The number of deaths in Colorado jumped 20% during the first six months of the coronavirus pandemic as at least 3,788 more residents died than would be expected, reflecting the outbreak’s grim toll on human life even beyond those killed directly by the virus.
The increase in fatalities is largely due to the respiratory disease COVID-19, which has become the fourth leading cause of death in the state.
But other causes — including overdoses, cirrhosis, heart disease, diabetes and Alzheimer’s — also saw significant spikes, according to an analysis of state data by The Denver Post.
“The pandemic has affected every aspect of our lives, including every aspect of our health care and our health,” said Dr. Matthew Wynia, director of the Center for Bioethics and Humanities at the University of Colorado.
Overall, an estimated 22,723 Coloradans died between March and August, which is up from the 18,935 deaths the state recorded on average for the same period during the three years prior, according to provisional death-certificate data from the state Department of Public Health and Environment.
There’s a lag in death-certificate data so it’s possible the number of fatalities during the first six months of the pandemic could still rise further.
The possible reasons for the increase in deaths beyond previously reported coronavirus fatalities varies.
Some people may have died from COVID-19, but were never diagnosed because testing, especially during the early days of the pandemic, was limited. Other deaths may include people who delayed getting care because they were afraid to visit a hospital or doctor’s office.
Measuring the impacts of the coronavirus pandemic, including its indirect death toll, is complex and it’s unclear how many of the fatalities are from missed COVID-19 diagnoses or because people delayed care.
Deaths increased across a broad range of illnesses and diseases, an indication of the sweeping changes the pandemic has wrought on everyday life. And at the same time, deaths have declined in some areas where people have predicted they would increase.
For example, suicides dropped 2% over previous years, to 639 deaths, in the first six months of the pandemic, according to the death-certificate data.
Deaths during the pandemic
The leading causes of death among Coloradans during the first six months of the pandemic:
2. Heart disease
3. Chronic lower respiratory diseases/COPD
5. Unintentional injuries
Causes of death that have seen increases during the first six months of the pandemic:
Drug overdoses: Up 40%
Chronic liver disease/cirrhosis: Up 29%
Alzheimer’s: Up 26%
Diabetes: Up 17%
Heart disease: Up 11%
Cerebrovascular disease: Up 8.6%
Source: Colorado Department of Public Health and Environment
Public health experts said looking at deaths, including those indirectly tied to the novel coronavirus, provides a greater understanding of the impact the pandemic.
“It is valuable information because it gives you sort of the standard look at deaths and helps you understand what some of the bias, the gaps are in our other surveillance system,” said Dr. Lisa Miller, professor of epidemiology at the Colorado School of Public Health.
Of the excess deaths, at least 1,627 were Coloradans who died from COVID-19 complications. This number is lower than the state Department of Public Health and Environment’s count of such fatalities, which sits just below 2,000 — a figure that, unlike the death-certificate data, includes non-residents who died from the disease while in the state.
When it comes to non-COVID deaths, drug overdoses saw the largest increase despite making up a small portion of fatalities.
Between March and August, 597 Coloradans died of overdoses, which is up 40% from the 3-year-average of 424 deaths, according to the state data.
The rise in drug overdose deaths could be an indicator of how job loss and social distancing during the pandemic are affecting people, said Dr. Christian Hopfer, medical director for the UCHealth Center for Dependency, Addiction and Rehabilitation.
“Social isolation is a big stressor,” he said.
Public health experts said the rise of deaths from heart disease, cerebrovascular diseases — which include strokes — and Alzheimer’s disease could include people who died from COVID-19, but were were not tested.
Public health and medical experts long have said COVID-19 deaths may be undercounted. While the novel coronavirus often first affects the lungs, the disease also can cause kidneys to fail and create blood clots that cause strokes and heart attacks.
“There were deaths early on that actually were COVID and were attributed to something else because we had no testing,” Wynia said.
There were 1,053 deaths from Alzheimer’s disease, which is 26% above the 3-year-average of 835, during the six months that ended in August, according to the health department data.
Just over 3,920 deaths were caused by heart disease, 11% above the average, while 1,054 deaths were caused by cerebrovascular diseases, which is 8.6% above the average, according to the data.
Deaths from heart and cerebrovascular diseases increases could also reflect the fact that people did not immediately seek help for severe conditions because they are afraid to go to hospitals during the pandemic.
“We were seeing really sick people who were sitting at home for many, many days,” said Dr. Richard Zane, UCHealth chief innovation officer and chair of emergency medicine with the School of Medicine, adding, “Two months ago, it was tragic and it is still persistent, but it’s not as dire as it was.”
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