That hasn’t been as easy as some would expect. And talking about death counts often opens up a whole line of questioning.
How many more people are dying now than otherwise would in a more normal year? Because the virus attacks the elderly and those with preexisting conditions, would those deaths have happened anyway?
As of Saturday, 139 people have died of the virus in Utah, according to the Utah Department of Health’s tallies, and more than 115,000 nationwide. How accurate are those counts?
Finally, we know that the disease has made an impact on nearly every aspect of society. Some of those can be deadly: people may put off going to the hospital fearing they would contract the virus there, people might die by suicide at a higher rate because of the isolation caused by social distancing, traffic accidents and homicides might have gone up or down in these unusual times.
Still, the CDC’s data confirms information we already have and new stats to consider. So with this in hand, let’s take a shot at answering those questions.
How are coronavirus deaths tracked?
Every time someone dies in America, a physician, coroner or medical examiner has to fill out a death certificate. For example, here’s how the CDC recommends a doctor fill out the death certificate for someone who experienced pneumonia for 10 days as a result of COVID-19.
Doctors can put COVID-19 on the form without a positive test, if that’s their best guess. For example, if someone had significant exposure to a confirmed COVID-19 case, then died of COVID-19 symptoms, doctors are instructed to put “Probable COVID-19” on the form. These are usually tallied with the confirmed coronavirus deaths. In Utah, public health leaders say they test people after they die in an attempt to catch all cases of the virus.
Then, doctors must list any significant conditions that played a role in the death in Part II of the form. That is where heart disease, diabetes, hypertension, or any other contributing factors are placed. Any number of conditions can be put here, but only the ones that played a role in the death in the doctor’s informed opinion.
These certificates are sent to the National Center of Health Statistics. Because these stats rely on manual entry, they typically lag a few weeks behind the daily coronavirus reports we hear from the counties and states. Some states even take a couple of months to report their data, but Utah is generally relatively quick about it.
How many excess deaths have occurred in Utah and the U.S.?
Overall, there have been a huge number of excess deaths in the United States. From Feb. 1 to May 30, there were an estimated 140,023 extra deaths in the nation.
In Utah, the situation is significantly better than it is in most states. According to the CDC’s data, Utah’s total number of deaths over the same timeframe was 252 more than expected. However, that number is just inside the confidence interval’s margin of error: it is possible, but unlikely, that the extra deaths are a result of a misestimate of the expected number. Only 11 states had a lower excess death number.
How many of those excess deaths are due to COVID-19?
The CDC separates the underlying causes of natural death into these categories: cancer, heart diseases, stroke, diabetes, Alzheimer’s disease, influenza and pneumonia, chronic lower respiratory diseases, kidney diseases, COVID-19, and an “other/unknown” category.
The good news is that there isn’t evidence of similar spikes in the Utah data. Typically, 77 people die every week of “diseases of the heart” in Utah, according to the CDC, but during the pandemic, 79 people died every week. It wasn’t a major difference.
The same is true for other common causes of death, like cancer, diabetes, Alzheimer’s and strokes. Even for pneumonia or chronic lower respiratory diseases, conditions you can imagine a coroner substituting for COVID-19, the death counts haven’t changed in Utah — the pre- and post-pandemic averages are extremely close, within one or two deaths per week.
What accounts for the other deaths?
Through May 30, Utah had 112 COVID-19 deaths. That explains a big chunk of the 252-ish excess deaths found in the CDC data, but not all of them. If other causes aren’t spiking, what explains the rest of the increase?
Each death is also labeled “Natural” or not — the latter category including homicides, suicides, and accidents. The vast majority of deaths are natural. In the early part of the pandemic, Utah’s rate of non-natural deaths declined from 43 per week on average to 36 per week on average.
There’s also been no big jump in non-natural deaths nationwide in the past three months, even with deaths from unknown causes potentially taken into account.
Who is dying?
Understandably, people see these numbers, compare them to life expectancy numbers — the average life expectancy in the U.S. is 78 years — and figure that COVID-19 is largely killing those who were near death anyway. But most old people have one preexisting condition or another, and once people make it to their 70s, most live quite a while longer. Remember that life expectancy is driven down by people who die when they are relatively young.
The other interesting disparity is that while 51% of Utah’s coronavirus cases have come in Salt Lake County so far, 66% of the deaths have come in the county. There’s no disparity in percentage of elderly in Salt Lake County compared with the rest of the state, nor in the numbers of those with preexisting conditions, so it’s not immediately clear why the death count would be higher in Salt Lake County. However, there have been well-documented outbreaks in some of Salt Lake County’s long-term care facilities in particular, which might explain the difference.
So yes, there are still questions to be answered, with more concrete data to come. But now three months into this crisis, we’re starting to get a clearer picture on the total effect the virus has had on people’s lives — and unfortunately, the end of them.