This week New Hampshire will mark a grim anniversary: A full year of COVID-19 deaths.

On March 23, 2020, the state’s first official death was announced due to what we were calling “the novel coronavirus.” The virus hasn’t seemed novel for a long time now but the deaths have kept coming: The total topped 1,200 this month, which is more people than live in 45 of New Hampshire’s towns.

The daily toll has declined since January but it isn’t going away. In recent weeks it has plateaued and shows signs of increasing again. We may be ready to be done with COVID-19 but it isn’t done with us.

That may not be the whole story about pandemic mortality. As I’ve discussed previously, the knock-on effects of the pandemic have certainly affected how many people die in New Hampshire and what kills them.

One obvious change, as has been discussed in a Monitor story and elsewhere, can be seen in influenza numbers.

The flu has been almost non-existent in the U.S. this year because socially distanced, masked people spread few germs. Normally about 50 people die from the flu in the Granite State annually; the number of flu deaths over the past year is in the single digits. In that case, COVID-19 actually saved some lives.

But another area where I thought COVID-19 would help hasn’t panned out. The sharp decline in driving should have reduced the number of fatal wrecks, but no: New Hampshire saw a typical number of road fatalities in 2020 – 102, compared to 101 the year before – even though traffic was down by about one-quarter. Nationally, the National Safety Council estimated that 2020 saw 8% more traffic deaths than 2019, reversing years of declining fatalities. Apparently, the empty roads went to our heads and we drove a lot faster.

And then there’s our overall health. Fear of catching COVID-19 has made many people, including me, delay going to the dentist or doctor in the past year. This can’t be good, although it’s hard to say for certain.

Anecdotal reports exist in the medical literature of a rise in more serious cases of cancer, perhaps because people skipped screening appointments. And the increased stress of the pandemic year, including losing jobs and losing loved ones, is going to take a toll. But that won’t show up in health statistics yet.

Other indirect mortality effects, such as benefits from reduced air pollution during the year, may never be teased out.

Here’s what can be teased out: Number of deaths. As I did last year, I have totaled up the state’s overall death count as compiled weekly by the CDC and compared it to figures from the previous five years.

The result: From the week that included the state’s first COVID-19 death through the week ending Feb. 28, 2021, which is the most recent data available, there were 12,618 deaths reported of New Hampshire residents compared to a five-year average of 10,931 – an increase of 1,687. During that period the state reported 1,170 deaths from COVID, implying an “excess” of 577 deaths. That is well beyond the average annual fluctuation of 400, indicating that the pandemic has killed people who don’t have “COVID-19” listed on their death certificates.

But there’s a complication.

Because the 365.25-day year isn’t evenly divisible by a 7-day week, every few years there’s an “extra” week because of the way the counting happens – and 2020 was one of those years. Roughly a week’s worth of deaths from 2019 and 2021 are counted as happening in 2020.

So let’s subtract 238 deaths, which is an average week, from the 2020 total. That brings the number of “excess” deaths down to 349, within the level of fluctuation we see in state mortality statistics from year to year.

It is possible that side-effects of the pandemic over the past year – stress, loneliness, avoided checkups and the like – have caused 349 people to die in New Hampshire who otherwise would have lived. But it’s also possible that there’s been little or no extra mortality.

Epidemiologists will be poring over medical and death-certificate data for years to parse out the exact effect of this pandemic. No matter the conclusion, we all know that the pandemic has taken a toll that goes beyond mere numbers.

That’s why we’re still wearing masks and not gathering in groups and doing all those other annoying things to limit the spread of viruses while we wait for vaccines to boost our natural immune systems. We don’t want to still be tallying the pandemic’s toll when another anniversary comes around.

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