[link to www.nytimes.com (secure)]

About 1.1 million Americans have officially died from Covid-19 since the start of the pandemic, a number that may be familiar by now. But here’s a less familiar one: According to one tabulation by the Centers for Disease Control and Prevention, more than 300,000 additional Americans have died over the past three years whom we would not have expected to in more normal times.



Almost every week for more than six months, the agency has calculated that total excess mortality was 50 percent larger than and often almost twice as large as the number of official Covid-19 deaths,



What are the hypotheses? The first is delayed care — that the pandemic made people postpone treatment for various problems, as doctors and hospitals triaged resources, sending them toward those ill with Covid-19 and away from other issues, and canceled visits and screenings prevented new diagnoses (and therefore treatment).

A second hypothesis is about the indirect effects of pandemic restrictions: not just missed medical care but social isolation, anxiety and unemployment, which can worsen a wide range of conditions, as well as, potentially, suicide and homicide and even car accidents and overdoses, to the extent they each deviated from historical patterns.

A third hypothesis is that Covid-19 infection does harm to the body that can linger after recovery for some people — not just in what is conventionally called long Covid, but also in other ways, by disturbing the function of various organ systems. (Damage to the cardiovascular system has been one particular area of research focus.) “We still don’t really grasp the entire spectrum and breadth of disease yet,” the Yale immunobiologist Akiko Iwasaki told me. “We are still learning.”