Alaska had more than 5,000 deaths last year. Of those, at least 529 were above what could be expected in a normal year — a calculation known as excess deaths.
The global pandemic ensured 2020 wasn’t normal. Public health experts across the country are examining excess deaths to find whether more people are dying from COVID-19 than reported.
The 2020 excess death numbers are still coming in and will likely rise. But a recent Department of Health and Social Services analysis counts 529 excess deaths in 2020 — more than double the 255 COVID-19 deaths reported.
Rebecca Topol compiles excess death reports for Alaska’s Division of Public Health. She emphasized the state’s numbers are preliminary, and it’s too soon to draw conclusions.
“Some of those might be unidentified COVID cases. But we don’t really know the answer to how many of those other ones that are not attributed to COVID might be COVID-related,” Topol said.
There are other causes behind Alaska’s excess 2020 deaths, including elevated levels of diabetes, cancer and heart disease. But the excess death figures are especially important for public health experts to understand the effect of pandemics and other disasters.
Some unreported COVID-19 deaths could be caused indirectly, from health care capacity shortages or patients afraid to visit the doctor during the pandemic putting off medical treatment. But nationally, public health experts are concerned about people who haven’t been tested or diagnosed with the virus dying from it.
A recent study published in the Journal of the American Medical Association said inadequate testing likely contributed to the difference between reported COVID-19 deaths and the number of excess deaths for otherwise healthy young people.
Alaska State Epidemiologist Dr. Joe McLaughlin said this may reflect a broader issue.
“I suspect this is happening throughout the country, here in Alaska, and in other states as well,” he said. “A number of these excess deaths are probably attributable … at some level to the epidemic: whether or not the person actually had COVID-19 and it was not detected, they weren’t tested, or some other potential factors.”
Even highly skilled doctors can’t be certain of all the causes when they fill out death certificates. State Chief Medical Officer Dr. Anne Zink said there are limitations to what doctors can know.
“I think that as a clinician, it can be hard, right?” she said. “Someone comes in and they’re sick, and you’re trying to figure out what’s going on. And maybe they’re older and they have underlying heart disease. And maybe they test positive for COVID or they don’t test positive for COVID, or they had COVID previously, but now they’ve had a heart attack.”
Zink said patient’s records don’t give the person writing the death certificate everything they need to know.
“It’s not like you just open up a flap or a note and you can see exactly what their cause of death was and what happened and all of the causes,” she said. “You’re trying to put this together clinically.”
Nationally, there were almost half a million excess deaths between March 2020 and January 2021. That’s 75,000 more than what’s captured in the COVID-19 count, according to The New York Times.
Zink said it will take time to understand the true number of people who died from COVID-19, including pandemic-related deaths.
“I think there will be hundreds of papers coming out for the next multiple years looking back on this pandemic and trying to understand this virus and how much to attribute to COVID or to other things,” she said.
Alaska’s excess death count for December isn’t yet comprehensive. If the final count goes up, as counts have in recent months, the final number of unattributed deaths could reach more than 600.
A final state report on 2020 excess deaths is expected later this year.
Andrew Kitchenman is the state government and politics reporter for Alaska Public Media and KTOO in Juneau. Reach him at akitchenman@alaskapublic.org.
