An analysis of deaths associated with COVID-19 in King County published on Sept. 1 shows that deaths have slowed dramatically since the early peak of the outbreak in April. However, COVID-19 still ranks overall as the 6th leading cause of deaths in 2020 in King County.
These are among the findings in a new report from Public Health—Seattle & King County, “Summary Report on Deaths Associated with COVID-19.”
Through Sept. 1, there have been 724 deaths attributed to COVID-19, with 680 of those confirmed and another 44 that are suspected or pending. In March, the report found that COVID-19 ranked as the third most documented contributing cause of death in the county, but in recent weeks, it has fallen to the number eight cause.
More than 90% of those who have died from COVID-19 were over age 60 (and the median age of death over the past six months has remained around 81 years).
More than 80% of those who have died from COVID-19 had an underlying medical condition.
Among racial/ethnic groups, more white people have died from COVID-19 than from any other race. But the age-adjusted rate of death shows a dramatic impact among Hispanic/Latinx residents, at 84 per 100,000 residents—three times higher than for whites, at 28 per 100,000. And for Native Hawaiians/Pacific Islanders, the death rate is more than four times higher than for Whites, at 121 per 100,000.
“This report gives us confidence that our official death counts are not missing large numbers of people who have died from COVID-19,” said Dr. Jeff Duchin, Health Officer for Public Health. “And it highlights that although the COVID-19 outbreaks in long-term care facilities that led to many deaths among older residents have decreased in response to effective COVID-19 prevention measures, the threat remains. This summer’s increases in COVID-19 cases in the community remind us that we cannot let our guard down.”
Understanding unrecognized COVID-19 deaths
Nationally, there’s been discussion of under-reported COVID-19 deaths.
To check for this possibility locally, Public Health calculated “excess deaths,” using a methodology from the federal Centers for Disease Control & Prevention.
This estimate shows that in King County between January 1 and August 18, 2020, there were 817 more deaths than would be expected in a typical recent year before the COVID-19 outbreak. Because the number of excess deaths varies from year to year, Public Health also estimated statistically significant excess deaths above and beyond what would be expected due to typical yearly variation in weekly deaths. This estimate found there were 264 excess deaths. By comparison, using the same time period, the total count of confirmed, suspected and positive COVID-19 deaths was 692.
Based on this analysis, there do not appear to be large numbers of potential COVID-19 deaths that are unrecognized in the official death counts.
What counts as a COVID-19 death
There is not yet a national standard methodology for COVID-19 death reporting, although approaches are under development. It might seem simple, but determining and classifying the actual cause of death can be complicated.
Initial counts of deaths in many localities included everyone who died and had tested positive for COVID-19. But that approach can miss cases — for example, there are people who die with COVID-19 symptoms but were never tested. There are also people who test positive, but die for unrelated reasons, such as a fall or a car crash. Those cases are not counted in King County, where deaths due to reasons other than COVID are removed, but some jurisdictions include them in official counts.
To improve clarity, accuracy and consistency, epidemiologists at Public Health completed a thorough review of all available data about local deaths in King County. They reviewed death certificate data to interpret medical information about causes of death, and also reviewed information about illness gathered through case investigations. After assigning classifications based on this information, they then examined trends over time among people who died from January 1 through September 1, 2020.