As if the 300,000 dead in the U.S. from COVID-19 weren’t horrific enough, consider how many more have died from the pandemic’s indirect effects. Evidence from the Centers for Disease Control suggests mortality is higher in 2020 than expected for reasons beyond coronavirus infections. Most of the excess deaths are health-related, but they extend as far as motor vehicle crashes.

A recent analysis based on the CDC data shows that 40,000 more Americans than expected died this year from diabetes, Alzheimer’s, high blood pressure and pneumonia. Some of these deaths may have been caused by the virus and just recorded improperly. But a large share may reflect the effect of people getting less health care. Non-COVID care has dropped as government mandates have prevented discretionary procedures and as patients have grown fearful of being infected at hospitals.

If the forgone care is having adverse health consequences, then it would be fair to consider them indirect costs of the pandemic. Evidence has long suggested that the U.S. health system suffers from substantial inefficiencies, so that the amount of care potentially could be reduced without worsening health outcomes.