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COVID-19 Ranks as Third Leading Killer of Americans

Only heart disease and cancer caused more deaths in the U.S. in 2020

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Just over a year ago, it didn't have a name. But by the end of 2020, COVID-19 had become the third leading cause of death in the U.S., trailing only heart disease and cancer and replacing suicide as one of the top 10 causes of death.

About 3.4 million deaths occurred overall in the U.S. last year, according to provisional data released by the Centers for Disease Control and Prevention (CDC), and COVID-19 was reported as the underlying cause or a contributing cause for approximately 378,000 (about 11 percent) of those deaths. Heart disease accounted for an estimated 690,000 deaths, while roughly 598,000 Americans died from cancer.

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"This is a pretty big deal,” says Justin Lessler, an associate professor in the Division of Infectious Disease Epidemiology at the Johns Hopkins Bloomberg School of Public Health. “I mean, to have a cause of death that was not even a cause of death that we would list in January of 2020 be the third leading cause of death over the course of the year is pretty exceptional.”

Top 10 Causes of Death in 2020

  1. Heart disease
  2. Cancer
  3. COVID-19
  4. Unintentional injury
  5. Stroke
  6. Chronic lower respiratory disease
  7. Alzheimer's disease
  8. Diabetes
  9. Influenza and pneumonia
  10. Kidney disease

Source: The Centers for Disease Control and Prevention (data is provisional and may change)

Deaths hit older adults, minorities the hardest

Older adults and communities of color were most impacted by COVID-19 deaths last year. According to CDC data, deaths from the new disease were highest among Americans 85 and older. To date, more than 95 percent of all COVID-19 deaths in the U.S. have occurred in people age 50-plus. Also, more men than women died from COVID-19, the report shows.

Looking at racial and ethnic breakdowns, the COVID-19 death rate was highest among Hispanics and American Indian and Alaska Natives. Black Americans and Native Hawaiian and Pacific Islanders also experienced a disproportionate rate of deaths from COVID-19.

"In fact, among nearly all of these ethnic and racial minority groups, the COVID-19-related deaths were more than double the death rate of non-Hispanic white persons,” CDC Director Rochelle Walensky said during a White House COVID-19 Response Team briefing on the topic. “Sadly, based on the current state of the pandemic, these impacts have remained in 2021, where we continue to see that communities of color account for an outsize portion of these deaths.”

Prioritizing these groups for vaccination and “heavily promoting the vaccine” to disproportionately impacted populations — and especially to workers whose jobs don't allow them to socially distance — is one way to prevent such a pronounced disparity from continuing, Lessler says.

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Efforts are underway to vaccinate the country's most vulnerable. In fact, more than 70 percent of people over the age of 65 have received at least one vaccine dose, Walensky confirmed, and mass vaccination sites are being set up in communities hit hardest by the coronavirus. Still, an analysis from the Kaiser Family Foundation shows that in many states, minority communities have received shares of the vaccine that are smaller than their shares of COVID-19 cases and deaths and smaller than their shares of the total population. What's more, the vaccination rate among white people is nearly twice as high as the rate for Hispanic people and 1.7 times as high as the rate for Black people.

COVID-19 continues to claim lives

The COVID-19 death count continues to climb. More than 200,000 Americans have lost their lives to the disease since the start of 2021, bringing the pandemic's total to more than 550,000. That's why Lessler predicts that even with effective vaccines, COVID-19 will likely hold a top-10 spot on this year's leading causes of death list.

"But I think in the second half of the year, the most likely scenario is we see [deaths from COVID-19] drop to more of a flu-type of level,” he said. “Still, that is a significant threat to human health, compared to other infectious diseases in the United States.” Between 24,000 and 62,000 Americans died from the flu during the 2019-2020 flu season, the CDC reports.

In addition to the vaccine, health experts say face masks and social distancing can help slow the spread of the coronavirus and protect high-risk individuals from the disease it causes.

"The data should serve, again, as a catalyst for each of us to continue to do our part to drive down cases and reduce the spread of COVID-19 and get people vaccinated as quickly as possible,” the CDC's Walensky said.