The magnitude of the country’s loss is almost unattainable to understand.
More Americans have died of Covid-19 than in 20 years of automotive crashes or on battlefields in the entire country’s wars combined.
Experts say deaths were all but inevitable from a recent virus of such severity and transmissibility. Yet, a million dead is a surprising toll, even for a rustic the scale of america, and the true number is sort of actually higher due to undercounting.
It’s the results of many aspects, including elected officials who played down the threat posed by the coronavirus and resisted safety measures; a decentralized, overburdened health care system that struggled with testing, tracing and treatment; and lower vaccination and booster rates than other wealthy countries, partly the results of widespread mistrust and resistance fanned by right-wing media and politicians.
The virus didn’t claim lives evenly, or randomly. The Latest York Times analyzed 25 months of information on deaths through the pandemic and located that some demographic groups, occupations and communities were much more vulnerable than others. A major proportion of the nation’s oldest residents died, making up about three-quarters of the overall deaths. And amongst younger adults across the nation, Black and Hispanic people died at much higher rates than white people.
Understanding the toll — who makes up the a million and the way the country failed them — is crucial because the pandemic continues. Greater than 300 individuals are still dying of Covid daily.
“We’re a rustic with the perfect doctors on this planet, we got a vaccine in an astoundingly short time frame, and yet we’ve had so many deaths,” said Mary T. Bassett, the health commissioner for Latest York State.
“It really must be a moment for us all to reflect on what form of society we would like to have,” she added.
The primary wave of deaths was concentrated within the Northeast, especially Latest York City and its suburbs. Nobody knew much in those early months. Doctors were unsure how best to treat the disease. Hospitals were overwhelmed. Deaths climbed sharply.
Latest York City was hit harder in March and April 2020 than every other city within the country has been through the pandemic. At the peak of this outbreak, a Latest Yorker was dying of Covid almost every two minutes — nearly 800 people per day, a rate five times as high as town’s normal pace of death.
Amongst them was Dr. Jay Galst, 69, an otherwise healthy ophthalmologist in Manhattan, who almost certainly contracted Covid from a patient. His widow, Joann Galst, blamed President Donald J. Trump, who sought to quell concern in regards to the virus in early March, asserting that it will go away with rising temperatures. She also blamed federal health officials, who declined to recommend masks for the general public in those earliest days.
“Does it give me consolation that he was doing the work that he loved?” Dr. Galst asked of her husband’s death. “That he was following preventive measures that we each thought was the perfect he could have done on the time? Probably not, since I now know, had we been truthfully informed of the immense danger we were all facing in Latest York City, we could have and would have done more.”
Epidemiologists have pointed to Latest York’s density and its role as a world hub of commerce and tourism to clarify the early spike in cases and deaths. Still, the earliest surge also took an acute toll in cities including Detroit, Latest Orleans and Albany, Ga.
A spike in emergency room visits to Latest York City hospitals by individuals who had “flu-like symptoms” in early March suggested that hundreds of city residents were infected.
Victor J. Blue for The Latest York Times
On March 15, Mayor Bill de Blasio shuttered bars and restaurants and announced that public schools would close the subsequent day. Gov. Andrew M. Cuomo imposed broad restrictions on nonessential businesses on March 22. Those near-lockdown measures were almost certainly chargeable for a greater than 50 percent reduction in transmission of the virus, a Columbia University study found.
By summer, Latest York was garnering praise as a model of infection control. Death rates in Latest York City would never rise as high as they did within the early wave.
But Dr. Thomas R. Frieden, a former head of the Centers for Disease Control and Prevention and a former commissioner of Latest York City’s Health Department, said he believed that restrictions got here too late. Greater than half of the Latest Yorkers who died within the earliest days may need lived, he estimated, had officials put the lockdown measures in place even per week or two earlier. “Cases were doubling every two days, and each two days you were doubling the impact,” he said.
Latest York’s political leaders cited lack of direction from the federal government, inconsistent messages from public health experts and the daunting task of getting the general public on board with a large disruption of on a regular basis life for the timing of restrictions.
“I don’t think any of us understood the dimensions of it,” Dr. Mitch Katz, who runs Latest York City’s public hospitals and took part within the de Blasio administration’s meetings, told The Times in March.
Wealthy Azzopardi, a spokesman for Mr. Cuomo, said an absence of tests and the Trump administration’s failure to shut down international travel “seeded Covid in Latest York for 2 months before our first confirmed case.’’
In an interview, Mr. de Blasio said, “It is tough to say to people when nobody had died and the cases are limited, ‘We’re closing down your livelihood, we don’t know when it’s going to come back back. We don’t know what’s going to occur to your life, we don’t know what’s going to occur to your loved ones.’” He added, “It’s not something you do frivolously.”
Becky Bennett said she and her father, Barrie, were like “peas in a pod,” climbing, biking and shooting together within the Blackfoot, Idaho, area. But vaccines were something they may not agree on.
“Please, kitten, don’t get the shot,” she recalled him telling her. “You don’t know what’s in it.”
He told her that the vaccines were a government scheme to “test her compliance,” citing YouTube videos.
Even after Mr. Bennett, 72, contracted Covid in December last 12 months and was struggling to breathe, his daughter said he was unwilling to vow her that he would get a shot if he recovered.
Lindsay D’Addato for The Latest York Times
Mr. Bennett, who was athletic and in good health, was eventually placed on a ventilator in an intensive care unit. He died in January.
Amongst wealthy countries, america has been notably unsuccessful at persuading residents to get fully vaccinated and boosted. Today, a few third of individuals across america haven’t been fully vaccinated, and a few 70 percent of the population has not received a booster. (Against this, 17 percent of individuals in Canada haven’t been fully vaccinated, and 46 percent haven’t had boosters.)
Nearly half of the deaths from Covid in america occurred after vaccines were made widely available. The failure to vaccinate, epidemiologists say, contributed to lots of of hundreds of deaths. In the course of the Omicron wave in December 2021 and January 2022, as an example, the Covid death rate in america was higher than in Germany, France, Britain or Canada, which had each fully vaccinated and boosted larger shares of their populations.
“It’s just sobering that in a rustic with remarkable resources like ours that we’re seeing deaths like this,” said Dr. Lisa Cooper, director of the Johns Hopkins Center for Health Equity. “And we’re seeing an absence of profit from therapy that we all know is accessible.”
Public health experts say the federal government didn’t do enough to assist the general public understand how effective the vaccines are, or to combat misinformation and conspiracy theories by some right-wing media and politicians.
The vaccines have been shown to be largely effective at stopping severe disease and death. But Debra Furr-Holden, an epidemiologist at Michigan State University and the incoming dean of Latest York University’s school of worldwide public health, said that deaths amongst vaccinated people had not been explained well and had exacerbated fears surrounding the vaccine and distrust of the federal government.
The C.D.C. has received data on deaths by vaccination status from only about half of the states, so it’s unattainable to know exactly what number of vaccinated individuals are among the many million who’ve died. But no less than 50,000 vaccinated people, lots of them older or without booster shots, were among the many deaths reported since late April 2021, when vaccines became widely available.
Still, vaccinated people have had a much lower death rate — unvaccinated people have been no less than nine times as more likely to die since April 2021.
Covid-19 death rates by vaccination status
20 deaths
per 100,000 people
The death rate for unvaccinated people has been no less than nine times that of vaccinated people.
20 deaths
per 100,000
people
The death rate for unvaccinated people has been no less than nine times that of vaccinated people.
20 deaths
per 100,000
people
The death rate for unvaccinated people has been no less than nine times that of vaccinated people.
Note: Data is weekly. | Source: C.D.C.
In recent months, states have scaled back on vaccination campaigns and incentives, and in addition dropped masking requirements and other mitigation measures that help protect the unvaccinated and other vulnerable people.
Dr. Furr-Holden said the push to get near a prepandemic normal — to place people back in restaurants, stadiums and offices — had overshadowed more time-consuming efforts to influence individuals who were still unsure about shots. And he or she nervous that government-ordered employer vaccine mandates drove some people away from the vaccines.
“As a substitute of blaming, shaming and attempting to ostracize those people, it will be higher to do the work to attempt to treatment their concerns,” she said.
Like many in her age group, Germaine St. John, 87, of Laramie, Wyo., counts several friends lost to Covid. One had moved to California. One had lived on the outskirts of Laramie. One other had had a second shot. She has spotted the obituaries of other acquaintances, too, within the local newspaper, The Laramie Boomerang.
In her 82 years as a Laramie resident she has raised a son, began a senior community theater group, enjoyed a profession on the local bank, found common cause with fellow political conservatives and, within the early Eighties, served as mayor. But well before the pandemic, she said, she had begun to feel sidelined due to her age. And the way in which some younger neighbors have declined to wear masks or refrain from large gatherings when cases were on the rise appeared to diminish the lives of those most vulnerable.
“This concept of ‘we’re going to die anyway,’” she said. “That’s awful to say about any age group.”
To guard herself, Ms. St. John, a widow, has kept mostly to herself, enduring bouts of maximum loneliness. She has found solace, she said, in a web-based community of older adults who share stories and take fitness classes. But when Covid fades, she plans to begin getting out more.
Matthew Defeo for The Latest York Times
“We’re within the last trimester of life, I sometimes say,” she said. “And I’m going to do what I can to meet my commitments to my son, my friends, my community.”
Older people are inclined to have weaker organ function and immune systems, leaving them more vulnerable to disease and fewer likely to reply to vaccines. Indeed, age has sometimes been a much bigger risk factor than vaccine status through the pandemic. People 80 and older who had gotten shots were almost twice as more likely to die at the peak of the Omicron wave as those of their 50s or early 60s who had not, based on C.D.C. data.
But public health experts said the reluctance of others to adapt their behavior was a contributing factor to the massive variety of deaths amongst older people over the course of the pandemic.
“Plenty of what has effectively been a slaughter has been the product of policies and public health failings, and just not caring,” said Dr. Louise Aronson, a geriatrician on the University of California, San Francisco.
Covid-19 death rates by age
3,000 deaths per
100,000 people
Older people have died at far higher rates than young people. For those under 25, the virus has been less lethal than traffic accidents.
Rates have greater than doubled with every 10 years of age.
For those 65 and older, Covid has been the third leading explanation for death, after cancer and heart disease.
Older people have died at
far higher rates than young
people. For those under 25,
the virus has been less
lethal than traffic accidents.
Rates have greater than doubled
with every 10 years of age.
For those 65 and older,
Covid has been the third
leading explanation for death, after
cancer and heart disease.
Source: C.D.C.
A typical refrain, Dr. Aronson said, is that older Americans may need died of something else — cancer, heart disease or old age — had Covid not hit them. But that doesn’t mean, she said, that their final years weren’t cut short. Within the two years before the pandemic, a median of 877,000 people over 85 died annually. In 2020 and 2021, the identical age group saw 100,000 more deaths than that annually.
Comparisons to the impact of the flu, which overwhelmingly kills older people, don’t delay either. Covid has killed no less than eight times as many individuals because the flu and pneumonia do in a comparable timespan, based on Andrew Noymer, an associate professor of public health on the University of California, Irvine.
“If I die of Covid today, my death is borrowed against future deaths,” Dr. Noymer said. “But the purpose is, it might be borrowed 10 years prematurely.”
By March 2021, Howard Jenkins, the pastor of Bethel A.M.E. Church in Windfall, R.I., already felt, he said, “bombarded by death.”
He had consoled quite a few congregants whose members of the family had died of Covid. He had eulogized a private friend who had died of Covid. Appalled on the toll the virus was taking over Black people, he said, he had overcome his own reluctance to get vaccinated in order that he could encourage others to achieve this.
Sophie Park for The Latest York Times
At 7 a.m. and seven p.m. prayer sessions along with his congregation, Mr. Jenkins said, he would hear from members of the family who had lost family members. “I could see the toll it was taking over the African American population, within the state and outdoors the state.”
Black and Hispanic people in all ages group have died at higher rates than white people. The racial disparity in deaths was especially extreme in the beginning of the pandemic, however the gaps remain today.
Covid-19 death rates by age and race
4,000 deaths per
100,000 people
Black and Hispanic people have had the very best death rates in all age groups.
Black and Hispanic people have had the very best death rates in all age groups.
Note: Rates for White, Black and Asian people exclude Hispanics. Rates for Native Americans and Pacific Islanders were less reliable due to low total counts and usually are not shown. | Source: C.D.C.
Hispanic people ages 25 to 54 died at a rate greater than 4 times as high as white people of the identical age group before vaccines became widely available. Black people of the identical age group died at greater than 3 times the speed during that period.
Covid-19 death rates amongst those ages 25-54
10 deaths
per 100,000 people
Note: Data is monthly. | Sources: C.D.C., Census Bureau
Partially, that’s because a disproportionate share of essential staff are people of color, public health experts said.
Another excuse for persistent disparities in deaths was lower vaccination rates. White people were significantly more more likely to be vaccinated than Black and Hispanic people in the primary months of the vaccine rollout.
The gap between Black and white people has since narrowed to about six percentage points, while Hispanic people now have a rather higher rate of vaccination than white people, based on a recent evaluation by the Kaiser Family Foundation.
David Hayes-Bautista, a professor of drugs and the director of the Center for the Study of Latino Health and Culture on the University of California, Los Angeles, said more crowded housing may also have contributed to higher transmission rates, hospitalizations and deaths in Black and Hispanic families.
In early 2021, at an east Los Angeles hospital that serves mostly Latino residents, “I could see it right there in front of my eyes,” Dr. Hayes-Bautista said.
“In regards to the third week of January, we thought, ‘We are able to’t add yet one more patient.’”
Meat-packing staff had been dying of Covid. Transit staff had been dying of Covid. Farm staff had been dying of Covid. On the Ralphs food market where Carmen Portillo worked as a cashier, the bakery manager had died of Covid.
“When you don’t have to come back back, don’t come back,” Ms. Portillo, 53, recalled her co-workers telling her after she took a brief leave. “Because that is bad.”
But like many staff who got here to be often known as “essential” because their jobs required in-person work, Ms. Portillo felt she had no alternative. Her husband, a restaurant employee, was making less due to closures, they usually had a mortgage on their home within the Los Angeles neighborhood of Van Nuys.
Mark Abramson for The Latest York Times
Whilst she silently raged at some customers who refused to wear masks, she said she took satisfaction within the praise she received from others.
“Not a single day passed by that somebody didn’t say, ‘You guys are heroes,’” she said.
Ms. Portillo survived a bout of Covid in the autumn of 2020, but an in depth friend, Jose Sanchez, a janitor at a Los Angeles-area mall, didn’t. Mr. Sanchez had tested positive a couple of days after accepting a ride home with a co-worker who was later found to have had Covid, Ms. Portillo said.
“They worked late, till 1 a.m.,” Ms. Portillo said. “There have been no buses at the moment.”
Nearly 80 percent of staff ages 20 to 64 who died of Covid in 2020 worked in industries designated as essential, based on data obtained by a team of researchers led by Yea-Hung Chen, an epidemiologist on the University of California, San Francisco. Staff in 11 sectors that were exempt from stay-at-home orders — including food services, health care, construction, transportation, agriculture and manufacturing — were almost twice as likely to die from Covid as others the identical age, the researchers found. About two-thirds of staff in america are employed in industries that fall inside the classification.
“These staff were by definition more exposed, however the extent of the disparities was striking,” Dr. Chen said.
Covid-19 deaths by occupation in 2020
Laborers and
material movers
1,770
Construction staff
3,143
Manufacturing staff
1,770
Drivers and
truck drivers
2,299
Construction
staff
3,143
Manufacturing
staff
1,770
Drivers and
truck drivers
2,299
Note: Chart shows 37,905 deaths amongst staff age 64 and under in 46 states. Some similar occupational categories have been collapsed into larger representative categories. In some cases, similar occupations from different industries are grouped together. Not all occupations are labeled. | Source: Yea-Hung Chen et al., preprint via medRxiv
Income can also be a predictor of an individual’s risk of dying of Covid on this country. People and not using a college degree and those that live in poorer neighborhoods have been more more likely to die of Covid than those with a university degree and other people who live in wealthier ZIP codes.
Data from the country’s three largest cities shows that the highest-income neighborhoods have generally seen the least death over the course of the pandemic, while the poorest neighborhoods have seen probably the most.
Covid-19 deaths by income in major cities
Higher death rate,
lower income
Lower death rate,
higher income
Higher death rate,
lower income
Lower death rate,
higher income
Higher death rate,
lower income
Lower death rate,
higher income
Note: Each dot shows deaths and income for one ZIP code. | Sources: Census Bureau, N.Y.C. Department of Health and Mental Hygiene, California Department of Public Health, City of Chicago
Lower incomes also correlate with a lower likelihood of vaccination, which is in turn related to Covid deaths. For instance, while Republicans have been much more more likely to go unvaccinated than Democrats, a divide also exists between high-earning Republicans and poorer ones: Based on one survey of self-identified Republican voters in June 2021 conducted by Abram Wagner, a University of Michigan epidemiologist, Republicans with monthly incomes of under $2,000 were twice as more likely to be unvaccinated as those with monthly incomes of $5,000 or above.
The USA is removed from the one country that has suffered a staggering death toll. The World Health Organization estimates that 4.7 million more people died in India through the pandemic than would have in normal times, and that a million more died in each Russia and Indonesia. Several smaller countries even have experienced higher death rates than america.
But there may be little doubt that America fared worse than just about all wealthy nations, with considered one of the very best rates of infection, based on an evaluation in The Lancet. Amongst working-age people, Dr. Chen said, essential staff “bore the brunt of those exposures.”
When Mary-Ann Carey of Granville, N.Y., fell and broke her hip in May 2020, she moved right into a nursing home for an eight-week stay. Her daughter, Frances Brunner, was terrified.
The nursing home, like others across the country, didn’t allow members of the family to come back inside, and Ms. Brunner nervous that the house was understaffed and could be hit by the virus, as so many others were through the pandemic.
“People’s members of the family were dying they usually couldn’t see them,” said Ms. Brunner, who said she eventually pulled her mother out of the house against the staff’s recommendations. “I got the best-case scenario because I got my mother back. I’m considered one of the lucky ones.”
Kristian Thacker for The Latest York Times
Her mother, who’s in her 80s, has suffered a cognitive decline and last 12 months became ailing with a stomach flu that left Ms. Brunner wondering whether she could proceed taking good care of her.
Ultimately, though, Ms. Brunner said the pandemic turned her against the thought of her mother living in a facility long run.
“That is my mother,” Ms. Brunner said. “If I put her in a nursing home, she’d never come home again.”
The virus swept through places like prisons, colleges and group homes, where people live together, however the toll was especially high in long-term care facilities, like nursing homes.
Residents of long-term care facilities continued to die long after the early months of the pandemic, and long after lockdowns that were criticized later for isolating seniors in dangerous, damaging ways.
As Delta after which Omicron swept the country months later, deaths in nursing homes rose again, though never to the degrees seen before vaccinations.
Some experts blamed relatively low vaccination rates amongst nursing home staff before shots were mandated by the federal government. But experts also pointed to problems that existed before the pandemic, like crowding, underfunding and staffing shortages.
Industry leaders have called on the federal government to make a significant investment to guard nursing homes by improving staffing and care.
But Dr. David Gifford, the chief medical officer for the American Health Care Association, which represents hundreds of long-term care facilities, isn’t optimistic.
“It’s baffling,” he said, “that public health and government officials indicate that there was a big proportion of the deaths from nursing homes, after which when asked to supply resources, they’re combative.”
Dr. Jim Wright, who was the medical director at a Richmond, Va., nursing home where 51 people died, said that Covid had exposed failings within the country’s system of long-term care centers that had yet to be widely addressed.
“What have we done to stop 200,000 nursing home deaths from the subsequent virus?” Dr. Wright, who now works at two different care facilities, asked. “We didn’t do much.”
Randolph Seals, 39, was elected the coroner for Bolivar County, in rural western Mississippi, in 2015. However the relentlessness of the deaths linked to Covid, and his personal ties to so many who were dying, brought him to the brink of quitting in the autumn of 2020.
By early 2021, when the South’s death rate spiked again, he wished he had. Then got here the Delta variant, and the Omicron wave, and it just got worse.
“It was a disaster that was coming back and back and back,” Mr. Seals said.
Houston Cofield for The Latest York Times
As hospitals overflowed, many residents died of their homes. The ripple effect of the pandemic was evident, too, as Mr. Seals began recording the deaths of individuals with heart or kidney disease for whom there have been no hospital beds. Now, he said, he’s handling the deaths of people that had Covid and never quite recovered.
The South has also experienced the very best death rates from Covid of any region. Partially, that’s since it is home to a few of the lowest vaccination rates within the country. Since vaccines became available, the common death rate fell in every single place however the South, where it rose by about 4 percent.
Epidemiologists also pointed to less stringent responses — lockdowns that ended sooner and masking restrictions that weren’t enforced as strictly, even after they were in place.
The South has also suffered since the share of adults with three or more chronic health conditions is higher on average than in every other region. Many chronic health problems are risk aspects for the coronavirus, and several other studies have suggested that 30 percent to 40 percent of all Covid deaths in america involved individuals with diabetes.
Mississippi has the very best Covid death rate of any state, and considered one of the bottom vaccination rates. Dr. Thomas Dobbs, the state’s health officer, said that even given the catastrophic problems with underlying illnesses in Mississippi, persuading more people to get vaccinated would have helped prevent many deaths.
It has been an uphill battle, Dr. Dobbs said, to compete with misinformation, especially on social media, and with individuals who tried to downplay the seriousness of the pandemic. Polarization across the virus and vaccines, he said, was devastating.
“Either you were fully on board or you probably did absolutely nothing and ran headlong into the thrill saw that was Covid,” he said.
For Mr. Seals, the coroner, the dimensions of loss has been hard to wrap his mind around.
“After I ran for county coroner, my biggest fear was a plane falling in my county, or a college bus crash,” he said. “Only the grace of God and my faith kept me grounded.”
Reporting was contributed by Brandon Dupré, Cierra S. Queen, Sarah Cahalan, Chloe Reynolds, Yves De Jesus, Laney Pope, Lauryn Higgins, Jess Ruderman, Bonnie G. Wong, Kristine White and Matt Craig.
Kitty Bennett and Alain Delaquérière contributed research.
Additional production by Or Fleisher, Nick Bartzokas and Don McCurdy.
In regards to the data
Unless otherwise noted, data on Covid-19 deaths in this text comes from a Latest York Times database of reports from state and native health agencies. Data is as of May 9, 2022, when 996,612 deaths had been reported in america, including Puerto Rico and the U.S. territories of American Samoa, Guam, the Northern Mariana Islands and the Virgin Islands.
The interactive graphics include as much as 996,612 dots on larger screens — one for every death. On smaller screens, each dot represents 4 deaths.
Data shown on the map and within the initial timeline is thru May 3, 2022, and excludes deaths in Puerto Rico, other U.S. territories and deaths for which the county is unknown. Data for Puerto Rico and other U.S. territories can also be excluded from demographic analyses of race and age.
Demographic data on Covid deaths comes from the Centers for Disease Control and Prevention’s National Center for Health Statistics, accessed via the C.D.C.’s WONDER database. Data is as of May 1, 2022, and includes deaths through April 16, 2022, at which point there have been 889,972 recorded deaths that had Covid-19 listed because the underlying cause. Deaths for which Covid-19 was listed on the death certificate but not because the explanation for death weren’t included.
Death certificate data for 2021 and 2022 stays incomplete and provisional. States and native health departments could have different criteria for reporting Covid deaths than the C.D.C. For these reasons, the demographic evaluation doesn’t include all reported deaths.
Data on death rates for unvaccinated and vaccinated people comes from a C.D.C. compilation of information from 25 state and native health departments covering 66 percent of the U.S. population.
Data on deaths amongst residents and staff members of nursing homes and other long-term care facilities comes from a Latest York Times database through June 1, 2021, and from the C.D.C. after that. The C.D.C. data includes only deaths from nursing homes and never from other long-term care facilities. Deaths shown within the timeline of deaths in nursing homes are those wherein the place of death was listed as a nursing home or long-term care facility within the WONDER database.
ZIP code data showing death rate by median household income includes cumulative death rate data through May 9, 2022, for Latest York City and Chicago. Los Angeles data comes from the California Department of Public Health via a research group led by Yea-Hung Chen and includes many but not all deaths occurring through the tip of 2021.