Vermont Deaths involving blunt force injuries MORE THAN TRIPLED in 2023 over *2020* / pre-pandemic baseline

We obtained the Vermont death certificates for 2023 and 2024 through May

We recently received the death certificates for Vermont’s 2023 deaths, and the 2024 deaths through May and a few from June (although these are likely to be missing a few that haven’t got logged int he system yet).

As we saw previously, although Vermont had relatively little excess mortality in 2020, 2021 and 2022 were much worse:

So how did 2023 go? Let’s see:

Although the raw total is down from the highs of 2021/22, it is still well above 2020.

Also ominous is that 2024 through May is basically where 2023 was at - in other words, worse than 2020 (and even 2021 which saw a surge in the latter part of the year):

Vermont has a very aggressive deviation between the deaths in nursing home residents (left) compared to non-NH residents (right):

While NH deaths are down a bit, deaths in non-NH residents are still about 20% excess over the pre-pandemic baseline - in 2023 (!!).

(To be intellectually honest, I wonder if there was a drop in the NH census in Vermont or misclassification of NH residents as non-NH residents after 2020, because 2020 didn’t have noticeable excess yet NH deaths still dropped into mortality *deficit* territory in all three years since.)

The vast majority of excess mortality is driven by the seniors - especially the nonagenarians (??):

So the topline numbers are not looking good.

There was one condition in particular I really wanted to see how it fared in 2023:

Blunt Force Injury Deaths

The most immediate wild trend I saw however is the number of deaths involving “blunt force” or “blunt trauma” (i.e., one of these phrases was used to describe a Cause of Death condition).

This was so eye-popping to me that I am going to try and recreate the experience for you here.

The following chart shows the number of deaths involving “blunt force/blunt trauma” through 2022:

The right side of the chart - particularly 2022 - looks like Mt Everest towering over its lilliputian compatriots of the other years. 2022 had more than 125% more deaths than *2020* - which itself showed zero deviation from the pre-pandemic trend.

This wild anomaly prompted me to discover that there was indeed a spate of excess deaths in the other states we had data for as well (Nevada, Massachusetts, Minnesota).

Naturally, this was the first condition I looked for in the new 2023 data.

I figured that at best 2023 would be in the ballpark of 2022, and probably at least a little bit below - the vast majority of these deaths were in seniors, mostly above the age of 80, so there should have been a severe depletion of the reservoir of the crotchety seniors susceptible to suffering serious kinetic accidents available to die.

This was not what I found.

So without further ado, behold:

2023 literally had MORE THAN TRIPLE THE NUMBER OF BLUNT INJURY DEATHS of 2020 (!!!). That this occurred in the face of overwhelming excess in 2022 is all the more shocking.

This excess mortality is seen in both men and women, with the sole distinction being that men had zero excess in 2020 but substantial excess in 2021 compared to women who saw slight excess in 2020 and more moderate excess in 2021 compared to men:

Underlying Cause of Death (UCoD)

The vast majority of these deaths list the blunt force injury as the UCoD, i.e. the condition judged by the coroner to be the primary cause of death:

This is a key detail, because it heavily implies that these deaths are not people who suffered a physical trauma injury but died of something else, rather the physical injury played a key role in causing the death.

Also noteworthy is that if we look at only the deaths where the blunt injury was the UCoD, 2023 is QUADRUPLE the ‘expected’ number of such deaths in a year (!!).

Age stratification of blunt force injury deaths

Also surprising is the age breakdown of these deaths. We typically see the greatest concentration of excess deaths in ‘young’ seniors, i.e. those ages 65-84. While there is definitely significant excess blunt injury deaths in these seniors (top chart below), there is a shocking degree of excess death in the older seniors, particularly those *over 90*(!!):

Also curious is that in the 70-74 cohort the first year of significant excess blunt force injury deaths is 2023, zooming to more than triple the prior 4 years. Another ‘anomaly’ here is that this cohort went from 2 such deaths in 2018 to 28 such deaths in 2023 - a 14x increase. More on this in a bit when we get to the non-seniors.

Nursing Home vs NON-Nursing Home Deaths

Another ominous clue about the nature of these deaths lies in the comparison between nursing home vs non-NH resident deaths - the trend exists in both:

However there is a key difference - whereas among NH residents, 2023 was only slightly above 2022, for NON-NH residents, 2023 towers over 2022, eclipsing the 2022 total by almost 70%.

Moreover, if we look at the age breakdown of blunt injury deaths among NON-NH residents, we see the following:

In the aggregate, seniors who reside outside of a nursing home or similar type facility are healthier and more mobile and functional compared to their peers living in a nursing home. They also typically have a greater degree of independence and familial support, which are hugely impactful for both cognitive and physical health. This is not a population where you would expect a sudden plague of physical incoordination, and if anything, decreasing physical mobility and coordination should result in these seniors being placed in a nursing home. This in turn would be expected to lead to an increase in deaths involving a physical injury among nursing home residents (a few of whom the physical accident occurred prior to their internment in a nursing home), as nursing home populations took in new members because they were at heightened risk of suffering a fall or tripping on the stairs.

What about the non-seniors?

There is a distinct trend of substantial excess deaths involving blunt force injuries among younger people as well. The following chart shows the number of such deaths for the population ages 0-64:

Here 2020 was right in line with the previous five years, and was not even the highest total - 2018 saw four more such deaths -37- compared to the 33 in 2020.

Then 2021 almost doubles the number of deaths in 2020, is basically double the pre-pandemic baseline in 2022, finally reaching triple the normal number of such deaths in 2023.

And these deaths are not skewed to the ‘almost seniors’, rather they are more concentrated in the *younger* side of non-seniors, especially the 18-34 year old cohort:

What about 2024?

Since we have the deaths from the first five months of 2024, we can see how 2024 is shaping up to be… which is a big YIKES:

On the bright side, Vermont may finally be running out of physically unadroit seniors to fall down the stairs.

Covid clown world

it would be criminal to ignore the 12 deaths that list covid and a blunt force injury:

“Covid deaths” indeed.