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How the Coronavirus Compares With 100 Years of Deadly Events

Only the worst disasters completely upend normal patterns of death, overshadowing, if only briefly, everyday causes like cancer, heart disease and car accidents. Here’s how the devastation brought by the pandemic in 25 cities and regions compares with historical events.

Deaths during coronavirus outbreak

Historical events

7x normal mortality
6x normal mortality
5x normal mortality
4x normal mortality
3x normal mortality
2x normal mortality
Normal mortality

Normal mortality

A wave of homicides devastated Chicago in 2016. But it caused only a small increase in overall mortality in the city.

A bad flu season in New York City raised all deaths to 1.05 times higher than during a normal winter.

Neither event nears the extraordinary wave of death during the coronavirus pandemic. We compared deaths in the worst months of the outbreak to past years, a measure often used to assess a disaster’s severity.

Even in Oslo, which has avoided a major outbreak, about 15 percent more people died than normal — rivaling the worst month of the AIDS epidemic in New York City.

The outbreak’s death toll in Miami rivals that of one of America’s worst recent flu seasons in Seattle.

Hurricane Maria killed thousands of people in Puerto Rico in 2017. Many died after widespread power outages overwhelmed hospitals. The increase in death was similar to the outbreak’s toll in Brazil’s two largest cities.

Demographers call these “mortality shocks” — sudden spikes in the total number of people dying not seen in the weeks before an event, and not likely to last once it is over. They’re often found during natural disasters, severe flu seasons, famines or wars.

Nearly 3,000 people in New York City died in a single day on Sept. 11, 2001. It was one of the largest mortality shocks in recent American history. Sixty percent more people died that September than normal.

On a relative scale, deaths increased more in Denver in March.

Death during the outbreak is often less visible than death from a terrorist attack or a natural disaster. Many people have died quietly, in nursing homes or at home. And some die without being tested and are excluded from official death counts.

These estimates include all deaths, offering a more complete accounting of the outbreak’s toll than official tallies. They include people who died directly from the coronavirus and those who died from other causes as hospitals have been stretched and people avoid seeking medical care.

The 1957 flu pandemic, also known as the Asian flu, killed at least one million people worldwide. In Santiago, Chile, one of the worst-hit cities, mortality doubled. That increase was only a little higher than the one during the coronavirus in Detroit.

2x normal mortality

Any disaster past this line — that is, one in which normal deaths double — should be declared an emergency, according to guidelines from the United Nations High Commissioner for Refugees.

Sweden kept schools and businesses open as most of Europe closed them and ordered citizens to stay home. The country has seen an extraordinary increase in deaths, especially in Stockholm. More than twice the usual number of people died there in April.

While national figures can broadly show the situation in each country, they can also obscure acute crises in densely populated cities, like Boston, where the virus spread rapidly before officials told people to stay home.

“If you’re looking at the total impact of the pandemic across an entire country, it may not seem like much is going on,” said Robert Anderson, chief of the mortality statistics branch at the C.D.C.’s National Center for Health Statistics. “If you really want to know what’s happening, you need to look at states, cities and local areas.”

Major cities with large outbreaks, like Paris, have rates of excess death far higher than the rest of their countries.

3x normal mortality

Few places have seen excess deaths of this scale — more than three times normal.

Now we see Boston’s toll during the 1918 flu, also known as the Spanish flu, the worst pandemic of the 20th century. It killed at least 50 million people worldwide, with about 675,000 deaths in the United States.

As the toll has eased in New York and in European capitals, cities across Latin America have begun to see astonishing increases in deaths. Deaths spiked in Lima in April despite a strict lockdown. More than 11,000 people died in May, about 8,000 more people than in previous years. That surpasses the worst month of the 1918 flu in New York City.

4x normal mortality

These figures reflect deaths only through May. In many cities in Latin America, Asia, Africa and the Middle East, the outbreak is still getting worse.

“Oh my goodness,” Dr. Anthony S. Fauci, the United States’ top infectious disease expert, said on Tuesday. “Where is it going to end? We’re still at the beginning of it.”

In Madrid, more than 14,000 people died between mid-March and mid-April. The city usually sees around 3,000 deaths during this period.

5x normal mortality

Few places ever see excess deaths of this scale outside of famine or war.

The death toll in Ecuador — one of the worst in the world — was far higher than the official number of Covid-19 deaths reported by the government. In Guayas, a coastal province that includes the city of Guayaquil, deaths spiked by more than five times.

New York City, long the epicenter of the U.S. outbreak, has experienced one of the most extreme increases in deaths. Mortality in April grew to almost six times the usual number.

6x normal mortality

Bergamo, a province in northern Italy of just under one million people, usually sees fewer than 1,000 deaths each month. But during the peak of its outbreak in March, nearly 6,000 people died. It may be the hardest-hit place in the world, so far.

A 9.0-magnitude earthquake set off a tsunami that sent waves crashing through coastal cities in northern Japan. It killed more than 11,000 people in Miyagi Prefecture that month.

This is not an exhaustive list of disasters. Many wars, famines and other events in the last century have caused even greater increases in death.

7x normal mortality

The Spanish flu outbreak in Philadelphia was deadlier than the current pandemic in any known city so far. In October 1918, almost 15,000 people in the city died, an extraordinary number of deaths for that time.

The coronavirus is unlikely to kill as many people as the Spanish flu did, but in the modern history of natural disasters, it will have few rivals.

7.3x
7.25x
7.2x
7.15x
7.1x
7.05x
6.95x
6.9x
6.85x
6.8x
6.75x
6.7x
6.65x
6.6x
6.55x
6.5x
6.45x
6.4x
6.35x
6.3x
6.25x
6.2x
6.15x
6.1x
6.05x
5.95x
5.9x
5.85x
5.8x
5.75x
5.7x
5.65x
5.6x
5.55x
5.5x
5.45x
5.4x
5.35x
5.3x
5.25x
5.2x
5.15x
5.1x
5.05x
4.95x
4.9x
4.85x
4.8x
4.75x
4.7x
4.65x
4.6x
4.55x
4.5x
4.45x
4.4x
4.35x
4.3x
4.25x
4.2x
4.15x
4.1x
4.05x
3.95x
3.9x
3.85x
3.8x
3.75x
3.7x
3.65x
3.6x
3.55x
3.5x
3.45x
3.4x
3.35x
3.3x
3.25x
3.2x
3.15x
3.1x
3.05x
2.95x
2.9x
2.85x
2.8x
2.75x
2.7x
2.65x
2.6x
2.55x
2.5x
2.45x
2.4x
2.35x
2.3x
2.25x
2.2x
2.15x
2.1x
2.05x
1.95x
1.9x
1.85x
1.8x
1.75x
1.7x
1.65x
1.6x
1.55x
1.5x
1.45x
1.4x
1.35x
1.3x
1.25x
1.2x
1.15x
1.1x
1.05x

Deaths in Chicago were 1.01 timesnormal.
Aug. 2016

1.05x Flu season in New York City, Jan. 2011

1.15x HIV/AIDS crisis in New York City, Sept. 1995

Oslo 1.16x

Fortaleza, Brazil 1.19x

1.25x Flu season in Seattle, Jan. 2017

Miami 1.26x

1.29x Hurricane Maria in Puerto Rico, Sept. – Oct. 2017

São Paulo, Brazil 1.29x

1.31x Chicago heat wave, July 1995

St. Petersburg, Russia 1.34x

Rio de Janeiro 1.36x

Istanbul 1.45x

Recife, Brazil 1.47x

Chicago 1.52x

Jakarta, Indonesia 1.54x

Moscow 1.60x

1.61x September 11th in New York City, Sept. 2001

Denver 1.75x

Milan 1.93x

Detroit 1.94x

1.99x 1957 flu in Santiago, Chile, Aug. 1957

2.00x Paris heat wave, Aug. 2003

Stockholm 2.18x

Boston 2.27x

2.42x Hurricane Katrina in New Orleans, Aug. 2005

Manaus, Brazil 2.56x

Paris 2.61x

Catalonia, Spain 2.95x

London 3.02x

3.61x Spanish flu in Boston, Oct. 1918

3.97x Spanish flu in New York City, Oct. 1918

Lima, Peru 3.99x

Madrid 4.57x

Guayas, Ecuador 5.50x

New York City 5.83x

Bergamo, Italy 6.67x

6.85x Earthquake and tsunami in Miyagi, Japan, Mar. 2011

7.27x Spanish flu in Philadelphia, Oct. 1918

7x

7x

7x

7x

7 times normal mortality

5x

5x

5x

5x

5x

London

New York City

Madrid

Paris

3x

3x

3x

3x

3x

Stockholm

France

Sweden

United States

England

and Wales

Spain

Normal mortality

April

May

April

May

April

May

May, 2020

April

April

7x

7 times normal mortality

7x

5x

5x

5x

Madrid

New York City

Paris

3x

3x

3x

France

United States

Spain

Normal mortality

April

May

April

May

April

7x

7x

5x

5x

London

3x

3x

Stockholm

Sweden

England

and Wales

April

May

April

May

5 times normal mortality

Stockholm

3x

Sweden

Normal mortality

May

April, 2020

5x

Paris

3x

France

April

5x

London

3x

England

and Wales

April

May

5x

Madrid

3x

Spain

April

May

7x

5x

New York City

3x

United States

April

May

*The data in the U.S. accounts for 86 percent of the population.