Not all excess mortality during the pandemic comes from infection: overdose deaths in Cook County

 A recent paper in JAMA reminds us that not all excess mortality during the pandemic is due to infection with Covid-19:

Mason M, Arukumar P, Feinglass J. The Pandemic Stay-at-Home Order and Opioid-Involved Overdose Fatalities. JAMA. Published online April 23, 2021. doi:10.1001/jama.2021.6700

"A total of 4283 opioid overdose fatalities occurred in Cook County from January 2018-December 2020, ranging from 12 to 53 weekly (eFigure in the Supplement). There was a mean of 23.0 deaths per week during the initial 100-week period (2018-2019), with little apparent seasonal variation. During the subsequent 15 weeks beginning in December 2019, deaths increased to a mean of 35.1 per week, followed by an even more pronounced increase during the 11-week stay-at-home order: 44.1 mean weekly deaths. In the 29 weeks after the stay-at-home order was lifted mean weekly deaths sharply declined and then began to increase toward the end of the period, at 32.7 deaths. Although deaths have declined below the peak weekly numbers seen during the stay-at-home period, opioid overdose deaths following the stay-at-home period remain elevated above pre-2020 levels."