The coronavirus pandemic may have caused tens of thousands of more deaths in the spring and summer than previously thought, a new study says.

Researchers at Virginia Commonwealth University in Richmond found nearly 75,000 more people may have died from the pandemic than what was recorded in March to July, according to the report published Monday in the peer-reviewed journal JAMA. 

By examining death certificates, the study found more than 150,000 deaths were officially attributed to COVID-19 during that period. But researchers determined that nearly 75,000 additional deaths were indirectly caused by the pandemic, bringing the total number of deaths for those four months to more than 225,000.  

Johns Hopkins University data puts the total COVID-19 death toll in the U.S. at just below 215,000.

“There have been some conspiracy theories that the number of deaths from COVID-19 have been exaggerated,” said Dr. Steven Woolf, director emeritus of the Center on Society and Health at Virginia Commonwealth University in Richmond. “The opposite is the case. We’re actually experiencing more death than we thought we were.”

Woolf says the deaths indirectly caused by the pandemic camefrom illnesses such as Alzheimer’s disease, diabetes and heart disease, which sharply increased in the same five states that recorded the most COVID-19 deaths. 

Delayed care, fear of seeking care or emotional crises stemming from the pandemic could have also contributed to these deaths, he says, as well as inaccurate death certificates that may have misidentified a COVID-19 death. 

Woolf saw a similar pattern in a previous study by researchers at Virginia Commonwealth and Yale universities that looked at excess deaths early in the pandemic, from March to April.

In that study, researchers found deaths from these other diseases spiked in states like New York, New Jersey and Massachusetts, where coronavirus cases surged during the beginning of the pandemic. In June and July, Woolf said similar deaths spiked in Southern states that experienced a summer surge in coronavirus cases.

Another notable finding is how long the surges lasted in various states. According to the study, the level of excess deaths in New York, New Jersey and Massachusetts were immense but short-lived, resulting in a “A-shaped” model.

In Sunbelt states, however, excess deaths began to gradually increase at the beginning of the pandemic then skyrocket in June, rising until Woolf’s team ended its research in July.

“This suggests it has some policy implications in terms of the consequences of the decision of some states to ease restrictions early in the pandemic,” he said. “It’s sort of a warning call going forward.”

Dr. Amesh Adalja, an infectious disease physician and senior scholar at the Johns Hopkins Center for Health Security, said the study confirms what doctors see every day in the hospital and underscored how badly federal officials have performed during the pandemic.

Empty chairs are on display to represent the 200,000 lives lost due to COVID-19 at the National COVID-19 Remembrance, on the ellipse behind the White House in Washington DC on October 4, 2020. ANDREW CABALLERO-REYNOLDS, AFP via Getty Images

While the study may be only a snapshot of March through July, he says the country is still seeing an excess of deaths from the coronavirus.

“The fact is even now in the fall with all the knowledge and the new tools … this is still killing people at a rate that’s much too high,” Adalja said.

The study contributes to research from the University of Washington that suggests nearly 400,000 people will die this year from COVID-19 or consequences of the pandemic. JAMA editor-in-chief Dr. Howard Bauchner said in a journal editorial published Monday the number of excess of deaths “cannot be overstated.”

“These deaths reflect a true measure of the human cost of the Great Pandemic of 2020,” he wrote.