Counting the Uncounted, Part II: Did Isolation Fuel Medical Errors and Deaths?
When we first asked, “How many people were isolated during COVID?” the numbers shocked even us.
In nursing homes, virtually every resident—about 1.3 million people at any given time—was cut off from family for 20 months. That adds up to ~800 million resident-days of isolation, affecting 2–2.5 million unique residents.
In hospitals, between 2020 and 2022, there were ~132 million hospitalizations. At least 44 million patients were admitted during periods of strict no-visitor policies, with as many as 87 million patients facing restricted or “one-visitor only” rules.
This was not rare. It was systemic.
But these estimates raise a deeper, even more unsettling question: Did enforced isolation increase the number of people who died due to medical mistakes?
Medical Errors: A Silent Epidemic
Medical errors were already one of the leading causes of death in America before COVID:
The Institute of Medicine’s 1999 report, To Err Is Human, estimated 44,000–98,000 preventable deaths per year.
Johns Hopkins researchers in 2016 put the figure at ~250,000 deaths per year—the third leading cause of death in the U.S.
A 2023 study estimated 371,000 deaths annually from diagnostic errors alone.
Even conservatively, that means hundreds of thousands of Americans die each year from mistakes—missed diagnoses, wrong medications, delayed care, or hospital-acquired infections.
The Pandemic Effect: Safety Under Siege
COVID strained hospitals and nursing homes to their breaking point. A federal Medicare analysis showed that during high-COVID weeks, adverse events jumped more than 60% compared to baseline. Staff shortages, chaotic workflows, and crisis conditions made errors more likely.
Now imagine removing one of the strongest safeguards: family at the bedside.
Loved ones ask questions, catch medication mix-ups, notice when something is off, and advocate for timely treatment. Research consistently shows that families improve communication and reduce errors. When they were locked out, an essential layer of protection disappeared.
Isolation and Delirium: A Deadly Link
One of the clearest pathways was delirium.
In a multinational ICU study, lack of family visitation was a major risk factor for delirium.
Delirium doubles the risk of death both during hospitalization and after discharge.
Isolation didn’t just create loneliness—it contributed to confusion, complications, and potentially higher mortality.
Building a More Realistic Estimate
So how much could isolation have increased deaths from medical mistakes?
Baseline: Using the Johns Hopkins estimate of ~250,000 error-related deaths per year, that’s ~750,000 deaths over 2020–2022.
Pandemic surge pressure: With error rates climbing during COVID peaks, the true number may have approached 900,000 deaths over those three years.
Isolation’s contribution: If isolation amplified error-related deaths by 3%–15%, with a mid-range of ~7%, that translates to:
Low scenario (3%): ~27,000 deaths
Mid scenario (7%): ~63,000 deaths
High scenario (15%): ~135,000 deaths
Even at the low end, tens of thousands of Americans may have died, not only from COVID itself, but because isolation stripped away a vital safeguard against error.
Why This Matters
These numbers are not meant to frighten—they are meant to bring accountability.
When we see that millions were isolated and tens of thousands may have died as a direct result, we can no longer treat enforced isolation as an unfortunate side effect. It was a dangerous policy failure that likely magnified an already hidden epidemic of medical mistakes.
The Human Face Behind the Data
Every statistic represents someone’s loved one.
A grandmother whose misdiagnosis went unchallenged because her daughter couldn’t be there.
A father who died after a medication error that his wife might have noticed.
My wife Elizabeth—just 40 years old—who spent 21 days isolated before she died.
Behind every number is a family that deserved better.
Never Again
At The NEVER Alone Project, our mission is clear: No patient should ever face hospitalization without the presence of a loved one or advocate.
The math shows the scale. The stories show the human cost. Together, they make the case for permanent patient protections.
We can’t undo what happened. But we can honor those we lost by ensuring that no patient is ever left alone again.
Because counting the uncounted isn’t just about numbers. It’s about truth. It’s about accountability. And it’s about change.