Only the worst disasters completely upend normal patterns of death, overshadowing, if only briefly, everyday causes like cancer, heart disease and car accidents. Here’s how the devastation brought by the pandemic in 25 cities and regions compares with historical events.
Deaths during coronavirus outbreak
Historical events
7x normal mortality
6x normal mortality
5x normal mortality
4x normal mortality
3x normal mortality
2x normal mortality
Normal mortality
NORMAL MORTALITY
A wave of homicides devastated Chicago in 2016. But it caused only a small increase in overall mortality in the city.
A bad flu season in New York City raised all deaths to 1.05 times higher than during a normal winter.
Neither event nears the extraordinary wave of death during the coronavirus pandemic. We compared deaths in the worst months of the outbreak to past years, a measure often used to assess a disaster’s severity.
Even in Oslo, which has avoided a major outbreak, about 15 percent more people died than normal — rivaling the worst month of the AIDS epidemic in New York City.
The outbreak’s death toll in Miami rivals that of one America’s worst recent flu seasons in Seattle.
Hurricane Maria killed thousands of people in Puerto Rico in September 2017. Many died after widespread power outages overwhelmed hospitals. The increase in death was similar to the outbreak’s toll in Brazil’s two largest cities.
Demographers call these “mortality shocks” — sudden spikes in the total number of people dying not seen in the weeks before an event, and not likely to last once it is over. They’re often found during natural disasters, severe flu seasons, famines or wars.
Nearly 3,000 people in New York City died in a single day on Sept. 11, 2001. It was one of the largest mortality shocks in recent American history. Sixty percent more people died that September than normal.
On a relative scale, deaths increased more in Denver in March.
Death during the outbreak is often less visible than death from a terrorist attack or a natural disaster. Many people have died quietly, in nursing homes or at home. And some die without being tested and are excluded from official death counts.
These estimates include all deaths, offering a more complete accounting of the outbreak’s toll than official tallies. They include people who died directly from the coronavirus and those who died from other causes as hospitals have been stretched and people avoid seeking medical care.
The 1957 flu pandemic, also known as the Asian flu, killed at least one million people worldwide. In Santiago, Chile, one of the worst-hit cities, mortality doubled. That increase was only a little higher than the one during the coronavirus in Detroit.
2X NORMAL MORTALITY
Any disaster past this line — that is, one in which normal deaths double — should be declared an emergency, according to guidelines from the United Nations High Commissioner for Refugees.
Sweden kept schools and businesses open as most of Europe closed them and ordered citizens to stay home. The country has seen an extraordinary increase in deaths, especially in Stockholm. More than twice the usual number of people died there in April.
While national figures can broadly show the situation in each country, they can also obscure acute crises in densely populated cities, like Boston, where the virus spread rapidly before officials told people to stay home.
“If you’re looking at the total impact of the pandemic across an entire country, it may not seem like much is going on,” said Robert Anderson, chief of the mortality statistics branch at the C.D.C.’s National Center for Health Statistics. “If you really want to know what’s happening, you need to look at states, cities and local areas.”
Major cities with large outbreaks, like Paris, have rates of excess death far higher than the rest of their countries.
3X NORMAL MORTALITY
Few places have seen excess deaths of this scale — more than three times normal.
Now we see Boston’s toll during the 1918 flu, also known as the Spanish flu, the worst pandemic of the 20th century. It killed at least 50 million people worldwide, with about 675,000 deaths in the United States.
As the toll has eased in New York and in European capitals, cities across Latin America have begun to see astonishing increases in deaths. Deaths spiked in Lima in April despite a strict lockdown. More than 11,000 people died in May, about 8,000 more people than in previous years. That surpasses the worst month of the 1918 flu in New York City.
4X NORMAL MORTALITY
These figures reflect deaths only through May. In many cities in Latin America, Asia, Africa and the Middle East, the outbreak is still getting worse.
“Oh my goodness,” Dr. Anthony S. Fauci, the United States' top infectious disease expert, said on Tuesday. “Where is it going to end? We’re still at the beginning of it.”
In Madrid, more than 14,000 people died between mid-March and mid-April. The city usually sees around 3,000 deaths during this period.
5X NORMAL MORTALITY
Few places ever see excess deaths of this scale outside of famine or war.
The death toll in Ecuador — one of the worst in the world — was far higher than the official number of Covid-19 deaths reported by the government. In Guayas, a coastal province that includes the city of Guayaquil, deaths spiked by more than five times.
New York City, long the epicenter of the U.S. outbreak, has experienced one of the most extreme increases in deaths. Mortality in April grew to almost six times the usual number.
6X NORMAL MORTALITY
Bergamo, a province in northern Italy of just under one million people, usually sees fewer than 1,000 deaths each month. But during the peak of its outbreak in March, nearly 6,000 people died. It may be the hardest-hit place in the world, so far.
7X NORMAL MORTALITY
Only the Spanish flu outbreak in Philadelphia was worse. In October 1918, almost 15,000 people in the city died, an extraordinary number of deaths for that time.
The coronavirus is unlikely to kill as many people as the Spanish flu did, but in the modern history of natural disasters, it will have few rivals.
7.3x
7.25x
7.2x
7.15x
7.1x
7.05x
6.95x
6.9x
6.85x
6.8x
6.75x
6.7x
6.65x
6.6x
6.55x
6.5x
6.45x
6.4x
6.35x
6.3x
6.25x
6.2x
6.15x
6.1x
6.05x
5.95x
5.9x
5.85x
5.8x
5.75x
5.7x
5.65x
5.6x
5.55x
5.5x
5.45x
5.4x
5.35x
5.3x
5.25x
5.2x
5.15x
5.1x
5.05x
4.95x
4.9x
4.85x
4.8x
4.75x
4.7x
4.65x
4.6x
4.55x
4.5x
4.45x
4.4x
4.35x
4.3x
4.25x
4.2x
4.15x
4.1x
4.05x
3.95x
3.9x
3.85x
3.8x
3.75x
3.7x
3.65x
3.6x
3.55x
3.5x
3.45x
3.4x
3.35x
3.3x
3.25x
3.2x
3.15x
3.1x
3.05x
2.95x
2.9x
2.85x
2.8x
2.75x
2.7x
2.65x
2.6x
2.55x
2.5x
2.45x
2.4x
2.35x
2.3x
2.25x
2.2x
2.15x
2.1x
2.05x
1.95x
1.9x
1.85x
1.8x
1.75x
1.7x
1.65x
1.6x
1.55x
1.5x
1.45x
1.4x
1.35x
1.3x
1.25x
1.2x
1.15x
1.1x
1.05
Deaths in Chicago were 1.01 timesnormal.
Aug. 2016
1.05x Flu season in New York City, Jan. 2011
1.15x HIV/AIDS crisis in New York City, Sept. 1995
Oslo 1.16x
Fortaleza, Brazil 1.19x
1.25x Flu season in Seattle, Jan. 2017
Miami 1.26x
1.29x Hurricane Maria in Puerto Rico, Sept. – Oct. 2017
São Paulo, Brazil 1.29x
1.31x Chicago heat wave, July 1995
St. Petersburg, Russia 1.34x
Rio de Janeiro 1.36x
Istanbul 1.45x
Recife, Brazil 1.47x
Chicago 1.52x
Jakarta, Indonesia 1.54x
Moscow 1.60x
1.61x September 11th in New York City, Sept. 2001
Denver 1.75x
Milan 1.93x
Detroit 1.94x
1.99x 1957 flu in Santiago, Chile, Aug. 1957
2.00x Paris heat wave, Aug. 2003
Stockholm 2.18x
Boston 2.27x
2.42x Hurricane Katrina in New Orleans, Aug. 2005
Manaus, Brazil 2.56x
Paris 2.61x
Catalonia, Spain 2.95x
London 3.02x
3.61x Spanish flu in Boston, Oct. 1918
3.97x Spanish flu in New York City, Oct. 1918
Lima, Peru 3.99x
Madrid 4.57x
Guayas, Ecuador 5.50x
New York City 5.83x
Bergamo, Italy 6.67x
7.27x Spanish flu in Philadelphia, Oct. 1918
7x
7 times normal mortality
7x
5x
5x
5x
Madrid
New York City
Paris
3x
3x
3x
France
United States
Spain
Normal mortality
April
May
April
May
April
7x
7x
5x
5x
London
3x
3x
Stockholm
Sweden
England
and Wales
April
May
April
May
*The data in the U.S. accounts for 86 percent of the population.
Muktita Suhartono contributed reporting from Bangkok, Carlotta Gall from Istanbul, Anatoly Kurmanaev from Caracas, Venezuela, Monika Pronczuk from Brussels, José María León Cabrera from Quito, Ecuador, Irit Pazner from Jerusalem, John Bartlett from Santiago, Mirelis Morales from Lima and Manuela Andreoni from Rio de Janeiro.
About the data: The all-cause mortality data obtained from each city varies: Some cities publish daily death totals dating back decades, and others only for the last few years. Places with less historical data, such as Istanbul, make for rougher historical comparisons. Historical baselines used to calculate excess deaths do not adjust for any expected reduction in recent deaths from non-Covid-19 causes or for two deadly flu epidemics in Europe during the winters of 2014-15 and 2017-18.
Sources:
Elizabeth Wrigley-Field, University of Wisconsin-Madison; Andrew Noymer; University of California, Irvine; Leslie Roberts, Columbia University Medical Center; Virginia Zarulli, University of Southern Denmark.
Homicides in Chicago: Chicago Tribune
Flu deaths in New York City and Seattle: Centers for Disease Control and Prevention
HIV/AIDS epidemic in New York City: HIV Epidemiology Program, New York City Department of Health and Mental Hygiene
Mortality in Oslo: Statistics Norway
Mortality in Moscow: Moscow City Government
Mortality in St. Petersburg: St. Petersburg City Government
Mortality in Brazilian cities: Registro Civil and Brasil.io
Mortality in Miami: Florida Department of Health
Hurricane Maria in Puerto Rico: Puerto Rico Vital Statistics System; Alexis Santos, Demographer at Pennsylvania State University
Chicago heat wave in 1995: Whitman et al., “Mortality in Chicago Attributed to the July 1995 Heat Wave”
Mortality in Istanbul: Istanbul Metropolitan Municipality
Mortality in Chicago: Illinois Department of Public Health
Mortality in Jakarta, Indonesia: Jakarta Department of Parks and Cemeteries
September 11 in New York City: Centers for Disease Control and Prevention
Mortality in Denver: Colorado Department of Public Health and Environment
Mortality in Milan and Bergamo, Italy: Italian National Institute of Statistics
Mortality in Detroit: Michigan Department of Health and Human Services
1957 flu in Santiago, Chile: Chowell et al., “Severe mortality impact of the 1957 influenza pandemic in Chile,”; General Directorate of the National Health Service of Chile
Paris heat wave in 2003: INSEE
Mortality in Stockholm: Statistics Sweden
Mortality in Boston: Massachusetts Department of Public Health
Hurricane Katrina: Centers for Disease Control and Prevention
Mortality in Paris: INSEE
Mortality in Madrid and Catalonia, Spain: Daily Mortality Surveillance System
Mortality in London: Office for National Statistics
1918 flu in Boston, New York City, and Philadelphia: U.S. Department of Commerce
Mortality in Lima, Peru: Mortality Information System
Mortality in Guayas, Ecuador: General Direction of Civil Registry; National Institute of Statistics
No comments:
Post a Comment