Tarrant County COVID deaths increased in 2021. But there is hope 2022 will be better.

More than 2,701 Tarrant County residents have died so far this year from COVID-19 — a 59% increase in local COVID deaths compared to the first year of the pandemic, according to state data.

The rise in county residents dying from the respiratory disease reflects two surges in cases this year, one driven by the Delta variant, as well as low vaccine uptake among county residents.

Amira Roess, a professor of global health and epidemiology at George Mason University, said the increase in deaths from COVID-19 was not a surprise to her.

“When more than half of the country had suboptimal vaccination rates, at a time when there was a very transmissible strain of the virus circulating, you would have expected rampant transmission,” Roess said. “And those individuals who were not vaccinated, especially those who have underlying conditions, and were elderly, did have the worst outcomes. And so you do expect to see an increase in deaths.”

Roess, an expert in epidemiology and mortality, added that relaxed mitigation measures like wearing masks and avoiding large crowds, and confusing messaging from public health officials also likely contributed.

In 2020, 1,695 county residents died from the disease, according to the state. Last year’s COVID mortality numbers reflect only 10 months of surveillance, as the first COVID death in Texas was not identified until March.

COVID-19 continues to be a leading cause of death

The respiratory disease has upended mortality trends in the U.S.

Epidemiologists track mortality during and after major events, like natural disasters or pandemics, not just by looking at the underlying cause of death. They also look at “excess deaths,” which is the difference between the number of people expected to die in a normal year and the number of people who actually did die.

In the year after the COVID-19 pandemic started in the U.S., deaths nationwide increased 21% compared to a normal year.

These increases reflect both deaths caused directly by COVID, Roess said, but also by the secondary effects of the pandemic on society and on the health care system. Some of those deaths might be because people delayed care for serious conditions to avoid exposure to the virus, or because local hospitals were so full of COVID patients that health care workers couldn’t care for someone who had a heart attack.

A complete accounting of mortality data for 2021, including how many excess deaths occurred in Tarrant County, will not be completed until next year.

The number of deaths caused directly by COVID could increase after the data is processed and certified. Tarrant County Public Health officials, for example, have tracked 4,915 county residents who have died from the disease since the pandemic began.

The local public health department tracks COVID deaths among county residents using a slightly different definition than that the state health department does, and its cases are also reviewed by department staff who will investigate certain deaths to determine whether COVID caused or contributed to the death. The state, meanwhile, relies solely on death certificate data to compile its numbers.

The Star-Telegram relied on the state’s data for this story to allow for consistent comparisons between deaths in Tarrant County and statewide deaths.

Disparities in death

Because the state’s death data is still provisional, a definitive account of the death disparities in Tarrant County is not yet available. But it is likely that the disparities in severe disease and death observed earlier in the pandemic will hold throughout 2021.

A nationwide analysis from the Kaiser Family Foundation said “age-standardized data show that Hispanic, Black, and American Indian and Alaskan Native people are at least twice as likely to die from COVID-19 as their White counterparts.” The analysis noticed that racial and ethnic disparities observed early in the pandemic have narrowed, but that Hispanic and Black Americans are still bearing an outsized burden of disease and death compared to their share of the population.

Mortality, and particularly excess mortality, are some of the easiest metrics to measure, Roess said. But she said she expects other metrics to continue to show similar inequities in the coming months and years. For example, a modeling study that looked at children who were orphaned by the COVID-19 pandemic estimated that of the 140,000 U.S. children who lost a primary or secondary caregiver to COVID-19, more than 65% are racial or ethnic minorities.

“The long term health consequences of COVID will be felt more acutely by the same populations that are often bearing the brunt of the health disparities in the U.S.,” Roess said.

Reasons to be hopeful

As the nation enters the third year of the COVID-19 pandemic, Roess said the situation could improve.

“I think there is a lot of reasons to be hopeful. First, the vaccines are very effective against severe disease, hospitalizations, and death,” she said. “And if it turns out that the vaccines and therapeutics continue to be effective, highly effective against severe disease, hospitalizations, and deaths, whether it’s the Omicron or some other variants, that’s wonderful reason to celebrate.”

The combination of increasing vaccination and successful treatments for COVID-19 are what will ultimately be needed to curb the death toll, she said.

As of Thursday, just 53% of county residents were fully vaccinated, according to state data. Nationwide, 60.5% are fully vaccinated against the disease. About a quarter of the country is fully vaccinated and has received a booster shot, which experts say will provide more long term protection than the initial vaccination alone.