Nationwide, 200,000 more people have died than usual since March. This number is about 60,000 higher than the number of deaths that have been directly linked to the coronavirus.

As the pandemic has moved south and west from its epicenter in New York City, so have the unusual patterns in deaths from all causes. That suggests that the official death counts may be substantially underestimating the overall effects of the virus.

When the coronavirus first took hold in the United States in March, the bulk of deaths above normal levels, or “excess deaths,” were in the Northeast, as New York and New Jersey saw huge surges.

The Northeast still makes up nearly half of all excess deaths in the country, though numbers in the region have drastically declined since the peak in April, according to a New York Times analysis of estimates from the Centers for Disease Control and Prevention.