While most deaths from each variant occur at the peak of a wave, it is difficult to determine when one variant takes over. The upper Midwest was deep in a wave driven primarily by Delta when Omicron arrived in the US last fall. Walker says that these transitions will occur at different times and at different speeds depending on where they are taking place.

By comparing known death tolls with Centers for Disease Control and Prevention estimates for variant prevalence in different areas of the country, researchers were able to estimate the percentage of people who died from a particular COVID strain. Walker says that there isn’t a lot of math involved in this. “It’s just that there’s so much data covering different places and time periods .”

Walker states that two elements of the findings stand out. The first is the toll from Omicron: Researchers estimate this currently dominant variant has killed 110,000 people so far. That’s despite the widespread misconception that Omicron is a mild variant. Two years ago, after 100,000 Americans had died in the first spring waves, Walker points out, the New York Times ran a front page headline calling the toll “an incalculable loss.” Now, Walker says, “we see a new variant come around and it’s caused a very similar death toll in the matter of a few months,” even with vaccines widely available. The 2022 death toll has fallen most heavily on older Americans, particularly those in nursing homes.

The second is the shifting geography caused by the pandemic. The Northeast experienced 215 deaths per 100,000 residents before the emergence of variants. Later, variants killed a disproportionate number of people in the South–158 per 100,000 residents. That’s something epidemiologists have understood in other ways; New York City experienced the highest per-capita death tolls of the entire pandemic in April 2020, while southern states experienced prolonged outbreaks over 2021. However, the new analysis could provide more specific numbers to this trend.

[Related: A deep dive on the evolution of COVID.]

But Susan Hassig from Tulane University in New Orleans is concerned about the limitations of this analysis. Hassig, who was not involved in this paper, says that “the variant isn’t all that drives mortality.” “If we were in lockdown during Delta,” she says. She attributes these policy differences to regional differences. New York City required masks indoors during variant-driven waves while southern states did not.

” They didn’t really discuss the most interesting findings, namely why the Northeast’s [death toll] was higher [est] within the non-variant environment and lower in the variant environment. “They left so much on the table.” Hassig says she acknowledges the difficulty of incorporating data on policies such as school closures and mask mandates, but that she would like to see at most vaccination status in the analysis.

The report’s authors state that the analysis was meant to observe deaths rather than explain them. According to Hassig, categorizing deaths by variants without considering other explanations risks overemphasizing variants in each wave. Deaths over the last six months are as much a product of undervaccination–among other policy outcomes–as they are of Omicron.

It’s a point that Walker acknowledged in an interview with Popular Science. Walker states that the shift in burden [from the Northeast to South] suggests that there is something more than just variants.

A focus on variants alone might not be enough to explain why one million Americans have died. This approach shows the continuing toll of failing global control of the pandemic. The deadliest variants in the United States emerged overseas, although Walker says “there’s nothing about the US which means that variants don’t emerge here.”

Walker says

Variants can be both “cause” and “effect”. Walker says that more infectious strains can cause outbreaks, but they are also a sign of uncontrolled global spread. This allows SARS-CoV-2 to develop new mutations.

The point of focusing only on variants, according to Zain Rizvi (research director at Public Citizen and co-author of the report), “is that it gets us back to the connection between global and local.” It shows that what happens at Lahore is important for what happens elsewhere in Louisiana.” This is a message that epidemiologists have repeated before, but it’s becoming more urgent as Congress’ appetite for funding for pandemics shrinks.

“We are shocked at the cost to the US population,” Rizvi said. “But we still wait for governmental action to reduce the risk of new variants emerging worldwide and to protect the lives and health of Americans at home .”

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