Excess mortality and potential undercounting of COVID-19 deaths by demographic group in Ohio

BackgroundThere are significant gaps in our understanding of the mortality effects of COVID-19 due to evolving diagnosis criteria, shortages of testing supplies, and challenges faced by physicians in treating patients in crisis environments. Accurate information on the number of deaths caused by COVID-19 is vital for policy makers and health care providers. MethodsWe performed a retrospective study of weekly data for Ohio. To estimate expected mortality in 2020 we employed data from 2010 through 2019, adjusted for secular trends and seasonality. We estimated excess mortality as the number of observed deaths less the number of expected deaths. We conducted the analysis for the entire population and by age, gender, and county. ResultsWe estimated 2,088 (95% CI 1,119-3,119) excess deaths due to natural causes in Ohio from March 15, 2020 through June 6, 2020. While the largest number excess of deaths was observed in the 80+ age group, our estimate of 366 (95% CI 110-655) excess deaths for those between 20 and 49 years of age substantially exceeds the reported number of COVID-19 deaths of 66. ConclusionsOur methodology addressed some of the challenges of estimating the number of deaths caused by COVID-19. Our finding of excess deaths being considerably greater than the reported number of COVID-19 deaths for those aged 20 to 49 years old suggests that current tracking methods may not capture a significant number of COVID-19 deaths for this group. Further, increases in the infection rates for this cohort may have a greater mortality impact than anticipated.