Public Health is a vast sprawling enterprise funded to the tune of hundreds of billions of dollars each year by the federal government, plus substantial private donations by nonprofits and some of society’s wealthiest people. We are scolded that such a robust well-funded behemoth is absolutely vital and indispensable to maintaining and promoting the general health and welfare of the population. But what if there is an extraordinary, once-in-a-lifetime type of excess mortality that dwarfs the scope of drug overdose deaths, affecting the whole of society across all age and demographic strata, and…is totally ignored by public health authorities?

Shockingly, this is actually happening in real time. We managed to obtain the death certificates representing all deaths covering 2015-2023 in four states that we can publicly publish data from, and they show a disturbing story of continuing pandemic-level excess deaths still ongoing today among a variety of conditions, many at even higher levels than we saw in 2020.

To be sure, death certificates are a flawed tool for data construction. They are rife with errors, prone to biases, subject to capricious and sometimes deliberate manipulative policy changes from on high, and rarely tell the complete story of the decedent’s demise. They are under the aegis of state health departments and the CDC, which doesn’t exactly inspire confidence about their quality or integrity.

But neither is it an indefatigable Sisyphean task to extract useful, useable data from the information logged and recorded on these indubitably wanting instruments, although progress often creeps along slowly enough to give the illusion that Zeno’s motion paradox accurately describes reality. (It definitely describes how I’m feeling after sinking almost 15 hours putting this albatross together.)

The point of this article is to show the public actual trends of excess mortality in the following conditions or Causes of Death (CoD):

1. Acute Renal Failure (ICD Code N17)
2. Pulmonary Embolism (ICD Code I26)
3. Hypertension, specifically the subset of Hypertensive Heart Disease (ICD Codes I11 & I13)
4. Physical Trauma Injuries (Various ICD Codes)
5. Diabetes (ICD Codes E10-E14)
6. Protein Calorie Malnutrition (ICD Codes E43-E46)
7. Sepsis (ICD Code A41)

These are far from the only conditions where there is clear excess mortality. However, these conditions are unique in that there is clear excess mortality in these conditions in every single state for which we have death certificates, and they affect a substantial number of deaths per year and are thus of great importance for public health.

Alas, if only we had public health authorities more interested in looking at evidence than deleting evidence.

Note: For some reason, Florida has refused to allow anyone access even to deidentified versions of their death certificates. Florida is the motherlode of mortality data, because of the population size and high concentration of seniors, the vast majority of whom were vaccinated with the mRNA covid vaccines. It seems very odd that the FL Department of Health continues to restrict public access. If we refuse to be transparent with the data in our possession, we cannot complain about the lack of transparency by the establishment. We thus call on Dr Ladapo and/or the DeSantis administration to allow public access to deidentified death certificates that will allow the public to see for themselves what the mortality data actually looks like. How can it be that the far-left states of MASSACHUSETTS and Vermont allow full unrestricted access to their death certificates by any citizen, but Florida won’t even allow access to redacted versions that don’t risk violating the privacy of decedents or their families??

I. ALL-CAUSE MORTALITY

The starting point for any exploration into the potential excess death phenomenon is first to see if there is actually excess death overall – are there more people dying than we would expect? If the answer is no, then excess deaths found within individual conditions or categories of disease may well be an ‘administrative phenomenon,’ i.e. they do not reflect a change in the circumstances of people’s health or deaths, but rather a change in how CoD’s are recorded.

Conversely, if there is excess mortality occurring, concomitant excess deaths found in specific CoD’s are presumptively representing an actual increase in the incidence and/or rate of death from these conditions.

All-cause mortality – in other words, all deaths from all causes – also provides a bird ’s-eye view of broad trends of who is dying at what rates, which can help identify novel factors affecting population mortality, which is very relevant for parsing mortality trends.

How to read the charts:

The bulk of this article is the charts, which follow the same basic design:

– each chart has a title on top that describes the parameters or conditions of the deaths shown by the chart

– charts can show deaths for a specific condition/s either by ICD 10 code, or by the text written on the death certificate itself

– “All ICD Codes”/”All Deaths”/”All Text CoD’s” in the title means that the chart shows deaths from all causes

– each bar represents the tally for one year

– the various shades of grey bars are for the years 2015-2019 (left to right)

– blue bar = 2020

– yellow bar = 2021

– red bar = 2022

– purple bar = 2023

– the number on the top of each bar indicates the number of deaths in that year that fit the conditions articulated in the title of the chart

Massachusetts All-Cause Mortality

The charts for each state are the same series, so we’re only going to explain them for MA in each condition (unless there’s a difference).

The following chart shows the total number of deaths in MA each year:

You can see right away that from 2020 onwards, the number of deaths is above the range in the pre-pandemic years (2015-2019). In other words, there were excess deaths in each year.

This is especially striking because of something colloquially referred to as the “pull-forward effect” (PFE). We would expect to see a mortality deficit following a year of substantial excess mortality if the “excess” deaths were predominantly people dying who were going to die very soon anyways. 

The average age of Covid deaths being roughly the life expectancy is a good illustration of this – the people killed off, especially in 2020 were those who were frail and predisposed to die soon. Had they not died in 2020, they would have overwhelmingly died over the next few years. So in essence, 2020 “stole” deaths from 2021, 2022, 2023 (in decreasing amounts from each successive year). This means that there is a greater portion of the deaths in 2021-2023 that are above the expected total than merely following the pre-pandemic baseline would yield.

Next up, we have a chart showing the average age of decedents in MA:

Whereas the average rises in 2020 well above prior years, the average age of death drops sharply in 2021 to lower than any of the prior five years (dropping more than a full year in the average age is bigger than it seems because it takes a lot of younger people dying to drag the average down when the vast majority of deaths are people in their 80s and 90s).

In other words, whereas 2020 deaths were among old and frail people, in 2021 the characteristics of decedents markedly skewed to younger people more than any prior year.

The most shocking and revealing conundrum of mortality trends – which we see in every state for which we have this data – is comparing deaths in nursing home residents (also includes similar type facilities such as assisted living or long-term care) to non-nursing home residents.

The following two charts show the total number of deaths of nursing home residents (left) and non-nursing home residents:

Separating them out shows that there is a far higher degree of excess mortality occurring in 2021-2023 outside of nursing homes that you can’t see in the total death count for the state because the depletion of nursing home deaths mostly cancels out the increase in deaths outside of nursing homes.

Keep in mind also that with the exception of Minnesota, we can only identify nursing home residents who died in the nursing home, but if they died elsewhere like in a hospital or hospice their nursing home residency is undocumented, so the discrepancy seen above is likely even larger in real life.

This dichotomy is also seen in the mortality trends for the majority of conditions, which we will document.

Minnesota

Minnesota’s overall excess mortality is more evenly spread out among the pandemic years compared to MA:

The average age of MN deaths however is even more anomalous:

NH/non-NH:

The following charts show side-by-side (1) the total number of deaths in non-NH residents (left), and (2) the total number of deaths in non-NH residents excluding all deaths which list covid as a CoD:

This is especially jarring, because there is clear rising excess death that has nothing to do with covid disease every year. This is not to say that all deaths that list Covid as a CoD are caused by Covid, which is patently false, but it highlights that even using the most upper limit of Covid deaths possible, there is still marked excess mortality occurring.

(I didn’t include this chart for MA because they over-attributed so many deaths to Covid that there is literally a mortality deficit in every year if you exclude all the Covid deaths. However, as we’ll see later we can show excess death in MA in individual conditions without covid.)

This final chart for MN ACM breaks down the non-NH resident deaths by men (left) vs women (right):

(I will include this chart where there is a substantial difference in the trends or overall number of deaths between men and women.)

Nevada

(Since we don’t have complete 2023 data from Nevada, we will only include 2023 where relevant.)

It’s interesting that the average age of death in Nevada is 3-4 years below the other states:

Vermont

Vermont has the fewest deaths overall by a wide margin, but has one of the worst post-2020 trends of excess death (Hopefully we will get the 2023 deaths soon, and we’ll be able to update this):

Even removing the Covid deaths there is clear excess mortality going on:

The upshot from all these states is that mortality levels have still not yet come back down to the old baseline, and this trend is especially pronounced in non-NH deaths.