Since the summer, Massachusetts has had more deaths per capita than surrounding states, and it is unclear why

Dr., an infectious disease specialist at Boston University School of Public. David Hammer said, “I think if many hospitals in Massachusetts have learned to better manage patients with COVID-19, and we should see a lower mortality rate.” Health and Physician at Boston Medical Center. “I just can’t easily explain why this figure is particularly high [than in nearby states]. “

Other experts shared Hammer’s surprise. The state’s world-class hospitals, high rates of insurance coverage and relatively low rates of COVID-19 transmission in the last few months all provide strong protection. Some speculate that The massive death toll at long-term care facilities, where 270 of the previous month originated, may provide part of the explanation. Others point to quirks of time, or random chance. But fundamentally, relatively It is difficult to explain the high loss of life here compared to New Jersey, Connecticut and New York, with surrounding states following otherwise similar paths through the epidemic.

States’ methods for counting and publicly reporting count-19 deaths vary, a Massachusetts official highlighted.

“As we continue to monitor our data, looking for trends over several weeks, it is important to note that states have different policies for determining COVID-19 deaths, which New York and New Jersey have Like when comparing in different states can cause discrepancies. Massachusetts COVID-19 Command Center spokesman Tory Majola said in an e-mail on Friday.

Generally, states follow national Criteria that classify certain COVID-related deaths as “confirmed” and others as “probable” – a designation that means some combination of a person’s symptoms, previous tests, exposure to the virus, or death certificate notes. Public health lead researchers to terminate. Chance died at least in part from COVID-19.

New York does not report potential COVID-19 deaths, while the other three states are compared here. However, data from Johns Hopkins University used in Globe’s analysis include potential cases reported by New York City, which account for the majority of cases and deaths in that state. Additionally, fatalities in confirmed cases account for more than 97 percent of Massachusetts’ total reported deaths, and even clear differences between deaths in the region here and elsewhere, accounting for potential discrepancies in reporting. is.

Massachusetts – such as New York, New Jersey and Connecticut – saw reported peaks in April, peaking shortly thereafter in the daily death count. According to data collected by Johns Hopkins and analyzed by the Globe, states were beginning to recover from their deadly first waves: total deaths from June to July in the four states declined by 69 percent.

However, Massachusetts only stopped progress, while the other three overtook. The death rate in those states fell below 2 per 100,000 in August, and remained low in September, despite some fluctuations.

While September deaths in Massachusetts were 60 percent lower than in June, the death rate was higher than in 26 other states, with many experiencing summers of infections and hospitalized waves.

Comparing mortality rates across states can still be difficult for many reasons, said Jennifer Nazo, an epidemiologist at the Johns Hopkins Center for Health Security. He added that even small differences in the timing of new cases or reporting methods can translate to largely unbearable disparities in deaths and mortality.

“But in terms of predictors of deaths, it has been very consistent. Nuzzo said age is probably the most important factor. “Generally, if you’re noticing big trends, it’s probably due to time when cases have started ticking and how long it takes to get to more vulnerable groups.”

When data showing the mortality rate of Massachusetts relative to other northeastern states were presented, many experts speculated that A weakness in the state’s initial epidemic response may still hinder its efforts in recovery: long-term care facilities, home to most Massachusetts residents who have died of COVID-19, remain unprotected Huh.

“The number is definitely related,” said Boston University epidemiologist Helen Jenkins. “My question would be, is Massachusetts still doing a bad job [long-term-care] Front? “

Of the more than 9,000 potential and confirmed COVID-19 deaths Massachusetts has reported during the epidemic, nearly two-thirds emerged from long-term care facilities. By comparison, about 40 percent of COVID-19 deaths are nationally associated with such settings, although some states attribute different deaths than Massachusetts. New York, for example, does not link COVID-19 deaths to nursing homes if a resident dies in a hospital and not in a nursing facility.

“The mortality rate per thousand in nursing homes in Massachusetts is out of whack, for lack of a better term, with a wide-ranging mortality rate. [state] Population, “said Alex Brill, a fellow at the American Enterprise Institute, a think tank in Washington, D.C. Brill and fellow researcher Benedick Ipolito found that Massachusetts was one of just four states with” particularly poor results within nursing homes Were, “the June report stated. Connecticut and New Jersey also fall into this category, although they deviated less from the national norm.

Investigations by the Globe Spotlight team found that Massachusetts’ initial epidemic response largely ignored the needs of nursing homes and other long-term care facilities rather than hospitals. State officials have since taken steps to correct its initial setbacks, but advocates said they are to go further, with hundreds of elderly care facilities still dying from COVID-19 each month.

“It’s not over for the elders,” said Al Norman, a longtime advocate for seniors. Norman said that the elderly working with him are afraid to enter the group’s care settings but often feel they don’t have anywhere else to go. “We are not really doing right with older people right now in terms of providing them options,” he said.

“Count the deaths of every nursing home, and that touches 10 or 11 employees,” said Elizabeth Dugan, associate professor of gerontology at Boston University, Massachusetts. Although COVID-19 concerns may fade in summer for many Massachusetts residents, long-term caregiving communities have led to a widespread sense of mourning and fear.

“We have the world’s leading medical care, but there was no focus on elder care. We do not think of nursing homes as part of the health care system, ”she said. “We could do better. We should have done better. “

A spokesman for the state’s COVID-19 Command Center, Majola said, “The Baker-Polito administration has taken adequate action since March to protect our most vulnerable seniors and continue to take necessary action on this ongoing epidemic, including Includes additional protection for older adults, standards. Care and infection disease control

“COVID-positive cases in long-term care facilities have declined by nearly 97 percent and died more than 90 percent since the height of the epidemic, and we closely monitor the impact of the virus on these facilities.”

Majola highlighted the state’s efforts in public health enforcement and awareness raising in “persistent high-risk communities” such as Chezia, Everett, Lawrence, and Framingham.

But BU epidemiologist, Jenkins, said the state’s approach has at least one thing: time for officials to determine where the death is coming from and why, in recent weeks, case counts and other key indicators Are ticking.

“There’s a lot going on in Massachusetts at the moment,” Jenkins said. “It seems that this is not the time to move on. It is time to stop to reflect. “

Dasia Moore can be reached at [email protected] Follow him on twitter @daijmoore.

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