The deathly 2021 summer of COVID-19

Refrigeration truck at Hiers-Baxley on Silver Springs Blvd. on Oct. 20, 2021 [Bruce Ackerman/Ocala Gazette] 2021.

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Posted November 5, 2021 | By Matthew Cretul
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The spread of the Delta variant through Marion County made this summer a particularly sorrowful one, with the lives of many neighbors ending too soon.

At the time of the summer surge, only local hospital workers were vocalizing to the community that their beds and ICU’s were full, and many more people were dying compared to the prior variant — and dying young.

With no state or local government alerts, the majority of Marion County residents went about their business debating vaccinations and masks, instead of the unusually high death count.

A lapse in reporting the numbers

The State of Florida and the Centers for Disease Control and Prevention (CDC) failed to coordinate on reporting COVID-19 statistics over the summer, preventing the public from understanding how many people were dying as a result of COVID, including the Delta variant.

Once the number and scope of deaths became accessible in October, statistics painted a picture of Marion County weathering the Delta variant far worse than many other parts of the state. The county was ranked 6 out of the 67 Florida counties for most COVID deaths per 100,000 since June, with 186.3 deaths per 100,000 residents.

Dr. Dave Kuhn of Trinity Clinic in Ocala has maintained a weekly COVID dashboard on his clinic’s Facebook page throughout the pandemic. His dashboard tracks local statistics including cases, positivity rates, hospitalizations and deaths, and he says the inability to access statistics can have a negative impact on public confidence.

“The state withholding death data creates the concern that something is being hidden from the public. In such a polarized society, with trust in the media and government so low, transparency should be a priority, particularly with a situation that so directly and significantly affects the general public,” Kuhn pointed out.

Not only did the inability to access timely and accurate information erode public trust, Kuhn also said not seeing death statistics specifically has the potential to hinder medical providers when they are trying to make the most informed decision they can for their patients.

“During the death data blackout, healthcare providers were not able to answer questions regarding fatality rates, which makes it more difficult to help patients with lifestyle risk assessments. While the state continued to release statewide death totals, no further demographic breakdown was provided, rendering epidemiological analyses impossible. That is certainly not ideal during the worst peak of the entire pandemic,” Kuhn explained.

Kuhn cautioned that just because COVID numbers are declining right now we shouldn’t take that to necessarily mean the worst has passed. Instead, he said, we should stay vigilant watching what the data tell us.

“Death data will always be a lagging statistic. This is due to strict qualification criteria that require time-consuming medical record reviews at the state and/or federal level. Because of this, death data can never be reported reliably in real-time. The final accurate death totals will lag two to four weeks behind the actual date of death during low points during a pandemic, and may lag as long as eight weeks during the peaks when the death toll is so high,” Kuhn described.

While Florida state-level governmental officials were privy to accurate and updated data, Bill Thompson, the public information officer for the Florida Department of Health in Marion County, stated in an email that, locally, health department officials were no longer provided death-related data as of June 3, which is around the time Florida switched from daily to weekly reporting of COVID-related statistics.

That also was just before the deadly Delta variant began infecting people in the state.

Delta arrives in Marion County

Kuhn detailed how and when the Delta variant arrived locally, and the toll it took on residents.

“By early June, Marion County had 996 confirmed deaths due to COVID-19. As of last week, the CDC reports that Marion County had 1,568 deaths. The Delta surge began in early July and ended in early October. Over that 90-day time period, Marion County had 572 deaths, or an annual fatality rate of more than 2,000 deaths a year, which would make COVID the leading cause of death in Marion County by far,” he described.

Kyle Johnson, the operations manager for Robert’s of Ocala Funerals and Cremations, said they saw a difference between the spikes in cases during the winter of 2020 and this summer.

“So, the Delta variant actually seemed to come to Marion County, or hit Marion County, a lot faster than the original COVID strain. We actually spiked significantly in August, really, and I know that the county as a whole got hit pretty hard in August and September, in particular,” he relayed.

Steve Tweedle, general manager of Hiers-Baxley Funeral Services, agreed. He said Delta was different than previous increases in cases.

“We experienced what everyone else was experiencing in that timeframe. It was a pretty steep increase at a fairly quick pace,” he said.

Locally, as well as nationally, numerous businesses felt the effects of COVID as the pandemic wore on. This was especially true of funeral homes, as they were forced to contend with the growing number of deaths.

“When more than 150 residents die each month due to COVID, combined with the expected fatalities from all causes other than COVID, local funeral homes are expected to face significant challenges handling the increased volume. Rarely would a county with a population density as low as Marion County experience a per capita fatality rate as high as we did,” Kuhn said.

The increased volume of deaths in hospitals led to logistical issues, and Johnson details exactly how.

“You can’t cremate until the death certificates are filed. Part of the death certificate being filed is the doctor has to sign off on a cause of death,” he explained.

“While the doctors are dealing with the same stresses that the funeral homes are dealing with and they get behind on their paperwork, which is understandable… but when they get behind that puts the entire process behind of getting a loved one from being into our care to actually getting to their final position, which is being cremation or burial,” Johnson continued.

Both Heirs-Baxley and Roberts of Ocala have agreements with local hospitals to hold any individuals who pass away without funeral arrangements in place. They also have agreements with smaller funeral homes in the area to utilize their storage and cooling facilities until the smaller organizations are able to perform whatever is necessary to prepare the decedent.

Due to the growing number of COVID-related deaths and the delays in paperwork processing, both Heirs-Baxley and Roberts of Ocala were forced to turn to refrigerated tractor-trailers in order to keep up with the rapidly growing demand.

“We did end up bringing in some extra refrigeration units,” Tweedle said. “And for us, it wasn’t a scrambling type of an issue. We were watching everything and we were able to react.”

Delta moves on but leaves behind a legacy

When asked to compare Delta’s arrival to previous COVID surges, Johnson was quick to describe the difference between the surge.

“I think that it felt like Marion County was heavier affected on the Delta variant than we were on the 2020 spike,” he mentioned. “It seemed like that Delta variant, though it didn’t last as long, it was significant.”

“We’ve seen a marked decrease in COVID cases over the last probably two to three weeks,” Tweedle remarked. “It’s almost like it stopped. And I would say that we’re kind of, we’re back to ‘normal.’ We’re back to where I would anticipate us to be on a normal year.”

But just because the cases are declining, the ICUs are emptying and life slowly returns to normal, Kuhn said there will be a lasting effect thanks to Delta.

“Working in the hospital during the peak of the Delta surge had profound effects on many nurses and other healthcare workers who lost young patients at a rate far higher than has been experienced in the last 100 years. The only exception would be during World War II and other times of war. Some nurses have already, or will be, diagnosed with PTSD as a result of their COVID experiences,” he said.

Johnson said the experiences Delta brought to Marion County and his industry won’t soon be forgotten.

“Funeral directors are very good with what they do. And most of the time, you just kind of have to be able to disconnect from it. But it’s a lot easier to create a disconnect when you know that the person who was on the other end lived a full life and they were 89 years old… whereas when you’re meeting with a 38-year-old widow, all she’s going to think about and talk about is, you know, the things that they never got to do. How unexpected it was, things like that. So that can be very taxing,” he opined.

Tweedle wants the public to know just how hard everyone worked as Delta tore through Marion County.

“It’s important for people to understand how much the different facilities that they chose to use, whether it be hospitals or funeral homes or whatever, how much the staff really stepped up. I think it’s very, very important for people to understand that,” Tweedle said.