One Million and Counting: Estimates of Deaths in the United States from Ancestral SARS-CoV-2 and Variants
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Abstract
Background
Over one million COVID-19 deaths have been recorded in the United States. Sustained global SARS-CoV-2 transmission has led to the emergence of new variants with increased transmissibility, virulence, and/or immune evasion. The specific burden of mortality from each variant over the course of the U.S. COVID-19 epidemic remains unclear.
Methods
We constructed an epidemiologic model using data reported by the CDC on COVID-19 mortality and circulating variant proportions to estimate the number of recorded COVID-19 deaths attributable to each SARS-CoV-2 variant in the U.S. We conducted sensitivity analysis to account for parameter uncertainty.
Findings
Of the 1,003,419 COVID-19 deaths recorded as of May 12, 2022, we estimate that 460,124 (46%) were attributable to WHO-designated variants. By U.S. Census Region, the South recorded the most variant deaths per capita (median estimate 158 per 100,000), while the Northeast recorded the fewest (111 per 100,000). Over 40 percent of national COVID-19 deaths were estimated to be caused by the combination of Alpha (median estimate 39,548 deaths), Delta (273,801), and Omicron (117,560).
Interpretation
SARS-CoV-2 variants that have emerged around the world have imposed a significant mortality burden in the U.S. In addition to national public health strategies, greater efforts are needed to lower the risk of new variants emerging, including through global COVID-19 vaccination, treatment, and outbreak mitigation.
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SciScore for 10.1101/2022.05.31.22275835: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics not detected. Sex as a biological variable not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Table 2: Resources
Software and Algorithms Sentences Resources We considered 26 mutually-exclusive categories that deaths could be assigned to: the 5 current and former variants of concern (Alpha, Beta, Gamma, Delta, and Omicron), 19 other variants and lineages which have been recognized by the WHO and detected in the U.S. (A.23.1, A.27, A.28, B.1.1.318, B.1.1.519, B.1.214.2, B.1.617.3, B.1.620, B.1.640, C.16, C.36, Epsilon, Eta, Iota, Kappa, Lambda, Mu, Theta, or Zeta), a composite group of the early non-VOI/VOC/VBM virus lineages, which we will refer to as … SciScore for 10.1101/2022.05.31.22275835: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics not detected. Sex as a biological variable not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Table 2: Resources
Software and Algorithms Sentences Resources We considered 26 mutually-exclusive categories that deaths could be assigned to: the 5 current and former variants of concern (Alpha, Beta, Gamma, Delta, and Omicron), 19 other variants and lineages which have been recognized by the WHO and detected in the U.S. (A.23.1, A.27, A.28, B.1.1.318, B.1.1.519, B.1.214.2, B.1.617.3, B.1.620, B.1.640, C.16, C.36, Epsilon, Eta, Iota, Kappa, Lambda, Mu, Theta, or Zeta), a composite group of the early non-VOI/VOC/VBM virus lineages, which we will refer to as “non-variant”, and “unknown” (deaths for which the week of occurrence is suppressed). Zetasuggested: NoneResults from OddPub: Thank you for sharing your code and data.
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:In general, reported deaths represent an undercount of total COVID-19 deaths, given limitations in testing and data.46 In addition, there is considerable uncertainty associated with some state variant proportions due to insufficient sequencing. Our model also uses variant proportion figures based on clinical testing which may lag behind actual variant circulation. For example, wastewater surveillance suggests that Omicron was circulating in the country before the first case was reported.47 This would also lead to underestimates of deaths caused by variants. Finally, we do not model disease transmission dynamics so our estimates should not be interpreted as the number of deaths that would have been prevented if novel variants did not emerge. Even in the absence of new variants, the non-variant SARS-CoV-2 would have continued to spread, resulting in additional deaths. SARS-CoV-2 variants detected around the world have imposed a significant mortality burden in the U.S. In addition to national public health strategies, greater efforts are needed to reduce the risk of new variants emerging globally. However, U.S. government officials have warned that they are running out of COVID-19 funds.48 Congressional lawmakers recently excluded $5 billion in funding for global treatment and vaccination campaigns from a new spending proposal, and there has been limited investment in next-generation vaccines that may offer greater protection against transmission.49, 50 Our analysis shows the si...
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
Results from scite Reference Check: We found no unreliable references.
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