PHOENIX — Arizona ranks number one in the nation when it comes to excess deaths. It’s a metric used to measure the number of deaths over what's expected for the state over time.
Will Humble, Executive Director for the Arizona Public Health Association says the excess death rate was a stable data point before the pandemic and therefore, a good baseline to measure the impact COVID is having on the state.
“What you clearly see both in Arizona and across the country is an increase in total mortality or total deaths over and above what you would normally expect in a regular year,” Humble said.
ABC15 data analyst Garrett Archer breaks down the numbers specific for Arizona.
“So according to CDC estimates, Arizona is at about 25% to 30% over what would be the expected amount of deaths for this last year," Archer said.
"That translates to about 10,000 to 20,000 extra deaths than we would expect to see,” he said.
Humble claims the reason Arizona has so many more excess deaths is because Governor Doug Ducey and former State Health Director Dr. Cara Christ failed to implement policy to prevent the spread of COVID, especially during the surges over the past two years.
“The biggest thing was last winter in December and January when bars, restaurants, and nightclubs were just open and they could do whatever they wanted, that started all kinds of chains of transmission that ended up resulting in the deaths of older persons who never went to a bar or nightclub,” Humble said.
Humble also points to the impact COVID-related issues had on non-COVID health conditions.
"Deaths from diabetes, deaths from heart disease, and it could be elective procedures that were delayed. Accidents and injuries were also another big category," Humble said.
Humble again blames the lack of mitigation from the governor and state health leaders on overwhelming the hospital system, and preventing people from either having access or seeking care.
"You also have the fact that the care within the hospital system during the surges is not what it normally is, and that results in excess deaths and mortality as well," he added.
Archer says policy is just part of the equation.
"Policy is going to be one measure, but another variable is the vaccination rates, especially early on during the Delta and Alpha surges. Arizona did not have a very high vaccination rate," Archer said. "We have a large older population because we are a retirement community and that will factor into things like excess deaths," he said.
The Arizona Department of Health Services disputes Humble's claims that failed policy by the governor and state health officials played a major role in the excessive death rate, sending ABC15 an extensive statement as to why.
"I encourage you to review this information we provided to your newsroom and others when the Arizona Public Health Association first promoted its report on excess deaths. In short, the CDC data the Arizona Public Health Association uses isn’t intended to answer the questions the group is attempting to answer.
Each death is an unspeakable tragedy for that person, their loved ones and Arizona as a whole. Out of respect for those who have died and those who continue to suffer from COVID-19, we politely suggest that attempts to draw conclusions from deaths - and stories that may result from these attempts - look carefully at the data, sources, and conclusions of those presenting findings before properly vetted, complete and consistent state-by-state information is available. In the case of the AZPHA report, we suggest that you look at cautions the CDC posts with the data (emphasis added) as well as the specific concerns we raise below:
These estimates are based on provisional data, which are incomplete. The weighting method applied may not fully account for reporting lags if there are longer delays at present than in past years. For example, in Pennsylvania, reporting lags are currently much longer than they have been in past years, and death counts for 2020 are therefore underestimated. Conversely, the weighting method may over-adjust for underreporting, given improvements in data timeliness in certain jurisdictions. Unweighted estimates are provided, so that users can see the impact of weighting the provisional counts. However, these unweighted provisional counts are incomplete, and the extent to which they may underestimate the true count of deaths is unknown. Some jurisdictions exhibit recent increases in deaths when using weighted estimates, but not the unweighted. The estimates presented may be an early indication of excess mortality related to COVID-19, but should be interpreted with caution, until confirmed by other data sources such as state or local health departments. It is possible that recent improvements in the timeliness of data could also contribute to the pattern where a jurisdiction exhibits recent increases with the weighted data, but not the unweighted. Conversely, recent increases may be missed in jurisdictions with historically low levels of completeness (e.g., Connecticut, North Carolina) either due to the lack of provisional data or insufficient weighting to address incomplete data.
We raise the following specific concerns with the report:
1. Estimating all-cause of mortality by excluding injuries and other (minor) natural causes is a limitation of this report. Injuries are among the top five causes of death in Arizona, and this cannot be overlooked in this type of study. It begs the question of whether the percentage of excess mortality found in this report is actually representative for Arizona.
2. The differences in burden of mortality between ADHS data and the result of this report (ref. Page 3) might stem from the assignment of COVID-19 as primary cause of death - that is, the various ways jurisdictions (CDC, states) determine a COVID-19 death case.
2. Figure 7 (page 6) begs the question of whether these rates are adjusted or crude. Comparison of mortality across time periods or even geographic areas is typically done using standardized rates, and it is worth asking whether AZPHA is following this best practice."