The Deadliest Month Yet

January saw one-fifth of all American COVID-19 deaths to date.

Paramedics bring a patient into the hospital.
Genaro Molina / Los Angeles Times / Getty

On January 21, 2020, the United States confirmed its first case of COVID-19. One year later, the country is still breaking grim records: January 2021 was the deadliest month of the pandemic yet, claiming more than 95,000 Americans, about one-fifth of the 433,751 deaths recorded to date, according to The Atlantic’s COVID Tracking Project.

The U.S. hit this mark even as the pandemic seems to be letting up, at least for now. Conditions have been improving since January 13, when the most reliable indicator of the coronavirus’s spread, hospitalizations, began a steady decline, from more than 130,000 to fewer than 95,000. The day before, the seven-day average of new cases began falling, and it has dipped from more than 246,000 to fewer than 143,000, a number not seen since mid-November. But the seven-day average of daily deaths remains above 3,000, as it’s been almost every day since January 9.

The death toll is poised to drop soon as well: There is a lag between when someone falls sick with COVID-19 and when they die (on average about two weeks), and another lag between when someone dies and when that death gets tallied by states (on average one week), so the deaths being reported now reflect the worst conditions of the pandemic. You can see this delay in how deaths have followed hospitalizations at the regional level. In the Midwest, where the death toll is already decreasing, hospitalizations peaked at the beginning of December, and deaths began to decline in the middle of the month. Hospitalizations in the Northeast peaked almost a month ago, and deaths started falling a couple of weeks ago. Meanwhile, we’re slightly more than two weeks out from the peak of hospitalizations in the South and the West, which both had higher peaks than other regions during this surge, and the daily-death averages there may be just on the verge of declining. Once they do, the national numbers should begin to reflect that trend.

But the decline in the death toll will be slow, if the prior two nationwide surges are any indication. Both took longer to fall than they did to rise: In the spring, for instance, it took less than two weeks for the seven-day deaths average to rise from 1,000 to 2,000, but about a month for it to recede to back under 1,000. While doctors and nurses have developed better treatment plans since then, the current surge has a peak that is substantially higher than that of the two prior ones, so the seven-day deaths average is almost certain to remain in the thousands for several more weeks.

February may represent a turning point in the pandemic, especially as the country’s vaccination campaign ramps up. But this month will continue to be deadly: Deaths have occurred that have yet to be reported, hospitalized patients will die, and thousands of new cases will turn into deaths. Even as the U.S climbs down from the pandemic’s peak, the country risks passing the monumental milestone—half a million deaths—by the end of the month.