What we know about the virus
Nearly two months since the first death in Wisconsin, many of the trends that emerged early on with COVID-19 deaths in Wisconsin have continued:
❚ Victims are more likely to be male. Women make up 41% of the toll. In terms of those tested, the breakdown is equal between men and women, suggesting COVID-19 is more deadly for men, who tend to have higher incidences of many underlying conditions.
❚ Roughly 200 of those who have died in Wisconsin were 70 or older. There is a smaller number of victims scattered across almost every age category, including eight victims in their 20s and 30s. Records are available on only half of those eight cases and all four were “morbidly obese.” There are no deaths of people younger than 20.
❚ In Milwaukee County, 10 people have died under the age of 50. All of them were listed as being obese.
❚ There has been at least one fatality in roughly half of the state’s 72 counties. The deaths have been concentrated in the state’s most populous counties: Dane, Waukesha, Racine and especially Milwaukee, which accounts for more than half of the state’s deaths.
❚ At least 39% of the deaths were among people living in nursing homes and assisted living facilities, according to state data.
❚ For those deaths in which the Journal Sentinel has amassed detailed information, the top underlying conditions are diabetes, high blood pressure, congestive heart failure, pulmonary disease and obesity. Dementia was cited as present in many cases but typically with other conditions.
❚ Statewide, 65% of those who have died are listed as white; 30% were African American. The white category includes victims who were Latino, who account for about 8% of the state’s total deaths.
❚ In Milwaukee County, roughly 50% of the 200 deaths were African Americans. The county’s black population is 39%.
❚ The “infection fatality rate,” or the percentage of people who tested positive and later died, is 4% in Wisconsin. The actual percentage is likely lower because experts say there are many more people who have mild symptoms or none at all but would test positive for COVID if there were greater capacity for testing.
❚ The pace of COVID-19 deaths has slowed and appears to be slowing with a slightly downward trend. The first death was reported March 20 and the peak period was in early April. In the past two weeks, deaths have been in single digits, though there have been a handful of days with deaths in double digits. Dying with and from COVID-19
As he considers the loss from COVID-19, Remington said he has looked at “years lost,” even given the older age of victims. He noted that someone who reaches age 70 in the U.S. is expected to live to 85.
With underlying conditions, those 15 years might be cut in half, but that time lost is an important way to measure the human cost of the pandemic, he said.
“Clearly, some of those who died were at the end of their lives. Others were not,” he said. “There are younger people with hypertension, and we don’t expect those people to die at 50 or 60. They may have lost 10 to 20 years.”
Even with the growing toll, there have been reports indicating that not everyone dying from COVID-19 is ending up in official counts.
Remington said it makes sense that deaths would be undercounted early on in a pandemic, and he expects the count will likely be more accurate as data emerge for periods later in April.
At the same time, doctors and pathologists need to examine each case closely. An average of 140 to 150 people die each day around this time of year in Wisconsin, Remington said, and it will be important to determine just which deaths are caused by COVID-19.
“We are going to see people die with (COVID-19) and not from it, and we need excellent diagnostics by doctors, medical examiners and coroners to tease out the cause of death: Did COVID lead to that chain of events resulting in death or COVID may have contributed but was not the cause. There is judgment there,” he said.
In Milwaukee County, the medical examiner reports seven cases of people who died and had COVID-19, but the cause of death was not from the virus. The causes included death from falls, heart disease and stroke, records show.
Researchers will be studying if the COVID pandemic may be “pulling deaths from the future,” hastening the deaths of people who were nearing death, though that will be not evident for several months, Remington said.
That was the case when Milwaukee’s water supply was contaminated with cryptosporidium in 1993, he said. Sixty-nine people died, mostly those with compromised immune systems and the elderly. Remington noted there was a dip in deaths later that same year.
There is an indication that may be happening to some degree in Milwaukee County during the COVID-19 pandemic.
Between March 1 and April 29, deaths classified as “natural” were down by 30% in Milwaukee County compared to the same time in 2019, according to the medical examiner’s office.
It’s too early to say if COVID deaths are pulling in deaths from the future, but that figure will be watched.
Remington said COVID has highlighted issues including health disparities in the country and the prevalence of underlying conditions like diabetes and heart disease.
“This disease brought to the surface the epidemic of chronic disease and conditions,” he said. “Who thought a virus would be so provocative in identifying underlying chronic illnesses?”
Contact John Diedrich at 414-224-2408 or jdiedrich@journalsentinel.com. Follow him on Twitter at @john_diedrich, Instagram at @john_diedrich, LinkedIn or Facebook.