Update on Excess Pandemic-Related Deaths in Arizona

While the death toll from the Covid pandemic is usually measured by Covid deaths, these deaths do not reflect the full impact of the pandemic on mortality. A more complete measure of pandemic-related deaths includes all causes of excess mortality during the pandemic. AZ has had the unfortunate distinction of leading the nation in the percent of excess pandemic-related deaths during 2020 -2022 compared to pre-pandemic levels.

While most of the excess deaths are attributable to the largely preventable high rate of Covid deaths in Arizona, many other causes of death were also elevated during the pandemic. Indeed, the CDC estimates that since 2/1/2020, Arizona has experienced 3,020 excess heart disease deaths, 2,223 excess strokes, 3,307 hypertensive diseases, 3,569 excess cancer deaths, 5,174 excess Alzheimer and dementia deaths, and 1,531 excess diabetes deaths.

For all categories combined, Arizona experienced a 31.6% excess of all cause deaths during the pandemic, while the US experienced a 19.2% excess.

The CDC National Center for Health Statistics (NCHS) has provided frequent updates on the numbers and percent of weekly, monthly, and yearly excess deaths since the start of the pandemic. While 2020 and 2021 death counts are considered “final” and complete counts of deaths, 2022 data is several months away from final status and is still considered provisional although mostly complete.  2023 data is considered both provisional and incomplete due to the lag in completing a death certificate after death, submitting the data to NCHS, and data processing.

Consequently, data for recent weeks undercount observed deaths and would result in underestimates of excess deaths. To address this undercount, NCHS provides “weighted” estimates of deaths that occurred in 2022 and 2023. The weighting factor is applied to the death counts and is based on comparisons between provisional and final deaths during previous years by week, state, and for various lag times.

In the following charts, NCHS weighted estimates of observed death counts were utilized to determine the percent of excess deaths from all causes for both Arizona and the US.

This first chart shows the estimated percent of weekly excess deaths during the pandemic for every week between 02/01/20 and 07/15/23 for Arizona and the US. This chart shows that the peaks in excess death in Arizona were typically much higher than the US peaks.  It also shows that in both AZ and the US, excess deaths have declined dramatically several months into 2023, approaching pre-pandemic levels. NCHS also estimated that there were 40,712 excess deaths in AZ and 1,335,688 excess deaths in the US over that time period.

The second chart shows the overall percent of excess deaths during the pandemic by race and ethnicity. Except for the “Other” race category, the percent of excess deaths significantly exceeded the US percent of excess deaths.

For all categories combined, Arizona experienced a 31.6% excess of all cause deaths during the pandemic, while the US experienced a 19.2% excess.

Editorial Note by Will Humble: Arizona’s terrible (and lethal) performance during the pandemic was not bad luck. It was largely due to former governor Ducey and former ADHS director Christ’s unwillingness to implement well-established interventions to mitigate the spread of the virus. In the summer of 2020, it was the fact they had no enforced mitigation in bars, nightclubs and restaurants – leading to the lethal summer of 2020. The lethal January and February 2021 was also largely due to the lack of mitigation in those environments. The 3rd wave of excess deaths in late 2021 and early 2022 was largely due to the governor’s executive orders that thwarted efforts to improve community vaccination levels (e.g. their ‘vaccine passport executive order).