How deadly is COVID-19? The worst outlooks make it the No. 3 killer of Americans in 2020

How deadly will COVID-19 be?

According to the worst-case scenario from the White House, it won't be as bad our two deadliest wars, but it'll be worse than our eight worst natural disasters combined.

In terms of past epidemics and pandemics, it won't be anywhere near as bad as HIV/AIDS or the 1918 influenza outbreak, but even so, it's likely to be the third deadliest killer of Americans in 2020.

According to projections from a new tracking survey, by the time COVID-19 is expected to peak in the U.S. later this month, more people will die of the disease each day than from heart disease or cancer, the current top two killers in the United States.

The projections, released by assistedlivingfacilities.org, a national organization that advocates for licensed assisted living facilities, are based on estimates from the Centers for Disease Control and the White House and will be updated daily. 

"We have attempted to provide all of the comparisons we can to allow people to understand the magnitude of this pandemic by putting it in the context that they best understand," a company spokesperson said. 

"Doing so requires looking at the data at different scales. Heart disease kills more Americans in a single year than both of the World Wars combined, and it kills more in a single year than the seasonal flu will likely kill in 20 years. Even with the massive scale of deaths due to heart disease, if you look at the data on the scale of a single day, COVID-19 has likely killed more people on April 7th than heart disease." 

The White House on March 31 projected that at the upper end of the scale, 240,000 Americans will die from COVID-19. The lower end of the scale projected 100,000 deaths. Newer models now project a lower total, but there is not uniform agreement on their accuracy.

According to the tracker, if the number of Americans who die from COVID-19 reaches the upper limit of 240,000 projected by the White House, the pandemic will claim more lives than auto accidents annually (about 170,000) and will be the nation's third deadliest killer in 2020.

According to the site, COVID-19 has become the seventh leading cause of death in the U.S. since Feb. 29, when the first coronavirus fatality was reported.

As the number of cases escalates, the number of deaths each day has steadily climbed past daily averages for bronchitis, stroke, Alzheimer's disease and the flu to become the third leading daily killer behind heart disease and cancer.

The site lists 10,680 COVID-19 deaths from March 1 to April 7. At the current fatality rate, sometime on Wednesday COVID-19 deaths will eclipse the 12,307 total for Alzheimer's disease in the same time frame and soon will pass the 14,839 deaths from stroke. 

Even in the worst case White House scenario, COVID-19 won't eclipse the annual estimate for heart disease deaths (640,000 in 2017) or cancer fatalities (599,000 in 2017).

Death toll could make history

The tracker also compares the projected number of COVID-19 deaths against major U.S. catastrophes.

Already the pandemic has claimed more lives than the worst natural disaster in U.S. history, the Galveston hurricane of 1900 (8,000 deaths), and the conservative White House estimated death toll of 100,000 is four times higher than the eight deadliest natural disasters in U.S. history combined.

Compared with the worst disease outbreaks, COVID-19's worst case scenario would rank it third behind HIV/AIDS (700,000 deaths since 1981) and the 1918 influenza epidemic, which killed 675,000.

In addition to HIV/AIDS and the 1918 influenza epidemic, the conservative estimate would fall behind the Yellow Fever outbreak of the early 1900s, the influenza outbreak of 1957-58, and would be roughly equal to the avian flu outbreak of 1968.

The conservative estimate is also nearly 40,000 deaths above the worst flu outbreak in the last 10 years, the 2017-18 season, which claimed 61,000 lives.

When compared against U.S. war fatalities, the upper White House estimate of 240,000 COVID-19 deaths ranks third behind the Civil War (750,000 killed) and World War II,(405,000 dead). The conservative estimate of 100,000 would rank fourth behind the Civil War, World War II and World War I (115,000 deaths).

The chart doesn't make comparisons to two major public health concerns that claim tens of thousands of lives annually: gun deaths and opioid deaths.

According to the Giffords Law Center to Prevent Gun Violence, an estimated 36,000 Americans are shot to death each year, including suicides. That number is a little more than a third of the conservative estimate of COVID-19 deaths.

According to the National Institute on Drug Abuse, an estimated 70,000 Americans died of drug overdoses in 2018, and nearly 47,000 involved opioids.

Rick Pendrick, whose public relations firm represents assistedlivingfacilities.org, said the organization did not set out to build a comprehensive list, but wanted to provide a factual basis of comparison so that people can form their own opinions about the severity of the COVID-19 pandemic.

"With Americans debating how deadly the coronavirus is, and the politics and economics involved, we just wanted to provide a source they can go to and find information for comparison," he said. "We're not taking a position, we just wanted to provide the facts."

John D'Anna is a reporter on the Arizona Republic/azcentral.com storytelling team. Reach him at john.danna@arizonarepublic.com and follow him on Twitter @azgreenday.

Top 10 causes of death in the U.S. in 2017

1. Heart disease (647,457)
2. Cancer (599,108)
3. Accidents (169,936)
4. Bronchitis, emphysema, asthma (160,201)
5. Stroke (146,383)
6. Alzheimer's disease (121,404)
7. Diabetes (83,564)
8. Influenza and pneumonia (55,672)
9. Kidney disease (50,633)
10. Suicide (47,173)

American deaths in U.S. wars

1. Civil War (1861-1865) 750,000
2. World War II (1941-1945) 405,000
3. World War I (1917-1918) 116,000
4. Vietnam War (1955-1975) 58,000
5. Korean War (1950-1953) 54,000
6. Revolutionary War (1775-1783) 25,000
7. Iraq War (2003-2011) 5,000
8. September 11th (2001) 3,000
9. Attack on Pearl Harbor (1941) 2,500
10. War in Afghanistan (2001-present) 2,200

Deaths from U.S. natural disasters 

1. Galveston hurricane (1900) 8,000
2. Hurricane Maria, Puerto Rico and North Carolina (2017) 3,000
3. Puerto Rico hurricane (1899) 3,000
4. San Francisco earthquake and fire (1906) 3,000
5. Okeechobee hurricane, Florida (1928) 2,800
6. Johnstown Flood, Pennsylvania (1889) 2,200
7. Hurricane Katrina, Louisiana (2005) 1,800
8. Heat wave (1980) 1,700

Source: assistedlivingfacilities.org