Climbing COVID-19 hospitalizations and death toll; how concerned should Americans be?

by mcardinal

Lauren Dempsey, MS in Biomedicine and Law, RN, FISM News 


In March of 2020 the Trump Administration announced a campaign to combat COVID-19. Americans were told that lockdowns were the key to flatten the curve and slowing the spread of the virus. This was essential in preventing hospitals from becoming overwhelmed with critically ill and dying COVID-19 patients which would put excessive strain on the healthcare system. 

This week the United Sates COVID-19 death toll surpassed 663,000 deaths, which was significant in that it reportedly accounted for .2% of the American population. But how significant is this number?

A study published in 2021, gathered information from the National Center for Health Statistics which showed the leading cause of death was heart disease, killing 690,000 people, cancer killed 598,000 people, and COVID-19 deaths ranked third with 345,000 deaths. In previous years medical errors were the third leading cause of death in the United States. Data for 2021 is still being collected, but currently the deaths that can be attributed to COVID-19 is over 250,000. Any loss of life is tragic, but in light of these numbers, will we start treating heart disease and cancer as equally alarming pandemics?

According to the CDC, it is acceptable to list COVID-19 as the cause of death for any death that can be attributed to COVID-19 or a death where COVID-19 is probable or presumed. This makes it complicated to determine if patients are dying from COVID-19 as opposed to with COVID-19. Reporting the numbers this way negates the contribution of previous illness, like cancer or comorbidities, that may have caused death.  To add more ambiguity to the situation the CDC is no longer collecting information on breakthrough cases unless they result in hospitalization or death, explaining that “this shift will help maximize the quality of the data collected on cases of greatest clinical and public health importance.” 

The Atlantic recently reported on a study conducted by Harvard Medical School, Tufts Medical Center, and the Veterans Affairs Healthcare System that evaluated data to determine why patients were being hospitalized.  Researchers used electronic medical records for COVID-19 admissions across the United States and used criteria from the NIH to determine if patients met the definition of having severe illness. 

Data from March 2020 through January 2021 showed that the number of patients with mild or asymptomatic disease was 36 percent. This number increased to 48 percent from January through June 2021 and in vaccinated patients 57 percent had mild or asymptomatic infections. It is equally important to note that the study showed unvaccinated patients had less severe symptoms, with 45 percent of cases being mild or asymptomatic. 

The study included 100 VA hospitals, but could be indicative of what other hospitals across the country are seeing.

The numbers can be very misleading. A hospitalization does not always mean that a patient is filling an ICU bed or that hospitals are operating at maximum capacity. Patients are testing positive, but not all of these patients are severely ill or even requiring hospitalization. However many patients are being admitted for observation or for supplement oxygenation and some patients were admitted for reasons unrelated to COVID-19. Currently there is no standardized method of collecting data and evaluating varying factors that contribute to COVID-19 hospitalizations and death, which would give a more accurate picture of the pandemic.