A shout out this morning to Nat King Cole and perhaps the most iconic Christmas lyric of all time. I started to list the artists that have covered the tune since, but space is limited (my apologies if your favorite rendition is by another). His The Christmas Song is a perennial classic, and in addition to the reference to the open fire carries "Although its been said, many times, many ways, Merry Christmas to you." This is one I find myself singing along to on the radio (the "radio" is a method for transmitting and receiving information and entertainment, similar to Spotify or Pandora).
Holiday songs are not all of that caliber. I also find myself distractedly singing along with the fruit of composer Randy Brooks. His 1978 hit, covered by Elmo and Patsy, has certainly gotten considerable air time over the years. As corny as it may seem, Grandma got run over by a reindeer and gets as much air time as any of them. I am particularly likely to join in on the chorus regarding gifts: "send them back!" The song narrates the sad passing of a family member stricken by the satirical impact of sleigh-pulling reindeer. Grandma's family is described in dealing with their loss, and remembrances. It is whimsical, and humorous, and has become a part of our fabric. But, death and loss are anything but humorous.
We find ourselves at the end of another year. It has been a year of interesting challenges (aren't they all?). There are undoubtedly a great many among us that are celebrating their first holiday season without some loved one, friend, partner, or coworker. According to the Centers for Disease Control (CDC), we have seen 3,389,099 deaths in America in 2020, and 3,161,734 in 2021 (so far). In 2019, the data suggests the total was 2,854,838. The increases look like this:
We are experiencing a higher volume of deaths, but 2021 demonstrates improvement (note that at the time of this writing, ten days remain in 2021 and these figures are bound to change). 2020 was almost 20% higher than 2019, while 2021 is only 11% higher than 2019.
It is as fair to note that the SARS-CoV-2 deaths in 2019 were either non-existent or unrecognized. The pandemic is believed to have first appeared in the U.S. in January 2020. Even if one believes the virus arrived earlier, any impacts were minimal until 2020.
There has been a great deal of discussion about the characterization of, labeling of, causes of death. Essentially, some question whether recent deaths have been misattributed to COVID-19 through lackadaisy, misfeasance, or worse. In time, perhaps that will be studied and clarified. However, we can look at some interesting comparisons in the data that is at hand.
In 2019, the CDC reported that "Influenza and Pneumonia" caused 49,783 deaths. In 2020, influenza deaths were only 8,786. In 2021, that decreased to 758. Those figures are subject to change. However using the data currently reported, the pneumonia deaths were 351,893 in 2020 (combined with influenza = 360,678) and 373,392 in 2021 (combined with influenza = 374,149). Thus, the deaths from the two, "Influenza and Pneumonia," were markedly increased over the last two years. Though the two were only 2% of all deaths in 2019, they have been 11% and 15% of the total in the last two years, illustrated thusly:
A significant increase in deaths from pneumonia, but curious fluctuation in the influenza rate. Notably, Influenza has been a persistent threat to our health. The CDC reports that in 2019 it was estimated to be responsible for 22,000 deaths; in 2018, 34,000; in 2017, 61,000. But, in 2020 only 8,786 and in 2021 only 758?
The category "all deaths involving COVID-19," according to the CDC, for 2020 totals 385,427. For 2021 that increased to 420,016. Despite the vaccination and other medical advances, COVID-19 deaths increased in 2021; some may find that difficult to reconcile. But, notably, if the COVID-19, Pneumonia, and Influenza cases ("CPI") are removed from the "all causes" total, the overall U.S. death rate has decreased in both 2020 and 2021. The CDC will eventually release data for "all causes" for those years, though the latest currently posted is for 2019 (which includes: heart disease, 659,041; Cancer, 599,601; accidents, 173,040; chronic lower respiratory diseases, 156,979, stroke, 150,005; Alzheimer's 121,499; diabetes, 87.647; and more).
So, without the CPI cases), overall deaths in 2020 (2,642,994) were down 6% from 2019 and the 2021 deaths (2,367,569) were down another 10%? The "other" causes of death like heart disease and accidents seem to be pausing? Or, are some of them even decreasing in recent years? It seems incredible that death from non-COVID/Pneumonia/Influenza is decreasing, although perhaps we might expect less vehicle accidents and deaths. However, VOX reports auto accident deaths increased in 2020 to 42,060 from 39,107, up 7.5%. That suggests that other causes are even more constrained. But, is it possible that some who are passing from Cancer, Alzheimer's, diabetes and other maladies are listed as COVID or Pneumonia deaths because of some positive test, suspicion of contributing cause, record-keeping indifference or otherwise?
We laugh at Grandma got run over by a reindeer each year, and perhaps sing along. But, this year we find ourselves amidst a very high volume of respiratory-disease death as we close our first two years of SARS-CoV-2. There is hope on the horizon. Whether we are seeing this virus evolve to an endemic state or whether the vaccines are blunting effects remains to be seen. See A Transition (December 2021). The symptoms being currently described are notably less severe, persistent, and pernicious. However, it is clear that despite the hope we perceive for the future a great many Americans are presently dying from respiratory illness. More still are likely suffering through symptoms, treatment, and even hospitalization related to or impacted by this virus. As we celebrate our holiday, there are many to remember.
As we close this year, I am reminded of the loss so many suffered this year by the humorous and preposterous Grandma got run over by a reindeer. Despite laughing, the fact is a great many have suffered a loss this year, and the holidays will be challenging, as will be the prospect of a new year without someone(s). It is an apropos time for us to all remember that vaccination, some distancing, and continued focus on simplicities such as hand-washing are worth consideration. It is a good time for us to remember those lost, and those left behind to mourn. If you are lucky to have not suffered such a loss in the last two years, perhaps strive to remember that your neighbors, friends, and coworkers may not be as fortunate. They may need you more these days than you know, even if that just means a periodic phone call, greeting with a wave, or email.
If you have suffered such a loss in 2021, you are in my thoughts this season as we pause to celebrate. I push the image of haphazard reindeer assault from my conscious and return in that spirit to Nat King Cole's celebrated lyric to say simply "Merry Christmas to you." May your season be bright, your burdens few, and Happy New Year to you.