From March 11 to May 2, there were a total of 32,107 deaths, 24,172 more that the city would have expected in that time based on past trends, according to a report from New York’s Department of Health and Mental Hygiene that was published by the U.S. Centers for Disease Control and Prevention. While Covid-19 was explicitly tied to 18,879 of the excess deaths through confirmed or probable cases, there were 5,293 excess deaths that may have come from other causes.

Excess deaths are a way of counting mortality that tries to capture not only victims of the virus, but also negative and positive side effects like people who died of a heart attack because they didn’t get to a hospital in time, or fewer people who died in auto accidents because of diminished road traffic.

The thousands of extra deaths illustrate the ongoing toll of the outbreak that has killed thousands, hospitalized many more, and created collateral economic and health-care damage as businesses have been shut down, emergency response services have been overwhelmed, and many medical procedures and visits have been canceled or delayed to create capacity to treat virus patients.