evidence: The temporal correlation between reported COVID-19 deaths and excess deaths reported to non-COVID-19 natural causes offers insight into the causes of these deaths, he says. "We observed peaks in non-COVID-19 excess deaths in the same or prior month as COVID-19 deaths, a pattern consistent with these being unrecognized COVID-19 deaths that were missed due to low community awareness and a lack of COVID-19 testing." [...] For the study, Stokes, Paglino, and colleagues utilized novel statistical methods to analyze monthly data on natural-cause deaths and reported COVID-19 deaths for 3,127 counties over the first 30 months of the pandemic, from March 2020 to August 2022. They estimated that 1.2 million excess natural-cause deaths occurred in US counties during this time period, and found that roughly 163,000 of these deaths did not have COVID-19 listed at all on the death certificates. [...] Many of these geographical differences in death patterns are likely explained by differences in state policies, COVID death protocols, or political biases by local officials that influenced COVID policies, the researchers say. In rural areas, for example, COVID-19 testing was more limited, and political biases or stigma around COVID may have affected whether COVID-19 was listed on a death certificate. Conversely, reported COVID-19 deaths may have exceeded non-COVID excess deaths due to successful mitigation policies that encouraged physical distancing and masking, and likely lowered cases of other respiratory diseases. Certain state protocols, such as in Massachusetts, also enabled death investigators to list COVID-19 as an official cause of death within 60 days of a diagnosis (until March 2022), rather than the 30-day limit in other states.