In the past year, the pandemic has had many effects on mortality, including deaths from COVID-19, however, drug overdose deaths continue to be a concern and appear to have been exasperated by the pandemic according to a report from Jenny Mercado, a Sonoma County epidemiologist.
Greater than expected deaths occurred by drug overdose in both sexes in ages 18-34, 55-64 and 75+ and in African American, white, non-Hispanic and Latinx residents. Specifically, greater than expected deaths by overdose occurred in folks living in Rohnert Park, Santa Rosa and the Sonoma Valley.
According to Mercado’s report, which she presented during the March 24 community COVID briefing, there were 135 unintentional drug overdose deaths and nine intentional overdose-related deaths in 2020.
Fentanyl was involved in 92% of all opiate overdose deaths.
There were 94 fentanyl-related deaths, six heroin-related deaths and 102 opiate deaths in 2020 (opiate deaths include heroin and fentanyl deaths).
“There are many effects of the pandemic on mortality including, but not limited to deaths from COVID-19 and overdose deaths continue to be a concern and appear to have been exasperated by the pandemic,” Mercado said.
Drug overdose deaths first increased in April 2020 and then spiked in June and decreased in August. Deaths increased again in September and plateaued through October before dropping off a bit in November.
Greater than expected deaths occurred in Latinx residents of both sexes ages 75 and up living in Rohnert Park, Petaluma, Penngrove, Santa Rosa and the Sonoma Valley. In this demographic, greater than expected deaths were from drug overdose, kidney disease, suicide, unintentional injury and chronic lower respiratory disease.
While suicide decreased among most population groups, there was a significantly greater than expected number of suicide deaths among the Latinx population.
Greater than expected deaths also occurred from drug overdoses, influenza, pneumonia and other causes in males ages 18 to 34 living in Rohnert Park, Penngrove and in the Russian River area.
“I want to point out that drug overdose is not a traditional leading cause of death and this includes both intentional and unintentional drug overdoses and overlaps with unintentional injury and suicide leading causes. It is such a large contributor to our deaths that I wanted to include it specifically,” Mercado said.
Sonoma County Health Officer Dr. Sundari Mase said the overdose data is concerning.
“It requires a deep dive in public health to find out what really is going on there. Is it a side effect of some of the negative outcomes of the stay-at-home orders, or more people not being able to do the things they love to do and enjoy? I think mental health has taken a big hit during the pandemic, especially among the elderly in the skilled nursing facilities and residential care facilities,” she said.
Mase added that the public health department needs to address the issue of drug overdoses.
Bill Carter, head of the Behavioral Health Division of the Sonoma County Department of Health Services, said the department is working on ramping up its behavioral and mental health services and programs.
“Our work in the department of health services in this area follows three tracks. We are a part of the community efforts to establish opioid prevention practices and education. The hospitals, the health clinics, other health entities and professionals have come together over the years to identify the best practices for education of the public to attempt to reduce the impact of opioids on the community,” Carter said. “We also have drug and alcohol programs that include residential treatment and specialty residential programs, and a number of suicide prevention efforts are ongoing.”
He said despite the reduction in suicide that was reported, the department is concerned about what the future holds.
“We are looking to step up suicide prevention efforts and community-based prevention efforts in the upcoming year because we recognize that while the rates are down, the stressors that people are experiencing are stressors that generally are risk factors for suicide,” he said.
Despite the alarming overdose figures, Mercado said the county has seen some positive pandemic effects on mortality.
She said this includes a decrease in unintentional injuries, excluding drug overdoses, as well as a decrease in influenza and pneumonia-related deaths.
“As expected, I think the stay-at-home order probably had a decrease in traffic-related unintentional deaths due to accidents and the decrease in influenza and pneumonia is probably because there aren’t as many opportunities for people to get infected and the wearing of face coverings may actually prevent other respiratory illnesses like influenza or other forms of pulmonary infection,” Mase said.
It’s important to note that 2020 deaths are considered preliminary until July 1, 2021.
“For this analysis, we examined 2020 deaths and compared these to what we would have expected to see given an average recent time period. We used the three-year time period from 2017 to 2019,” Mercado said of the mortality report.
Leading causes of death for the three-year period and 2020 were cancer, heart disease, Alzheimer’s Disease, stroke, unintentional injury, COVID-19, chronic lower respiratory disease, diabetes, chronic liver disease, suicide, influenza and pneumonia, Parkinson’s Disease, kidney disease, congenital anomalies, homicide and conditions originating in the perinatal period.
Cancer is the number one leading cause of death in the county.
“Leading causes of death were similar in 2020, except for the addition of COVID-19 as the sixth leading cause of death,” Mercado said. “Deaths in Sonoma County in 2020 remain relatively similar to 2017-19 until June 2020 when they began to increase. From June to November there were 274 excess deaths in Sonoma County in 2020 compared to the previous three-year time period and this mirrors the trend in 2020 COVID-19 deaths by month.”
As of March 25, Sonoma County has had 308 COVID-19 deaths and a total of 29,059 cases.
