My young granddaughters and I took a stroll through Pagosa’s Hilltop Cemetery on Memorial Day. We don’t have any family members buried there, but we recognized some familiar names. Amelie pointed out the large headstone with the name “Yamaguchi” carved upon it — the name given to the downtown park were they ride bikes once or twice a week.
Simone asked why the headstones where there in the first place. Folks that have died in our family in recent years have chosen to be cremated, so Simone was unfamiliar with the idea of headstones, and caskets, and burials… and flowers on Memorial Day.
Here’s one of those screenshots I’ve been sharing, taken from reporter John Ingold’s May 21 Colorado Sun article… a preliminary tally of ’causes of death’ for Colorado during the medically-challenging month of April, 2020.
The new ’cause of death’ category “COVID-19” had been added to the chart in April… but the most striking change to previous months’ reports is the number of “Other” deaths. This category, in April, includes more than twice as many reported deaths as it did three months earlier, in January.
From Mr. Ingold’s article:
Having an accurate understanding of death in the time of coronavirus will ultimately help health officials better understand the virus’ spread and plan for future pandemics. Were deaths due to COVID-19, the disease caused by the coronavirus, underreported or overreported? Did the statewide stay-at-home order increase deaths from other causes?
But a slew of factors muddy the data right now, including lack of testing early on in the pandemic, delays in reporting, confusion over how to fill out and record death certificates and a patchwork of rules and regulations by local health departments and county coroner’s offices.
“Everybody is trying to do the best we can, every one of us,” said Jill Romann, the Douglas County coroner. “But the numbers are going to be wrong this first year, no matter what.”
Colorado’s new second-leading cause of death
According to Mr. Ingold’s animated graphic, the category “COVID-19” was still a minor ’cause of death’ until mid-April. The first confirmed death from COVID-19 in Colorado took place in early March, but it took more than a month for the disease to surpass “Heart disease” as a leading cause.
According to Mr. Ingold, 6,761 Coloradans died during March and April last year. This year, that number increased by “at least 17%”, with a total of 8,190 dying during March and April.
We say “at least” because it can take several weeks for someone’s death to be included in official statistics. The number of “COVID-19” deaths and “Other” deaths for April is almost certain to increase in the coming weeks. It seems likely that more than 1,500 Coloradans died this March and April that died during those same months last year.
Mr. Ingold’s article addresses the spike in “Other” deaths:
But, drawing from the same data source, only 696 people in those months are recorded as having died from COVID-19. That means there are still hundreds of additional “excess deaths” — deaths over and above what would be expected based on historical averages — in March and April that have not been attributed to the pandemic, at least yet. (On Thursday, the state health officials reported that 1,001 people have died in Colorado so far due to COVID-19, but, again, it takes time for those deaths to be recorded in the numbers used in this analysis.)
The “state health officials report”, linked above, takes us to the National Center for Health Statistics (NCHS) website, which also offers this breakdown for recent “COVID-19” deaths nationally. Although the NCHS chart says “Updated May 22” the totals include only the deaths tallied up until April 11.
As we see here, the folks at NCHS who track ’causes of death’ have a category for “COVID-19 Deaths” (U07.1) and a range of categories (J12.0-J18.9) for “Pneumonia Deaths”, plus a range of “Influenza Deaths” ((J09-J11).
They are also tracking deaths that combine “Deaths with Pneumonia and COVID-19” (J12.0-J18.9 and U07.1)
And there’s a total for “Deaths with Pneumonia, Influenza, or COVID-19 (U07.1 or J09-J18.9)” But, according to my pocket calculator, none of those combinations of individual causes totals “136,219” … so it’s a bit of a mystery how these ’causes of death’ are being counted. As far as I know, from the past few weeks of writing about COVID-19, the vast majority of people who get infected show mild symptoms, if any, and recover within a few days. But some people develop severe acute respiratory conditions and die.
Were they killed by the virus? Is it more accurate to say, were they killed by their own body’s immune response to the virus? No one seems to know the answer to that question.
Were they killed by an immune response that worsened existing chronic conditions?
From Mr. Ingold’s article:
Colorado’s death certificates have three different lines where a cause of death can be listed, arranged in order of relevance, with the immediate cause being listed first and the underlying cause being listed last. Then, there is a whole other section where “other significant conditions” can be stated.
So if a person who has lung cancer contracts COVID-19 and dies of acute respiratory distress syndrome brought on by an associated pneumonia, what gets listed where?
[Douglas County coroner Jill Romann] said some physicians will list the underlying condition first, seeing that as the ultimate cause of death. But, she said, that’s not how it’s supposed to work.
“If what tipped them over the edge is COVID, that is what the death certificate should read,” she said.
As we noted, individual death certificates are filled out by attending physicians and coroners who may not be expert at recognizing a COVID-19 infection, especially when the nation is suffering from a shortage of test kits. But another piece of the mystery has to do with elderly individuals, who may already be on their death bed or close to it, passing away during a pandemic.
From Mr. Ingold’s article:
There are also some coroners in the state, including Logan County Coroner Dave Tennant, who think at least some of the increase in deaths in Colorado may be attributed to the state’s aging population…
“We are seeing a lot of elderly, 89 year olds pass away, even 100 year olds. And that’s just natural things,” Tennant said…
Maybe we ought to take a closer look at places where 89-year-olds might naturally be found.
Like nursing homes? That will be the subject of my editorial, tomorrow.
Bill Hudson began sharing his opinions in the Pagosa Daily Post in 2004 and can’t seem to break the habit. He claims that, in Pagosa Springs, opinions are like pickup trucks: everybody has one.