2020 was deadliest year in past 25 in Montgomery County. And it wasn’t just COVID

More Montgomery County residents died last year than in any year in at least a quarter century and possibly much longer, as the pandemic made 2020 the deadliest year in U.S. history, according to a Dayton Daily News analysis of preliminary state and federal health data.

COVID-19 killed more than 370 people in Montgomery County in 2020 and contributed to a 14% increase in the annual death toll, according to preliminary data from the Ohio Department of Health.

But more people also died of other causes, like heart disease and diabetes, and some medical experts say it’s likely many of these “excess deaths” were indirectly due to the coronavirus because people delayed or avoided medical treatment during the pandemic.

“We have theories ― we don’t exactly know ... but people aren’t able to access the health care system because it’s been overwhelmed with COVID, or people are choosing to put off care because of fear of encountering COVID by going to the hospital,” said Dr. Valerie Weber, professor of medicine and dean of the Boonshoft School of Medicine at Wright State University.

The preliminary state data suggest most other counties in the region saw an increase in deaths last year compared to 2019, including Butler (+19%), Champaign (+13%), Clark (+16%), Greene (+9%), Miami (+6%) and Warren (+15%) counties.

Death counts from Ohio Department of Health   
 20192020# change% change
Montgomery 6,4137,30489114%
Source: Ohio Department of Health   

About 7,304 people died in Montgomery County last year, which was an increase of 891 deaths from 2019, according to preliminary data from the Ohio Department of Health.

That was by far the highest death count and the largest increase in deaths since 2007, according to the most recent available state data.

The data is preliminary, meaning it is likely to change. But the data is likely an undercount, since coroners and physicians have about six months to finalize and certify death information.

The CDC publishes county-level death data online that goes back further, and while it is very similar to the state data it is not identical.

The CDC data suggest Montgomery County’s death count and increase in the deaths last year were the highest in at least 25 years, this newspaper found.

Top killers

In 2020, the leading causes of death in the county were heart disease (1,499 deaths); cancer (1,209); accidents (530); stroke (509) and chronic lower respiratory disease (301), according to preliminary state data.

COVID-19 killed 371 people in the county, potentially making it the fifth leading cause of death, according to the preliminary state data.

COVID-19 is very dangerous because it is a novel virus that no one is immune to that spreads easily, said Weber.

“This particular (coronavirus) is virulent, easily spread and it is deadly, especially in older people or people with comorbidities,” she said.

COVID-19 can lead to severe pneumonia and dangerously low oxygen levels, Weber said, and sometimes it attacks and damages many internal organs.

Weber said it remains a mystery why the virus kills some patients but only causes minor symptoms in others.

Fears about the virus are completely understandable, she said, but unfortunately many people have avoided hospitals and medical settings because they are scared about potential exposure, which means they aren’t getting treatment for other chronic conditions and serious ailments.

“This is not just in Montgomery County, this is not just in the U.S. ― this is worldwide,” she said.

Credit: Jim Noelker

Credit: Jim Noelker

Other problems

Six of the nine leading causes of death in Montgomery County killed more people in 2020 than they did in 2019, according to the preliminary state data.

Last year, deaths from diabetes increased about 14%, while fatalities from heart disease increased 6%.

Septicemia deaths increased 26%; stroke-related deaths rose 1%.

During this crisis, many Americans have delayed getting care for heart attacks and strokes during the pandemic, which can lead to worse outcomes, and some people also developed unhealthy eating and drinking habits and a sedentary lifestyle, said Salim Virani, chair of the writing committee for the American Heart Association’s 2021 Statistical Update.

COVID-19′s “influence will directly and indirectly impact rates of cardiovascular disease prevalence and deaths for years to come,” he said.

However, Montgomery County saw fewer deaths from kidney disease (-20%), chronic lower respiratory disease (-8%) and accidents (-7%).

The decrease in accidents coincides with fewer motorists traveling on local roadways, because of stay-at-home orders, remote working and learning and bars, restaurants, and other entertainment businesses closing or significantly scaling back operations.

Some people have been laid off and lost wages or medical benefits, which has limited access to health care or their ability to pay for services, possibly impacting their health, said Dr. Roberto Colón, chief medical officer with Miami Valley Hospital.

Troublingly, he said, many people during this crisis haven’t been seeking preventative care and vital medical treatment because of a false notion that hospitals and medical settings are unsafe and have a higher risk of COVID-19 transmission than other places.

Credit: Will Jones

Credit: Will Jones

Health care workers take significant protective measures to prevent the spread of disease far beyond the safety protocols people use in everyday life, Colón said.

“We are trying to convey to everybody, the hospitals and the health care offices are absolutely safe environments when you need care,” he said. “You should not avoid them out of fear for getting sick.”

Patients also can use telemedicine and remote screening options to limit in-person contact, he said.

Colón said it’s unclear how much COVID-19 is to blame for excess deaths across the country, but some articles and research suggest it could be responsible for a very large share of the additional fatalities.

“For those who believe COVID haven’t touched them directly because they haven’t been infected, we want to make sure they realize there are other medical conditions they need to be paying attention to during this time,” he said. “You don’t want to neglect them, just because of a fear of COVID.”

Weber said it’s tragic to lose so many people to a virus that can be stopped from spreading with social distancing, wearing masks and following other basic safety guidelines.

She said sadly 2021 also likely will have an elevated death toll because COVID-19 cases surged early this year and the vaccine rollout has been a slow process. About 8% of the U.S. population has been vaccinated.

2020 top causes of death in Montgomery County

Heart disease: 1,499 deaths

Cancer: 1,209

Accidents: 530

Stroke: 509

COVID-19: 371 deaths

Chronic lower respiratory disease: 301 deaths

Alzheimer’s Disease: 241 deaths

Diabetes: 188 deaths

Septicemia: 139 deaths

Kidney Disease: 99 deaths

Influenza and Pneumonia: 99 deaths

Source: Ohio Department of Health

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