COVID’s Uncounted Losses: Deaths at Home Increased in NJ During Pandemic

On Dec 16, 2021

Total deaths in New Jersey last year far surpassed the average numbers in prior years, but not all of those “excess” deaths are directly attributable to COVID-19. A significant rise in at-home deaths in 2020, coupled with a decline in hospitalizations for serious health events like heart attacks and strokes, suggest that delays in seeking care may have cost many New Jerseyans their lives during the pandemic.

The New Jersey Hospital Association and its Center for Health Analytics, Research and Transformation examined data from the New Jersey State Health Assessment Data (SHAD) system and hospital discharge data. That review, Excess Deaths: The Hidden Impact of COVID-19 on Mortality in New Jersey, identified a number of trends associated with mortality in New Jersey as COVID-19 peaked in 2020. Key findings include:

• New Jersey recorded 95,715 deaths in 2020, with COVID-19 listed as the primary cause of death for 16,458 individuals. Even accounting for COVID mortality, the remaining 79,257 deaths in 2020 is 4.3% higher than 2017 through 2019, when total deaths never exceeded 76,000 in a single year.
• Deaths that occurred in the home were approximately 28% higher last year than the prior three-year average (28,326 versus 21,890).
• Hospitalizations for emergent medical conditions such as heart attack, heart failure, stroke and kidney disease experienced double-digit declines in 2020 compared with the number of hospitalizations averaged over the prior three years.

“This data begins to shed light on the uncounted toll of COVID in individuals who delayed seeking necessary healthcare,” said NJHA President and CEO Cathy Bennett. “During COVID’s peak in New Jersey in the spring of 2020, EMS teams throughout the state shared anecdotal reports of individuals who waited too long to seek care for life-threatening conditions. Sadly, this data indicates that those reports were not isolated and, in fact, may be counted among COVID’s terrible impact on N.J. residents.”

The top three causes of deaths at home in 2020 were diseases of the heart, cancer and diabetes, according to the state’s SHAD data. The four-year trend shows the significant rise in each category in the pandemic’s first year:

• At-home heart disease deaths numbered 7,583 in 2020, compared with 6,116 in 2019; 6,078 in 2018; and 5,847 in 2017.
• At-home cancer deaths totaled 7,313 in 2020, compared with 5,957 in 2019; 6,012 in 2018; and 6,161 in 2017.
• At-home deaths attributable to diabetes numbered 1,245 in 2020, compared with 749 in 2019; 750 in 2018; and 766 in 2017.

Meanwhile, hospital admissions for four key emergent conditions (heart attack, heart failure, stroke and kidney disease) decreased by more than 16% in 2020. In the prior three years, 2017-2019, admissions for these conditions never shifted more than 1.9% annually.

“It’s impossible to know whether these excess deaths could have been prevented with timely access to hospital care,” said Sean Hopkins, senior vice president of CHART. “But the trends are troubling, and they reinforce a critical message during a public health emergency: Please don’t delay seeking the care you need.”

The full report and other CHART resources can be found at www.njha.com/CHART.

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