An abnormal amount of Americans have died in 2020, but more than a quarter of the additional deaths aren’t attributable to coronavirus, according to Centers for Disease Control and Prevention health data.

While coronavirus is to blame for the majority of excess 2020 U.S. deaths, other conditions such as diabetes, high blood pressure and pneumonia have all caused more deaths than expected, according to a New York Times analysis of the Centers for Disease Control and Prevention (CDC) data. But, some experts said increased deaths could still be the indirect effect of coronavirus.

“You end up having to choose between your prescription medications or buying groceries or keeping a roof over your head,” Dr. Steven Woolf, director emeritus of the Center on Society and Health at Virginia Commonwealth University, told the Times.

More than 356,000 more people in the U.S. have died than normal, the Times reported. The CDC determined expected death counts based on historical trends since 2013.

Diabetes accounted for 15% of excess deaths, the most outside of coronavirus, while Alzheimer’s, high blood pressure, pneumonia and flu, heart disease, strokes, sepsis and kidney failure represented the remaining excess deaths, according to The Times. There is also some fear that the pandemic may cause future adverse health conditions.

“A person who survived the pandemic may end up deteriorating over the next few years because of problems that happened during the pandemic,” Woolf said, according to The Times.

Woolf co-authored an October study that supported the CDC data and showed significant excess deaths beyond coronavirus.

The U.S. has reported more than 16 million coronavirus cases and nearly 300,000 coronavirus deaths since the outbreak of the virus in the spring, according to The COVID Tracking Project. President Donald Trump declared a national emergency as the virus began spreading rapidly in March.

Meanwhile, the pandemic has caused U.S. mental health to decline. Americans’ mental health hit a 20-year low, according to a Gallup survey published Dec. 7.

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