This week marks five years since March 13, 2020, the day President Donald Trump declared a national state of emergency over the novel coronavirus outbreak. By that date, only 57 Americans had died of COVID-19 and 1,645 had been diagnosed with the virus. Three days later, the White House issued the President’s Coronavirus Guidelines for America. Among other things, the guidelines advised Americans to avoid bars, restaurants, shopping trips, and social visits. They also recommended that governors in states with evidence of community transmission should close schools, bars, restaurants, food courts, gyms, and other indoor and outdoor venues. By then, the death toll had risen to 102.
Sticking to peer-reviewed science and setting aside the political question of what the government should do with this information, what do we know now about how deadly the pandemic was? On Monday and yesterday, we looked at what researchers have discovered over the past five years about the efficacy of facial masking for protection against COVID-19 and the use of hydroxychloroquine and ivermectin for treating coronavirus infections. Next, we’ll discuss what researchers have determined about the safety and efficacy of COVID-19 vaccines.
Today, we look at estimates of how many Americans have died of COVID-19. Some initial projections were frightening. On March 16, 2020, a team of epidemiological modelers associated with the Imperial College London published an alarming study calculating that 2.2 million Americans would die of COVID-19 if measures to stem the spread of the virus were not taken soon. A year later, a retrospective article in The Lancet: Microbe noted that “this information became foundational in decisions to implement physical distancing and adherence to other public health measures because it established the upper boundary for any worst-case scenarios.” On March 18, 2020, I asked: Are we battling an unprecedented pandemic or panicking at a computer-generated mirage?
Others expressed more sanguine views. For example, Elon Musk bet $1 million with his (former) friend neuroscientist Sam Harris in March 2020 that there wouldn’t be as many 35,000 cases (never mind deaths) of COVID-19 in the United States. In an interview with Reason, New York University law professor Richard Epstein stood by his March 16, 2020, article (since removed) from the Hoover Institution, in which he asserted the total number of deaths from COVID-19 globally would top out under 50,000 and that the United States we would see “about 500 deaths at the end.”
In an effort to gauge the pandemic’s toll, various researchers early on tried to nail down the infection fatality rate for the illness—that is, the percentage of infected individuals expected to die. At the beginning of the pandemic, no one knew crucial information, such as how fast the virus could spread, what percentage of infected people would remain asymptomatic, and whether they could transmit the virus to more vulnerable individuals. Initial infection fatality rates ranged widely.
For example, an April 11, 2020, study headed by Stanford physician Jay Bhattacharya (now a nominee for director of the National Institutes of Health) calculated an infection fatality rate of 0.12–0.2 percent. This suggested that COVID-19 was not much more deadly than seasonal flu. This contrasts with the Lancet study, which projected a 0.9 percent infection fatality rate from COVID-19 infections. These figures compare with the estimated U.S. infection fatality rate of 0.64 percent for the 1918 influenza pandemic.
Calculating deaths from epidemics takes years. More than 100 years later, estimates for the number of deaths stemming from the 1918 influenza pandemic globally still range from 17 to 100 million. So, keep in mind that COVID-19 death counts will still be contested for years to come.
In addition to tracking deaths attributed to COVID-19, researchers aim to account for those missed by formal diagnoses by calculating excess deaths. Excess deaths are typically defined as the number of deaths during a particular period above the usual, expected number of deaths under normal conditions.
A February 2024 article in Proceedings of the National Academy of Sciences calculated excess deaths between March 2020 and August 2022, concluding that around 1.2 million Americans had died of COVID-19. A January 2025 analysis in the Journal of the Royal Statistical Society: Statistics in Society Series A calculated excess pandemic mortality in the United States for 2020 and 2021 at 920,731. Interestingly, Stanford biostatistician John Ioannidis, a skeptic of worst-case COVID-19 pandemic claims, and his colleagues calculated in a December 2023 Proceedings of the National Academy of Sciences article that the U.S. suffered 1,220,295 excess deaths between 2020 and 2023. Notably, they also calculated that the U.S. actually experienced 3,456 fewer than expected deaths of Americans aged 14 and under during that period. Considering that all of these calculations use data from 2023 or earlier, they suggest that the Centers for Disease Control and Prevention’s current count of 1,225,281 American deaths from COVID-19 and related causes is somewhat conservative.
As a side note, several practitioners of the dismal science calculate in their March 2025 National Bureau of Economic Research study that the approximately 1.4 million excess deaths among Americans aged 25 and older between 2020 and 2023 have reduced the future outlays of Social Security by about $156 billion.
What have researchers learned about the infection fatality rate for COVID-19? The picture remains hazy. A rough calculation, assuming that 80 percent of Americans have had a bout of COVID-19, suggests an infection fatality rate of 0.45 percent. A June 2024 study in Infectious Disease Modelling calculated the median pre-vaccination rate for the U.S. at 0.214 percent. This is close to the rate reported by Bhattacharya and his colleagues back in 2020.
The upshot: Since Trump’s COVID-19 national emergency declaration, COVID-19 has either been the underlying cause of or contributed to the deaths of some 1.3 million Americans.
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