How many Alaskans died last year in the pandemic? ‘Excess death’ count sheds some light

A mostly empty hospital hallway
A nearly empty critical care unit at Bartlett Hospital on April 7, 2020, in Juneau, Alaska. on (Photo by Rashah McChesney/KTOO)

Alaska had more than 5,000 deaths last year. And of those, at least 529 were above what could be expected in a normal year — what’s known as excess deaths.

The global pandemic ensured last year wasn’t a normal year. Public health experts across the country are examining excess deaths as they study whether significantly more people are dying from COVID-19 than what’s being recorded.

The 2020 excess death numbers are still coming in and will likely go up. But, the 529 excess deaths in a new report were already more than twice as many as the 255 deaths Alaska doctors have determined the coronavirus disease caused in 2020. 

Rebecca Topol compiles Alaska’s excess deaths reports for the state’s Division of Public Health. She emphasized in early January that the state’s numbers are preliminary. And she said it’s too soon to draw conclusions. 

“Some of those might be unidentified COVID cases, but we don’t really know the answer to that — how many of those other ones that are not attributed to COVID might be COVID-related,” Topol said. 

There are specific conditions and causes related to Alaska’s excess deaths in 2020, including elevated levels of diabetes, cancer and heart disease. But the excess death figures are especially important to public health experts to understand the effect of pandemics and other disasters. 

With COVID-19, some of the excess deaths could have come indirectly from the pandemic — from things like health care capacity shortages or patients putting off medical care because they were afraid to go to the doctor during the pandemic. But public health experts nationally have been concerned that people who haven’t been tested for or diagnosed with the virus are dying from it

For example, a recent study published in the Journal of the American Medical Association said inadequate testing for the coronavirus likely contributed to the difference between the number of excess deaths of otherwise healthy young people, and the recorded COVID-19 count. 

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 in mid-January. “A number of these excess deaths are probably attributable … at some level to the epidemic, whether or not the person had actually had COVID-19 and it was not detected, they actually weren’t tested, or some other potential factors.”

Part of the challenge is that even highly skilled doctors may not be certain of all of the causes of death 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 the patient’s records don’t automatically give the person writing the death certificate everything they need to know.

“And so, 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 471,000 excess deaths between March 15, 2020, and Jan. 16, 2021, which is 75,000 more the reported COVID-19 count, according to The New York Times

Zink said it will take time to better understand the true number of people who died from COVID-19, or the other causes of excess deaths related to the pandemic. 

“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 of that was to COVID or to other things,” she said of the excess deaths.

Alaska’s excess death count for December doesn’t include all deaths for the month, since it takes time to report deaths. If December’s final count goes up like it has in recent months, the final number of excess deaths for 2020 could reach 600 or more.

A final state report on 2020 excess deaths is expected later this year.