Illinois deaths skyrocketed in April, but were they all COVID-19?

More Illinois residents died in April than in any other month since at least 1999, but not all the additional deaths are attributed to known COVID-19 cases.

Illinois Department of Public Health figures shows 12,417 people died in April. From 2015 to 2019, the state averaged 8,875 deaths each April. That's an increase this year of almost 40% above what the state averaged in the previous five Aprils.

Confirmed COVID-19 cases account for 2,256 of this year's additional April deaths. But that still leaves almost 1,300 more deaths than what the state sees during the average April.

Public health officials believe those deaths resulted from uncounted COVID-19 cases, heart attacks and strokes in recovered or asymptomatic COVID-19 patients, seasonal influenza, drug overdoses and people who succumbed because they did not seek medical attention while COVID-19 was rampant.

"There's not going to be one single thing," said Dr. Emily Landon, head of the University of Chicago's infectious disease prevention and control program. "But the body count, the effect of the pandemic, is so much bigger than just COVID."

March and May both experienced higher than average death counts, but the spikes can be largely attributed to COVID-19 diagnoses. In May, 12,139 Illinoisans died, 3,035 from COVID-19, according to IDPH figures. Without those deaths, the May death toll in Illinois would be 2.9% higher than the average for May from the previous five years.

In March 10,105 people died in Illinois. Only 99 were confirmed COVID-19 cases as the outbreak began to ramp up. Even without the coronavirus deaths, the March figures would have exceeded the average for the previous five years of 9,573.

IDPH officials called the death tallies for 2019 and the first five months of 2020 "provisional" because the figures haven't gone through the standard rigors of data compilation. However, IDPH officials note they are aware of the "excess deaths" over the past three months.

"The data does show there are 'excess deaths,' and potential reasons could be deaths that were exacerbated by COVID-19 such as heart disease or other chronic diseases," an IDPH spokesperson wrote in an email response to questions about the spike in death totals statewide. "Although less likely, there could be more COVID-19 deaths than are being reported."

The state's confirmed death toll from COVID-19 is more than 6,700. However, another 204 deaths are listed as "probable" COVID-19 fatalities because the deceased exhibited symptoms but were never tested. During April, the height of Illinois' outbreak, there was a shortage of testing supplies and equipment, which made it difficult for caregivers to test symptomatic people.

The virus can cause lingering problems in patients who were infected and were either asymptomatic or recovered from the disease, Landon noted.

"We know COVID causes blood clotting," she said. "Based on what we know now, some of those people who died of myocardial infarctions (heart attacks) and strokes probably were infected and got a blood clot."

Some people put off seeing their doctors and the consequences could linger, said Courtney Hughes, an associate professor of public health at Northern Illinois University.

"There's no doubt that the pandemic is impacting people's health welfare decisions either because of the disruption it would have on their work lives or their fear of contracting the disease at the hospital," she said. "The idea that so many people are not electing to have procedures could have a snowball effect on their health and become a bigger and bigger problem down the road."

According to death figures for Illinois from the Centers for Disease Control and Prevention, only once since 1999 has the state recorded more than 11,000 deaths in a month before the COVID outbreak. That was in January 2018 during a particularly nasty flu season, Landon noted.

This year's flu season was also notably rough, and it came on later than normal, she said. Landon believes some of the excess deaths in March, April and May might have been from seasonal influenza.

Natalia Derevyanny, a spokeswoman at the Cook County medical examiner's office, said, "We've seen a dramatic uptick in opioid-related overdose deaths." She estimated the office has seen double the opioid deaths during the first five months of this year compared to the same time period last year.

DuPage County Coroner Rich Jorgensen echoed her assessment.

"The isolation, we believe, really affected people in rehabilitation and among those who were trying to remain clean and sober from addiction during this," Jorgensen said. "There has been without question a big uptick."

Public health officials said it will take years to sort out the death figures from this outbreak.

"I don't think we're really going to know everything about this until afterward, when it's all over," Hughes said. "But it's vitally important to understand for the sake of preparing for future pandemics."

Since 1999 the state averages 8,721 deaths each month, according to IDPH and CDC figures. From March to May of this year, the state is averaging 11,554 deaths, most of them in Cook County and the surrounding collar counties.

"To be honest, with everything going on, we have not had the time to look at the numbers and figure out what is up," said Howard Cooper, Lake County coroner. "We still haven't been able to catch our breath."