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MSDH Study Finds Mississippi In-Hospital COVID-19 Death Rate Above Nation For Most of Pandemic

Nurse's Station with four medical professionals dressed in PPE, preparing a rolling bed for a COVID patient
Comparing a Mississippi State Department of Health study with Journal of American Medical Association and Centers for Disease Control data shows that, except for the earliest days of the pandemic, Mississippi’s death rate for hospitalized patients has been above the national average. Photo courtesy Joe Ellis/UMMC Photography

In the first year of the COVID-19 pandemic, roughly 15% of Mississippians hospitalized with COVID-19 died, a rate that places Mississippi above the national mortality rate in every period after the initial outbreak in the northeastern United States. Mississippi in-hospital deaths peaked during the first quarter of 2021, likely the result of the winter surge stretching the state’s hospital system to its limits.

Intensive-care unit mortality proved even worse, with more than 37% of ICU patients dying of COVID-19. Ventilated patients fared worst of all. Of all patients on life support, 64.4% died in the hospital, a survival rate of just higher than one in three.

Comparing the data to a Journal of the American Medical Association study of earlier periods nationwide found that Mississippi had a significantly higher death rate than the national average for all periods except for the first, when the virus first arrived in the Northeast. 

COVID-19-Associated Hospitalizations by Quarter, Mississippi, 03/01/2020 - 03/31/2021compared to JAMA Study of Nationwide Hospital Mortality Trends 03/2020 - 11/2020
Comparing the two studies shows Mississippi trending below the initial outbreak period, where states like New Jersey and New York had many deaths, and then rising above it for the following periods. Graphic data courtesy MSDH / JAMA

In the nationwide study, which examined 20,736 hospitalizations across 31 states, mortality rates for hospitalized COVID-19 patients peaked in March and April 2020 at 19.1%. After that period, which aligns with the northeastern surge at the beginning of the pandemic, hospital mortality declines significantly nationwide, dropping to 11.9% and declining to roughly 11% in later periods.

Cause Uncertain for State’s Mortality Rate

Mississippi’s data come from a newly released Mississippi State Department of Health study that examined hospitalization trends between March 2020 and March 2021. The data do not include trends from the ongoing delta wave of COVID-19. On social media, State Health Officer Dr. Thomas Dobbs explained that data “from Hospital Discharge dataset (are) derived from hospital coding that is often submitted months after discharge. Always 1 Quarter plus behind.”

The JAMA study does not cover the winter surge period, where Mississippi’s hospital mortality trended at its highest, but where the data overlap, Mississippi’s hospital mortality rate is consistently higher than nationwide averages. CDC data from the omitted period show a hospital death rate in the first quarter of 2021 that is below Mississippi’s 16%.

Further study would be necessary to assert the cause for Mississippi’s higher COVID-19 mortality. The state now has the highest death rate from the virus of any in the U.S., surpassing New Jersey this month. 

Notably, MSDH’s study found that, while the majority of COVID-19 hospitalizations were in metropolitan areas, like Jackson, “the highest in-hospital mortality … was reported by midsize facilities located in micropolitan areas. Most likely, this finding reflects a high burden of COVID-19 cases in these regions and insufficient resources to deal with an influx of critically ill patients,” the study suggests.

Photo of Dr Dobbs speaking
Dr. Thomas Dobbs summarized MSDH’s findings simply: “stay out of (the) hospital with vaccine and monoclonal antibodies.” Photo by AP/Rogelio V. Solis

The JAMA study notes that many of the people admitted to the hospital suffered from common pre-existing conditions—hypertension and diabetes foremost among them. Existing health disparities for the population of Mississippi may be a contributor to its high death rate.

Mississippi has one of the highest rates of hypertension in the U.S. as well as one of the highest rates of diabetes. West Virginia, which matches or exceeds Mississippi for these pre-existing conditions, has had a significantly lower death rate than the Magnolia State, however.

Dobbs summarized the findings simply. “Best strategy—stay out of hospital with vaccine and monoclonal antibodies.”

Delta Declining, ICU Usage High

In the present, the delta wave of COVID-19 continues to decline, with daily case counts dropping and the swell of hospitalized patients dipping out of peak-crisis levels, although overall intensive-care unit availability remains slim. Today, MSDH announced 1,557 new cases of COVID-19 and 22 deaths, with 15 occuring in the previous week and six occurring in late August or early September.

Total COVID-19 hospitalizations have dropped by roughly half in the last month, down just below 800 in yesterday’s report. But critical case counts of COVID-19 in the state’s ICUs and on life support have remained more durable as total hospitalizations have declined. Mississippi’s ICUs still hold 305 COVID-19 patients, with more than 200 on ventilators. 

As delta has declined, new vaccinations have leveled off from their surge, though they have still yet to decline to their July valleys, with roughly 20,000 vaccinations a week. The week ending Sept. 18, 2021, saw 51,697 new vaccinations.

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