ArticlePNAS nexus2022
Excess natural-cause deaths in California by cause and setting: March 2020 through February 2021.
Article in PNAS nexus, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- Applying machine learning to identify unrecognized COVID-19 deaths recorded as other causes of death in the United States.Science advances · 2026Article
- Minimal Impact of COVID-19 on One-Year Mortality on US Patients with Cancer Diagnosed Early during the Pandemic.Cancer research communications · 2025Article
- Excess Deaths in California During the COVID-19 Pandemic, by Healthy Places Index Quartile, February 2020-April 2022.Public health reports (Washington, D.C. : 1974) · 2025Article
- Spatiotemporal patterns of excess mortality from non-COVID causes of death in the United States, March to December 2020.American journal of epidemiology · 2025Article
- Demographic changes in COVID-19 mortality during the pandemic: analysis of trends in disparities among workers using California's mortality surveillance system.BMC public health · 2024Article
- Excess natural-cause mortality in US counties and its association with reported COVID-19 deaths.Proceedings of the National Academy of Sciences of the United States of America · 2024Article
- Accuracy of the Verbal Autopsy questionnaire in the diagnosis of COVID-19 deaths in a Brazilian capital.Revista do Instituto de Medicina Tropical de Sao Paulo · 2024Article
- Excess mortality in US Veterans during the COVID-19 pandemic: an individual-level cohort study.International journal of epidemiology · 2023Observational
- Monthly excess mortality across counties in the United States during the COVID-19 pandemic, March 2020 to February 2022.Science advances · 2023Article
- Associations between mortality from COVID-19 and other causes: A state-level analysis.PloS one · 2023Article
- Monthly excess mortality across counties in the United States during the Covid-19 pandemic, March 2020 to February 2022.medRxiv : the preprint server for health sciences · 2022Article
- Dynamics of racial disparities in all-cause mortality during the COVID-19 pandemic.Proceedings of the National Academy of Sciences of the United States of America · 2022Article
- The impact of the SARS-CoV-2 pandemic on cause-specific mortality patterns: a systematic literature review.Zeitschrift fur Gesundheitswissenschaften = Journal of public health · 2022Review
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
Excess mortality has exceeded reported deaths from Covid-19 during the pandemic. This gap may be attributable to deaths that occurred among individuals with undiagnosed Covid-19 infections or indirect consequences of the pandemic response such as interruptions in medical care; distinguishing these possibilities has implications for public health responses. In the present study, we examined patterns of excess mortality over time and by setting (in-hospital or out-of-hospital) and cause of death using death certificate data from California. The estimated number of excess natural-cause deaths from 2020 March 1 to 2021 February 28 (69,182) exceeded the number of Covid-19 diagnosed deaths (53,667) by 29%. Nearly half, 47.4% (32,775), of excess natural-cause deaths occurred out of the hospital, where only 28.6% (9,366) of excess mortality was attributed to Covid-19. Over time, increases or decreases in excess natural non-Covid-19 mortality closely mirrored increases or decreases in Covid-19 mortality. The time series were positively correlated in out-of-hospital settings, particularly at time lags when excess natural-cause deaths preceded reported Covid-19 deaths; for example, when comparing Covid-19 deaths to excess natural-cause deaths in the week prior, the correlation was 0.73. The strong temporal association of reported Covid-19 deaths with excess out-of-hospital deaths from other reported natural-cause causes suggests Covid-19 deaths were undercounted during the first year of the pandemic.
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