The Hidden Impact of COVID-19

New data visualization reveals undercounted deaths associated with the pandemic.

By Katharine Chilcutt

Since the onset of the COVID-19 pandemic, deaths attributed to many other health conditions — Alzheimer’s, heart disease, cancer and diabetes, for example — have killed far more Americans than would be expected in a pre-pandemic year.

Hidden Impacts

The Journal of the American Medical Association and others are warning that official counts are underestimating the number of deaths associated with the pandemic, with studies indicating the number of people who would not have died in any other year has been undercounted by 20% to 36%.

“This is not a normal year,” says John Mulligan, a computing researcher in the School of Humanities. “You get rid of COVID deaths, and we are still well above the average.”

The Centers for Disease Control (CDC) defines “excess mortality” as “the difference between the observed numbers of deaths in specific time periods and expected numbers of deaths in the same time periods.” Mulligan, in partnership between Rice’s Center for Research Computing and the Medical Futures Lab, used CDC data to create a new dashboard that sheds light on this troubling trend, making it easier for researchers to spot state and regional patterns in 12 different categories.

For example, a surge in Alzheimer’s deaths in the early months of the pandemic showed how COVID-19 has taken a larger toll than official numbers have shown. A nursing home patient with Alzheimer’s might recover from COVID-19 but lose the sense of taste or smell. Soon, that patient might stop eating. A couple of weeks later, that patient might die.

“Was that COVID?” Mulligan asks. “Do you want to add that to the number of COVID deaths your nursing home has on the books?

“The undercount reflects rampant problems within the American health care system and public health programs,” Mulligan says. “As outbreaks continue to cripple hospitals, the excess mortality data exposes ‘a slow-burning background crisis’ that’s absolutely the effect of underinvesting in public health.”

“We are going to be working to understand the full impact of COVID for a long time, because it has touched so many parts of our lives in ways that are not visible based on just the narrow counts of infections and deaths that are directly attributed to COVID,” says Kirsten Ostherr, the Gladys Louise Fox Professor of English, chair of the Department of English and director of Rice’s Medical Futures Lab.

“Where interactive data visualizations tend to give the user a sense of certainty and control over unruly data-sets, I wanted, with this dashboard, to allow people to drill down into some of the unanswered and underexplored dimensions of the pandemic,” Mulligan says. The COVID-19 Excess Mortality Data Visualization is updated weekly at