{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T05:32:56Z","timestamp":1790487176694,"version":"4.1.0"},"reference-count":40,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2020,10,29]],"date-time":"2020-10-29T00:00:00Z","timestamp":1603929600000},"content-version":"unspecified","delay-in-days":302,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Epidemiol. Infect."],"published-print":{"date-parts":[[2020]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Deaths are frequently under-estimated during emergencies, times when accurate mortality estimates are crucial for emergency response. This study estimates excess all-cause, pneumonia and influenza mortality during the coronavirus disease 2019 (COVID-19) pandemic using the 11 September 2020 release of weekly mortality data from the United States (U.S.) Mortality Surveillance System (MSS) from 27 September 2015 to 9 May 2020, using semiparametric and conventional time-series models in 13 states with high reported COVID-19 deaths and apparently complete mortality data: California, Colorado, Connecticut, Florida, Illinois, Indiana, Louisiana, Massachusetts, Michigan, New Jersey, New York, Pennsylvania and Washington. We estimated greater excess mortality than official COVID-19 mortality in the U.S. (excess mortality 95% confidence interval (CI) 100 013\u2013127 501\n                    <jats:italic>vs.<\/jats:italic>\n                    78 834 COVID-19 deaths) and 9 states: California (excess mortality 95% CI 3338\u20136344)\n                    <jats:italic>vs.<\/jats:italic>\n                    2849 COVID-19 deaths); Connecticut (excess mortality 95% CI 3095\u20133952)\n                    <jats:italic>vs.<\/jats:italic>\n                    2932 COVID-19 deaths); Illinois (95% CI 4646\u20136111)\n                    <jats:italic>vs.<\/jats:italic>\n                    3525 COVID-19 deaths); Louisiana (excess mortality 95% CI 2341\u20133183\n                    <jats:italic>vs.<\/jats:italic>\n                    2267 COVID-19 deaths); Massachusetts (95% CI 5562\u20137201\n                    <jats:italic>vs.<\/jats:italic>\n                    5050 COVID-19 deaths); New Jersey (95% CI 13 170\u201316 058\n                    <jats:italic>vs.<\/jats:italic>\n                    10 465 COVID-19 deaths); New York (95% CI 32 538\u201339 960\n                    <jats:italic>vs.<\/jats:italic>\n                    26 584 COVID-19 deaths); and Pennsylvania (95% CI 5125\u20136560\n                    <jats:italic>vs.<\/jats:italic>\n                    3793 COVID-19 deaths). Conventional model results were consistent with semiparametric results but less precise. Significant excess pneumonia deaths were also found for all locations and we estimated hundreds of excess influenza deaths in New York. We find that official COVID-19 mortality substantially understates actual mortality, excess deaths cannot be explained entirely by official COVID-19 death counts. Mortality reporting lags appeared to worsen during the pandemic, when timeliness in surveillance systems was most crucial for improving pandemic response.\n                  <\/jats:p>","DOI":"10.1017\/s0950268820002617","type":"journal-article","created":{"date-parts":[[2020,10,28]],"date-time":"2020-10-28T22:34:33Z","timestamp":1603924473000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":59,"title":["Excess mortality in the United States during the first three months of the COVID-19 pandemic"],"prefix":"10.1017","volume":"148","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2890-6966","authenticated-orcid":false,"given":"R.","family":"Rivera","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9796-513X","authenticated-orcid":false,"given":"J. E.","family":"Rosenbaum","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W.","family":"Quispe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2020,10,29]]},"reference":[{"key":"S0950268820002617_ref11","unstructured":"11. Spencer, MR and Ahmad, F (2016) Timeliness of death certificate data for mortality surveillance and provisional estimates. Vital statistics rapid release special report no. 001. US Department of Health and Human Services, Centers for Disease Control and Prevention. National Center for Health Statistics, National Vital Statistics System. Available at https:\/\/www.cdc.gov\/nchs\/data\/vsrr\/report001.pdf."},{"key":"S0950268820002617_ref12","unstructured":"12. US Census Bureau. National population by characteristics: 2010\u20132019. Available at https:\/\/www.census.gov\/data\/tables\/time-series\/demo\/popest\/2010snational-detail.html."},{"key":"S0950268820002617_ref32","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2020.1017"},{"key":"S0950268820002617_ref40","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-12-251"},{"key":"S0950268820002617_ref24","first-page":"30464","article-title":"Cardiovascular implications of the Covid-19 pandemic: a global perspective","volume":"S0828282X","author":"Boukhris","year":"2020","journal-title":"Canadian Journal of Cardiology"},{"key":"S0950268820002617_ref29","first-page":"1","article-title":"COVID-19 patients\u2019 clinical characteristics, discharge rate, and fatality rate of meta-analysis","volume":"127","author":"Li","year":"2020","journal-title":"Journal of Medical Virology"},{"key":"S0950268820002617_ref19","doi-asserted-by":"publisher","DOI":"10.1201\/9781315370279"},{"key":"S0950268820002617_ref17","doi-asserted-by":"publisher","DOI":"10.1890\/07-0043.1"},{"key":"S0950268820002617_ref3","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2020.116"},{"key":"S0950268820002617_ref37","first-page":"1","article-title":"Mortality attributable to seasonal influenza in Greece, 2013 to 2017: variation by type\/subtype and age, and a possible harvesting effect","volume":"24","author":"Lytras","year":"2019","journal-title":"Euro Surveillance: Bulletin Europeen Sur Les Maladies Transmissibles = European Communicable Disease Bulletin"},{"key":"S0950268820002617_ref39","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp2002125"},{"key":"S0950268820002617_ref15","unstructured":"15. CDC (2020) Daily updates of totals by week and state: provisional death counts for coronavirus disease 2019 (COVID-19). Available at https:\/\/www.cdc.gov\/nchs\/nvss\/vsrr\/COVID19\/index.htm."},{"key":"S0950268820002617_ref23","unstructured":"23. CDC (2020) COVIDView: a weekly surveillance summary of U.S. COVID-19 activity. Available at https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/coviddata\/covidview\/index.html."},{"key":"S0950268820002617_ref8","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2008.03.014"},{"key":"S0950268820002617_ref14","unstructured":"14. New York Times (2020) Coronavirus in the U.S.: latest map and case count. Available at https:\/\/www.nytimes.com\/interactive\/2020\/us\/coronavirus-uscases.html."},{"key":"S0950268820002617_ref27","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201111-2042ST"},{"key":"S0950268820002617_ref18","unstructured":"18. Quealy, K (2020) The upshot: the richest neighborhoods emptied out most as coronavirus hit New York City [original data analysis]. New York Times. May 15, 2020."},{"key":"S0950268820002617_ref28","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcv.2020.104363"},{"key":"S0950268820002617_ref31","doi-asserted-by":"publisher","DOI":"10.1080\/22221751.2020.1746199"},{"key":"S0950268820002617_ref7","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2012.301050"},{"key":"S0950268820002617_ref10","doi-asserted-by":"publisher","DOI":"10.7326\/M20-1491"},{"key":"S0950268820002617_ref2","doi-asserted-by":"publisher","DOI":"10.1002\/sim.8314"},{"key":"S0950268820002617_ref34","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.25829"},{"key":"S0950268820002617_ref35","doi-asserted-by":"publisher","DOI":"10.1017\/CBO9780511755453"},{"key":"S0950268820002617_ref36","unstructured":"36. New York City Department of Health and Mental Hygiene (2020) Influenza surveillance report week ending April 18, 2020 (Week 16)."},{"key":"S0950268820002617_ref30","first-page":"577","article-title":"Clinical and virological data of the first cases of COVID-19 in Europe: a case series","volume":"92","author":"Lescure","year":"2020","journal-title":"The Lancet Infectious Diseases"},{"key":"S0950268820002617_ref21","unstructured":"21. National Vital Statistics System (2020) Guidance for certifying deaths due to coronavirus disease 2019 (COVID-19). National Vital Statistics System: vital statistics reporting guidance (Report 3), April 2020."},{"key":"S0950268820002617_ref4","doi-asserted-by":"publisher","DOI":"10.1080\/23744235.2018.1472805"},{"key":"S0950268820002617_ref33","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2020.03.005"},{"key":"S0950268820002617_ref26","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiu224"},{"key":"S0950268820002617_ref25","unstructured":"25. 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Available at https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/hcp\/guidance-postmortemspecimens.html."},{"key":"S0950268820002617_ref6","doi-asserted-by":"publisher","DOI":"10.3201\/eid2203.150977"},{"key":"S0950268820002617_ref5","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001558"},{"key":"S0950268820002617_ref13","unstructured":"13. Madrigal, A , Hammerbacher, J , Kissane, E and COVID Tracker team. COVID tracking project. Available at https:\/\/covidtracking.com\/data."},{"key":"S0950268820002617_ref9","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.6775"},{"key":"S0950268820002617_ref16","doi-asserted-by":"publisher","DOI":"10.1016\/S2542-5196(18)30209-2"}],"container-title":["Epidemiology and Infection"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0950268820002617","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,11,9]],"date-time":"2020-11-09T03:39:22Z","timestamp":1604893162000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0950268820002617\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020]]},"references-count":40,"alternative-id":["S0950268820002617"],"URL":"https:\/\/doi.org\/10.1017\/s0950268820002617","relation":{"has-preprint":[{"id-type":"doi","id":"10.1101\/2020.05.04.20090324","asserted-by":"object"}]},"ISSN":["0950-2688","1469-4409"],"issn-type":[{"value":"0950-2688","type":"print"},{"value":"1469-4409","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020]]},"assertion":[{"value":"Copyright \u00a9 The Author(s), 2020. Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e264"}}