Study: COVID-19 variants responsible for nearly half of one million U.S. Deaths

COVID-19 variants were responsible for approximately 460,000 deaths in the U.S. since the start of the pandemic, according to a new preprint study released this week by researchers at the Yale School of Public Health and Public Citizen.

Over 40% of COVID-19 deaths — approximately 430,000 — were caused by three SARS-CoV-2 variants first detected outside of the U.S.: Alpha, detected in the U.K. (40,000 deaths); Delta, detected in India (274,000 deaths); and Omicron, detected in Botswana and South Africa and often referred to as “mild” (118,000 deaths). Other lesser-known variants, including those that were first detected in the U.S., accounted for approximately 30,000 deaths.

The study notes that 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. The White House has requested $5 billion to fight the pandemic globally. “To get this pandemic behind us, we have to ensure the world is vaccinated. Every major variant that has hit us hard was first identified outside the United States,” wrote Dr. Ashish Jha, the White House COVID-19 response coordinator, earlier this year. “There is no domestic-only strategy for a pandemic — certainly not one that could possibly work.”

The study also tracks variant deaths state-by-state and by U.S. census region, revealing a particularly devastating toll in the Southern census region. The South recorded the most variant deaths per capita (158 per 100,000 people) and overall (206,000 deaths), while the Northeast reported the fewest per capita variant deaths (111 per 100,000 people) despite recording the most non-variant COVID-19 deaths per capita (215 per 100,000 people), highlighting the changing nature of the U.S. epidemic over time.

In Texas and Florida, SARS-CoV-2 variants caused over 44,000 and 40,000 COVID-19 deaths respectively, more than in any other state. On a per capita basis, West Virginia and Kentucky suffered the highest number of variant deaths, with 229 and 212 deaths per 100,000 people, respectively. The findings likely reflect differences in vaccination coverage, prior immunity, use of non-pharmaceutical interventions, demographics, and social vulnerability.

The authors of the study, including multiple scientists from the Yale School of Public Health (YSPH) Modeling Unit, constructed an epidemiologic model using public data from the Centers for Disease Control and Prevention on COVID-19 deaths by state and circulating variants.

“The findings reiterate a basic truth that the U.S. has tragically tried to ignore,” said Robert Weissman, president of Public Citizen. “There will be no end to the pandemic here in the U.S. until there is an end to it everywhere. For our own national interest, not to mention for humanitarian reasons, we must lead the way in providing full funding for the global effort to vaccinate, test and treat everyone.”

“Two years ago, the U.S. recording 100,000 COVID-19 deaths was rightfully described as ‘An Incalculable Loss’ on the front page of The New York Times. The fact that the Omicron variant alone exceeded that mark in a few months is really at odds with the idea that ‘Omicron is mild’ and this is now just an ordinary seasonal virus,” said Jo Walker, an infectious disease epidemiology PhD candidate at the Yale School of Public Health who led the analysis. “What will next winter, or the next time a new variant emerges, look like if we scale back, rather than strengthen, our ability to respond to the virus?”

“The story of how the U.S. reached one million deaths cannot be fully told without understanding the global pandemic,” said Zain Rizvi, research director at Public Citizen and a co-author of the study. “Ending global vaccine and treatment inequity can help protect American lives. We are only as safe as our neighbors.”

Other Yale School of Public Health scientists involved in the study were Associate Professors of Epidemiology Nathan Grubaugh, Gregg Gonsalves, and Virginia Pitzer. The study has been submitted to the medRxiv preprint server for health sciences.