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Traci Sikes's older sister Debbie had survived several health setbacks in life — a heart attack, a cancer diagnosis, and a couple of botched surgeries for a bad back. But by early 2023, the 68-year-old from Brownwood, TX, was in remission from lymphoma, feeling stronger, and celebrating a birthday for one of her 11 beloved grandchildren.
Then Debbie caught COVID-19. Less than 2 months later, in March, she died of severe lung damage caused by the coronavirus.
Traci was able to make the trip from her home in Washington state to Texas to be with Debbie before she died. She was grateful that she arrived while her sister was still lucid and to hear her sister's last word -- "love" -- spoken to one of her grandchildren before she took her final breath.
"My sister was wonderful," Sikes said. "And she shouldn't be gone."
Just 6 months after President Joe Biden declared last fall that "the pandemic is over," Debbie's death was a painful reminder to Traci and her family that COVID hasn't actually gone anywhere. Just as both the World Health Organization and U.S. government recently ended the 3-year-old coronavirus public health emergency, COVID is still killing more than 100 people every day in the U.S., according to the CDC, andamid widespread efforts to move on and drop protective measures, the country's most vulnerable people are still at significant risk.
The prevailing attitude that we need to learn to live with the current level of risk feels like a "slap in the face," for COVID grievers who have already paid the price," said Sabila Khan, who co-founded a Facebook group for COVID loss support, which now has more than 14,000 members.
It also minimizes the continuing loss of life and that so many people are still dying traumatic and unnecessary deaths, she said.
"It feels like it's been brushed aside," she said. "Like, 'It's business as usual. It's over. Take off your mask.' My family and I are still masked, and we're probably the only ones masked in any given room."
The abandoning of protective measures also fails to recognize the ongoing and catastrophic risks of long COVID and the experiences of an estimated 26 million people in the U.S. living with long COVID.
"It's been drummed into us that death is the only serious outcome [of the virus] and we still haven't made enough space for the idea that long COVID is a very serious outcome," said David Putrino, PhD, director of rehabilitation innovation for the Mount Sinai Health System in New York City, who has helped care for thousands of patients with long COVID.
Historic Drop in Life Expectancy
More than 1.1 million Americans have died from COVID over the past 3 years, and experts say the official numbers are likely underestimated due to errors in death certificate reporting. Although deaths have waned from earlier in the pandemic, the disease has become the fourth leading cause of death in the U.S. after heart disease, cancer, and "unintentional injury" such as drug overdoses.
What makes these deaths all the more tragic is that COVID is a preventable disease, said Carla Sevin, MD, a critical care doctor and director of the Pulmonary Patient Care Center at Vanderbilt University Medical Center in Nashville. Masking, available vaccines, and social distancing have all been shown to significantly lower the risk of spreading and catching the virus. New drugs have also made it possible for infected people to survive COVID.
"It's possible to not spread COVID," she said. "It's possible to protect yourself against COVID. It's possible to treat COVID. And we're doing all of those things imperfectly."
By the end of 2021, Americans overall were dying 3 years sooner, on average, than they were before the pandemic, with life expectancy dropping from 79 years to 76 years, the largest decline in a century.
Globally, the COVID death toll is nearing 7 million. Across all ages, on average, each person who died passed away 10 years younger than they otherwise would have. That's tens of millions of years wiped away.
As U.S. surgeon and health researcher Atul Gawande, MD, put it in a New York Times essay about the pandemic response: "Human development has been pushed into reverse."
What Is an Acceptable Threshold of Death?
In the U.S., more than 80% of deaths from the disease have been in people age 65 and older. Underlying medical conditions and disabilities also raise the risk of severe illness and dying from COVID.
The virus is also disproportionately killing Black, Hispanic, and Indigenous people and those with less access to health care. Racialized groups are dying from COVID at younger ages. COVID advocates and Americans who've lost loved ones to the disease say our willingness to accept these facts and the current mortality rate amounts to health-based discrimination.
"Would politicians be approaching this differently had it mostly affected rich white people?" Khan said.
Khan's dad, Shafqat, was an advocate and community organizer for Pakistani immigrants. After contracting COVID, he was rushed to a hospital near his daughter's Jersey City, NJ, home from a rehab facility where he was being treated for an aggressive form of Parkinson's disease. For the 8 days her father was in the hospital, she and other family members couldn't visit him and he wasn't even well enough to talk on the phone. He died from COVID in April 2020.
"My father was an extraordinary person who did so much good and he died alone, terrified in a hospital," she said. "I can't even wrap my head around that and how he deserved more. No one deserves that."
At Vanderbilt University Medical Center, where she works as a critical care doctor, COVID deaths are now different from those in the early days of the pandemic, Sevin said. Most patients now in the intensive care unit are older and immunocompromised — and they tend to blend in more with others in the intensive care unit. That makes the impact of COVID even more hidden and easily ignored.
"It's easy not to value somebody who's an invisible number you don't know," she said. "You don't see them writing their will and talking to their best friend. You don't see the tears rolling down their face because they know what's going to happen to them and they're going to asphyxiate to death."
One COVID patient who died recently in Sevin's ICU ward was an older woman who had no living relatives. "She was very, very lonely and we would always stand outside the door on rounds and she would motion for us to come in, but we had to then all gown up," Sevin said. "It just breaks your heart that people are still having to go through it."
Sevin finds it frustrating that so many of the measures that public health officials fought so hard for over the last 3 years — including masking guidelines, government-funded vaccine clinics, and access to potentially life-saving antiviral medications — are now going away because of the lifting of the pandemic emergency declaration.
What makes matters worse, she said, is that public consciousness about taking precautions to protect others is starting to disappear in favor of an "all or nothing attitude" about the continued risks.
"Like either I'm going to stay home and be a hermit or I'm going to just throw caution to the wind and go to bars and let people yell in my face," she said. "We learned some hard lessons and I wish we could hold onto those."
Americans like Traci Sikes who've lost loved ones and health care workers on the front lines say it is particularly frustrating that so many people are framing the current response to the risks of COVID as "personal choice" over responsibility to others, as well as a sense of fatalism and lack of urgent care.
"Why does nobody seem to be angry about this?" Sikes said. "People talk about COVID like it's just another thing to die from. But my sister didn't have to die from it at all."
Traci Sikes, Vancouver, WA.
Sabila Khan, co-founder, Covid-19 Loss Support for Family & Friends Facebook group.
Carla Sevin, MD, director, Pulmonary Patient Care Center, Vanderbilt University Medical Center, Nashville.
David Putrino, PhD, director, rehabilitation innovation, Mount Sinai Health System, New York, N.Y.
NPR: "Joe Biden says the COVID-19 pandemic is over. This is what the data tells us."
CDC: "Covid Data Tracker."
PNAS: "Tracking the reach of COVID-19 kin loss with a bereavement multiplier applied to the United States."
CDC: "Life Expectancy in the U.S. Dropped for the Second Year in a Row in 2021," "COVID-19: People With Certain Medical Conditions."
WHO: "Coronavirus (COVID-19) Dashboard."
Journal of Public Health: "Years of life lost associated with COVID-19 deaths in the USA during the first year of the pandemic."
The New York Times: "The Aftermath of a Pandemic Requires as Much Focus as the Start," "My Patients Will Not Be the Same. None of Us Will."
JAMA Network Open: "Variation in COVID-19 Mortality in the US by Race and Ethnicity and Educational Attainment."
PLOS Medicine: "Variation in racial/ethnic disparities in COVID-19 mortality by age in the United States: A cross-sectional study."
The Associated Press: "Biden ends COVID national emergency after Congress acts."
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Cite this: COVID Emergency Over, but Hundreds Are Still Dying Weekly - Medscape - May 17, 2023.