Some of the people who died from the virus would’ve died anyway, but almost 21000 excess deaths in a city of 8.6 million is about 0.25% of the population dying in excess.
There are causes of death other than the virus. People with heart attacks, strokes, cancer, accidents, etc may not be getting the medical care they need.
But also due to the lockdown you’d assume there may be fewer accidents like work accidents or car accidents. But also you’d expect more at home accidents (falling down the stairs, etc).
How does this relate to how deadly the virus is? If 1/4 of the city has been infected and about 0.25% of the city has died in excess, and assuming the virus has a much higher R0 than we originally thought does that mean closer to 0.7-1% of people will die by the time its all over?
This is precisely what the experts said would happen if the health care system was overwhelmed.
How many people die as the result of the pandemic is not a matter of counting up the number of people who have “COVID-19” listed on the death certificate.
But to answer your question; no, that’s probably not to be expected. The astounding additional mortality in NYC is likely attributable to a lack of adequate health care, which results in people with heart disease, strokes, cancer and the like not getting the attention they needed. If many more people are infected but over a long period of time such that the health care system is not overwhelmed, the relationship between infections and added mortality won’t be the same.
Possibly, but the link is not particularly obvious. For example, an earlier report (PDF!) found that the peak of nursing home deaths was in early April (April 8); that suggests most of those patients were infected no later than the middle of March. However, Cuomo’s order about nursing homes accepting COVID patients returning from hospital was issued on March 25, and the peak date for such admissions was April 14 (i.e., AFTER the bulk of the infections and deaths had occurred). That timeline doesn’t really mesh well with the theory that the infections were spread primarily by returning patients.
Perhaps not coincidentally, the peak for nursing home staff reporting symptoms was in mid-March, which led the NY Dept of Health to conclude that staff coming to work while infectious was the main driver of patient infections.
This report was based on the data available to the NY Dept of Health as of July 2020; whether its conclusions will need to be modified in response to the revelation that NY undercounted nursing home deaths is a hot topic.
It is worth pointing out that the patients covered under the March 25 order were those being discharged from a hospital. “[Nursing homes] are prohibited from requiring a hospitalized resident who is determined medically stable to be tested for COVID-19 prior to admission or readmission.” [text of order–PDF] That means that probably the majority of those who had a positive test result were recovering from COVID and no longer required a hospital level of care, which also implies they were probably past the infectious point. (Remember, this was early in the pandemic, when tests were in very short supply, and hospitals weren’t generally retesting COVID patients after apparently-successful treatment.)
Meanwhile, pretty much every state has had a lot of COVID deaths in nursing homes, just because the frail elderly are particularly susceptible to fatal complications. This includes states that had no analogue to the New York order and did not admit known COVID cases to nursing homes. For example, in North Dakota about 1 of every 25 nursing home patients died of COVID (that’s not four percent of the deaths, but four percent of all of the people living in North Dakota nursing homes in the last six months).