We investigate why the USA, unlike Canada and Western European countries, has a sustained exceedingly large mortality in the “COVID-era” occurring from March 2020 to present (October 2021). All-cause mortality by time is the most reliable data for detecting true catastrophic events causing death, and for gauging the population-level impact of any surge in deaths from any cause. The behaviour of the USA all-cause mortality by time (week, year), by age group, by sex, and by state is contrary to pandemic behaviour caused by a new respiratory disease virus for which there is no prior natural immunity in the population. Its seasonal structure (summer maxima), age-group distribution (young residents), and large state-wise heterogeneity are unprecedented and are opposite to viral respiratory disease behaviour, pandemic or not. We conclude that a pandemic did not occur. We infer that persistent chronic psychological stress induced by the long-lasting government-imposed societal and economic transformations during the COVID-era converted the existing societal (poverty), public-health (obesity) and hot-climate risk factors into deadly agents, largely acting together, with devastating population-level consequences against large pools of vulnerable and disadvantaged residents of the USA, far above preexisting pre-COVID-era mortality in those pools. We also find a large COVID-era USA pneumonia epidemic that is not mentioned in the media or significantly in the scientific literature, which was not adequately addressed. Many COVID-19-assigned deaths may be misdiagnosed bacterial pneumonia deaths. The massive vaccination campaign (380 M administered doses, 178 M fully vaccinated individuals, mainly January-August 2021 and March-August 2021, respectively) had no detectable mitigating effect, and may have contributed to making the younger population more vulnerable (35-64 years, summer-2021 mortality).

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