A positive stage of Covid – The New York Times

The United States has reached an important milestone in the long fight against Covid: the total number of Americans who die every day – from whatever cause – is no longer historically abnormal.

Excess deaths, as this number is known, have been an important measure of the true Covid toll, as they do not depend on obscure attribution of deaths to a specific cause. Even if Covid is underdiagnosed, the excess deaths statistic can capture its effects. The statistic also captures The indirect effects of Covidlike the wave of vehicle accidents, gun deaths and deaths from missed medical treatment during the pandemic.

During the worst phases of Covid, the total number of Americans dying each day was more than 30% higher than normal, a shocking increase. For long periods over the past three years, the surplus was above 10%. But in recent months, excess mortality has fallen almost to zero, by three different measures.

After three horrific years, in which Covid killed more than a million Americans and transformed swaths of daily life, the virus has morphed into an ordinary disease.

The story is similar in many other countries, if not quite as positive:

The power of immunity

Progress stems mainly from three factors:

• First, about three-quarters of American adults have had at least one shot of the vaccine.

• Second, more than three-quarters of Americans have been infected with Covid, providing natural immunity against future symptoms. (About 97% of adults fall into at least one of these first two categories.)

• Third, post-infection treatments like Paxlovid, which can reduce the severity of symptoms, have become widely available over the past year.

“Almost all deaths are preventable,” Dr. Ashish Jha, who until recently served as President Biden’s top Covid adviser, told me. “We’re at a point where almost everyone who’s up to date on their vaccines and gets treatment if they have Covid, they rarely end up in hospital, they almost never die.”

This is also true for most people at high risk, Jha pointed out, including the elderly — like her parents, who are over 80 — and people with compromised immune systems. “Even for most – not all but most – immunocompromised people, vaccines are actually still quite effective in preventing serious disease,” he said. “There’s been a lot of misinformation that somehow if you’re immunocompromised, vaccines don’t work.”

The fact that excess deaths have fallen close to zero helps drive home this point: If Covid was still a serious threat to large numbers of people, it would show up in the data.

One point of confusion, I think, has been how many Americans — including us in the media — have talked about the immunocompromised. They are a more diverse group than informal discussions often imagine.

Most immunocompromised people are at little additional risk from Covid – even people with serious illnesses, such as multiple sclerosis or a history of many cancers. A much smaller group, such as people who have had kidney transplants or are undergoing active chemotherapy, face higher risks.

With vs from

The Covid toll, to be clear, has not fallen to zero. The CDCs covid main webpage estimates that around 80 people a day have died from the virus in recent weeks, which equates to around 1% of total daily deaths.

The official number is likely exaggerated as it includes some people who had the virus at the time of death, even though it was not the underlying cause of death. Other data from the CDC suggests that almost a third recent official Covid deaths have fallen into this category. A study published in the journal Clinical Infectious Diseases has just similar findings.

Even so, some Americans are still dying from Covid. “I don’t know anyone who thinks we’re going to eradicate Covid,” Jha said.

Dr. Shira Doron, infection control manager at Tufts Medicine in Massachusetts, told me that “age is clearly the most important risk factor.” Covid victims are both older and disproportionately unvaccinated. Given the vaccination policy, recent victims are also disproportionately Republican And white.

Each of these deaths is a tragedy. Preventable deaths – because someone did not receive available vaccines and treatments – seem particularly tragic. (Here’s a guide from The Times to help you think about when to have your next booster shot.)

Yet the number of Covid deaths is now low enough that they are hard to notice in the overall death data. They can be overwhelmed by fluctuations in other causes of death, such as the flu or car accidents.

Almost a year ago, President Biden angered some public health experts when he declared, “The pandemic is over.” It was perhaps premature to make this statement. But the milestone of excess deaths suggests that’s true now: the pandemic is finally over.

Related: Researchers are working to ensure that developing countries do not have to rely on vaccine rich nations in a future pandemic, reports the Washington Post.

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