EXPLAINER: What else is contributing to Alaska’s COVID-19 deaths?

ANCHORAGE, Alaska (KTUU) - More than 800 Alaskans and visitors to the state have died from COVID-19 since the beginning of the pandemic more than a year and a half ago. There are a number of conditions health professionals and epidemiologists say can make a person more high-risk to getting severely ill or dying of COVID-19, but that isn’t the case for every COVID-19 death.

The state and Centers for Disease Control and Prevention have data that shows the demographics of Alaskans dying from COVID-19, and what other contributing causes factored into their deaths.

A recent look at state data found that it was the third-leading underlying cause of death for Alaskans in 2021, behind cancer and heart disease. It was the primary cause of death for 294 Alaskans. A doctor lists up to four contributing conditions on a death certificate, with the “underlying” cause being the primary factor.

While 822 people’s deaths have been contributed to by COVID-19, many had other underlying conditions, which COVID-19 made worse. The state explains its process for determining a COVID-19 death on its website, and says that doctors list COVID-19 only if it actually contributed to a person’s death, and not simply if they tested positive for the disease.

The state of Alaska’s Department of Health and Human Services recently released a report that details information available about the state’s pandemic experience through Sept. 30, 2021. While the report only includes data available through that time frame — and not, for example, the four dozen additional deaths reported to the state Monday — it offers a look at who, in a general sense, in Alaska is dying from COVID-19.

Of the 620 deaths with information available at the time of the report, 373 were men and 247 women.

While the largest portion of the people who die of COVID-19 in Alaska are white — 301 of them, representing 48.5% of the state’s COVID-19 deaths, according to the report. That’s a much smaller proportion than white people represent in the population of the state, 64.8%. Thirty-three people who were Native Hawaiian or Pacific Islander have died from COVID-19, according to the report. That’s more than 5% of the state’s COVID-19 deaths, when the community represents just 1.6% of the Alaska population.

Alaska Native people die from COVID-19 at nearly twice the rate at which they live in Alaska, the report shows. COVID-19 has killed 180 Alaska Native people, for 29% of the state’s deaths, while they represent 15.5% of the population. Other races and ethnicities are much closer in line with their population rate in Alaska.

When it comes to age, older Alaskans are much more likely to die from COVID-19. At the time of September’s monthly report, Alaskans over 70 accounted for 58% of the state’s COVID-19 deaths. That’s before the 76 combined deaths rereported by the state on Monday and Tuesday, many of whom were older.

No Alaskans under the age of 20 have died from COVID-19 so far in the pandemic. Eleven Alaskans in their 20s have died from it, a well as 19 people in their 30s, and 37 in their 40s. That number jumps up to 68 people who were in their 50s, which is 11% of the state’s COVID-19 deaths, and commensurate with their representation of 12.4% of the statewide population.

More than one-fifth of COVID-19 deaths in Alaska have been people in their 60s — or 126 of them. One hundred eighty-two Alaskans who died from COVID-19 were in their 70s, and 177 were over 80 years old, making up 28.5% of the state’s COVID-19 deaths. This age group of elders represents just 2% of the population.

The CDC has a tool that breaks down the other contributing factors to people’s deaths from COVID-19. A number of issues can be listed as contributing to a person’s death by the attending physician or medical examiner. Non-COVID-19 examples demonstrated by the health department are a person who has coronary artery disease (the underlying condition) and experiences coronary artery thrombosis, acute myocardial infarction (a heart attack) and a rupture of the myocardium (the immediate cause of death).

The CDC’s tool has data for 703 Alaska COVID-19-related deaths, so the leading contributor to death is COVID-19 in the list. Also contributing to Alaskans’ COVID-19 deaths are a number of conditions, some of which may be related to COVID-19 infection, and some which may have been previous or underlying conditions. All of the conditions were listed on death certificates, according to the CDC’s data. The CDC says 5% of the death certificates nationwide listed only COVID-19 as a cause of death, and those with causes in addition to COVID-19 had an average of four contributing ailments.

Influenza and pneumonia were the second-leading cause of death to COVID-19 in COVID-related deaths, with 399 Alaskans’ deaths. “All other conditions and causes” numbered 312. Respiratory failure was noted for 228 people. Adult respiratory distress syndrome factored in to 83 Alaskans’ deaths from COVID-19, and 72 included renal failure. In September, Alaska’s largest hospital was having to make decisions as to which patients could be put on a renal replacement machine due to a lack of machines and staff to operate them.

Chronic lower respiratory diseases contributed to the deaths of 68 Alaskans from COVID-19. Hypertensive diseases contributed to 63. Fifty-six Alaskans with diabetes died from COVID-19, and 53 Alaskans had both cancer and COVID-19 that lead to their deaths.

Heart failure contributed to 55 Alaskan deaths, and ischemic heart disease and other circulatory diseases to 53, cardiac arrhythmia contributed to 48 COVID-19 deaths. Obesity contributed to 44 of those deaths.

Sepsis contributed to 38 Alaskan COVID-19 deaths, while cerebrovascular diseases, dementia and other respiratory diseases each contributed to more than 30 COVID-19 deaths.

Injuries and other adverse events contributed to 18 deaths, according to the CDC’s dashboard, while Alzheimer’s contributed to 15.

The state of Alaska cites recent research that shows that, regardless of a person’s underlying health conditions, being active for 150 minutes or more a week greatly improves the outcome of a person who gets infected with COVID-19.

“There’s more and more data coming out that exercise and diet make a huge difference not only for COVID but your overall health,” Dr. Anne Zink, the state’s chief medical officer, said in a public health video call last week. “It just keeps being articulated in numerous studies, so make sure you’re getting out to play every day regardless of your age.”

The state health department has shared guidance citing those studies. One was published in the peer-reviewed British Journal of Sports Medicine, and studied nearly 50,000 adults diagnosed with COVID-19. It found that those who had more than 150 minutes of moderate to vigorous physical activity each week were less likely to get seriously ill, hospitalized or die from COVID-19.

While the impacts of physical activity may not be specific to COVID-19 infection, the authors noted that physical activity improves immune functions and reduces severity of other viral illnesses. Physical activity also strengthens lung and heart function, and can reduce systemic swelling, which is how COVID-19 damages the lungs, according to the study’s authors.

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