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See the latest news and updates about COVID-19 and its impact on the Charlotte region, the Carolinas and beyond.

Mecklenburg County Had A Surge Of 'Excess Deaths' Not Listed As COVID-19. Should They Have Been?

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Steve Harrison/WFAE
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MEDIC deputy director Jonathan Studnek said he believes Mecklenburg's large number of "excess deaths" is driven in part by people who died from COVID-19 but were never tested.

During the first seven months of the coronavirus pandemic, COVID-19 killed 361 people in Mecklenburg County, according to the county health department’s official count.

But a WFAE review of state Department of Health and Human Services data shows that the pandemic likely killed far more.

In addition to those official COVID-19 deaths, Mecklenburg County had 342 more fatalities in the spring and summer than it did a year earlier.

And the county had a far greater percentage of such non-coronavirus deaths than the state — as well as any other large county in North Carolina.

Jonathan Studnek, the deputy director of MEDIC, said he believes the deaths were driven by two factors.

The first is that people were afraid to seek preventative medical care and that ultimately led to more fatalities. The second theory is that some people had COVID-19 but were never diagnosed with the coronavirus. They quickly became sick and died before they were tested.

In the past year, MEDIC has seen a 30% increase in people who called for an ambulance but were dead when medics arrived.

“I think that undiagnosed COVID is a real issue, especially in the spring because we knew there was a lack of access for testing," Studnek said. “I think there is this pool of COVID in the community that’s undiagnosed. Folks are either reticent to get tested, (or) don’t think it’s that big of an issue, and then it develops into larger problems.”

In trying to determine the true impact of COVID-19, researchers nationwide have focused on what’s known as “excess mortality.” That means projecting how many people would have died in 2020 if there was no pandemic and then looking at the total number of deaths on top of that.

The Department of Health and Human Services is slow to process death certificates and its database for 2020 is incomplete. WFAE analyzed mortality from March to September 2020.

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Overall Mortality In North Carolina

From March to September 2019, there were 54,945 deaths in the state. Based on increases in deaths in previous years, North Carolina was on track for about 56,100 people to die in the spring and summer of 2020, before the pandemic.

Fast-forward to March through September 2020, when 60,004 people died. The state recorded 3,774 people who died of COVID-19 during that time.

That indicates that COVID-19 was responsible for almost all the state’s excess mortality – 97%.

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Mecklenburg County tells a different story.

The county had 3,581 deaths between March-September 2019. Based on previous years and population growth, the county would have expected to have anywhere from 3,625 to 3,725 deaths in 2020, assuming there was no pandemic.

During the pandemic, 4,283 people died.

But the official Mecklenburg COVID-19 death toll for April through September is 361. That still leaves between 200 and 300 excess deaths.

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At the end of 2020, Mecklenburg County's official per-capital COVID-19 death rate was among the lowest of the county's largest counties.

Aaron McKethan, a senior policy fellow at the Duke-Margolis Center for Health Policy, reviewed WFAE’s analysis on excess deaths and mortality. He said it appears that Mecklenburg indeed has some more unknown excess deaths — and he’s not sure why.

“I am not surprised we have excess deaths above what has been reported by official COVID-19 statistics,” he said in an email. “And we know the risk of death is uneven at the person level and therefore varies by geography.”

He theorized that there would be more mortality in places with “larger concentrations of unhealthy, elderly, low income, and black, indigenous, or other persons of color.”

But while Mecklenburg has a higher percentage of minority residents than the state, its population is younger. Nearly 17% of the state’s population is 65 and older. In Mecklenburg, it’s 11.5%.

Mecklenburg Could See More Heart Attacks, Other Respiratory Deaths

The Mecklenburg County Health Department said it believes it's too early to analyze total mortality for 2020 because the DHHS data is still considered provisional.

This summer, deputy health director Raynard Washington said the health department reviewed deaths from the spring in a search for “missing COVID” deaths. At the time, he said the county believed there were only a handful of deaths that were undiagnosed COVID-19.

In October, county health officials gave a presentation to county commissioners about overall mortality. They noted that overall deaths were up – but did not talk about the large numbers of non-COVID excess deaths or make a comparison to the state.

The county did an analysis of the type of deaths through the first six months of 2020 and compared it to all of 2019.

That data suggested there could be more people dying of heart disease and COPD — chronic obstructive pulmonary disease. If those trends held up, Mecklenburg would have seen nearly 100 additional deaths from heart disease and COPD in 2020. None of those deaths would have been officially attributed to COVID-19.

But researchers have found that in addition to COVID-19 being a respiratory disease, it can also lead to heart attacks.

Studnek of MEDIC said he believes there are people still avoiding the doctor’s office or hospital because they are afraid of being infected by the coronavirus.

Over the winter, MEDIC’s lowest-priority calls were down 40% compared with a year earlier.

“To me, that says folks aren’t calling 911,” he said. “These are people who don’t know another way to get their (health) problem solved. That’s our largest bucket of transports. And that group is much (lower) than it’s ever been.”

He said he believes the state’s non-COVID-19 excess deaths will increase when DHHS releases death data from the winter. That’s when coronavirus infections increased rapidly in the state, and when most of the deaths occurred.

And he said there will be even more non-COVID-19 excess deaths in Mecklenburg County in November, December, and January. At the height of the pandemic in January, Studnek said DOAs were more than double than a year earlier.

For the entire pandemic – March 2020 to February 2021 – Studnek said there were 1,123 DOAs. A year earlier – March 2019 to February 2020 – there were 855.

“That period of December to January to February — the only word to describe it as tragic,” he said. "We thought the spring was bad, but the winter was terrible. The ability to take care of patients, the stresses on the hospital system, and the ambulance crews were nothing like what happened in the spring. It was magnitudes of times more complicated to manage and difficult to deal with because of the influx of the cases and the severity of the disease."

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