The number and rate of COVID deaths in Virginia has been lower since the omicron variant took hold. But deaths haven't peaked yet, either.
Since Jan. 2021, unvaccinated residents in the state have died of COVID-19 at a rate 4.2 times higher than vaccinated residents.
RTD - A1 Feb. 4, 2022
While COVID-19 cases and hospitalizations are on the downswing in Virginia, there is no indication deaths related to the omicron wave are abating.
Deaths have displayed an irregular pattern the past two months, increasing and decreasing and increasing again, but the decreases might be explained by the lag of death certificates reaching the Virginia Department of Health.
It's unclear how deaths will be impacted by omicron, a variant that has infected more people, caused more hospitalizations than at any point in the pandemic, but has been less likely to cause severe disease.
"It's too early to say if deaths during the omicron wave could meet or exceed deaths observed from the initial wave of delta," said Dr. Brandy Darby, a veterinary epidemiologist and member of the state health department's COVID-19 response and health information teams.
It's important to remember, Darby said, that omicron might appear to be less severe because so many people now have a level of immune protection against severe outcomes through vaccination or previous infection.
For those without immunity, a severe infection and death are still possible.
Among death certificates already received, there were 198 average confirmed and probable deaths per week associated with COVID-19 in December and January.
That's slightly below the delta wave, from August to November, when there were 209 average deaths per week.
A confirmed death is recorded when a person dies following a positive PCR test. A probable death is recorded when the person tests positive on an antigen test or has COVID symptoms and a known exposure.
The percentage of deaths that were marked probable increased during omicron, as demand for take-home tests ballooned, and some who were unable to find a test never took one.
The curve of deaths during omicron hasn't resembled delta, which displayed a steady increase followed by a steady decrease. Since omicron began, death totals have staggered from 137 the first week of January to 206 one week later, based on death certificates received so far. The numbers will rise and could more closely mirror the delta wave as the state health department processes death certificates from January.
In each wave of the pandemic, deaths have lagged behind cases and hospitalizations. To see deaths remain high even as cases go down is normal.
"This is expected," Darby said. "There is an inherent lag in deaths being reported because of the nature of the disease, the time it takes to investigate and report deaths and the time it takes for death certificates to be processed."
People who have received vaccines continue to see better outcomes than the unvaccinated. Since Jan. 2021, unvaccinated residents of the state have died of COVID at a rate 4.2 times greater than the vaccinated. During omicron, the difference was even more stark, with the unvaccinated dying in late December at a rate 15 times greater than those who received the shots.
The death rate has been generally lower in the northern and eastern portions of Virginia and higher in the western and southwestern portions, where the vaccination rates are lower. There have been 177 deaths per 100,000 residents in Richmond since the start of the pandemic. But in Alleghany County along the West Virginia border, there have been 612 deaths per 100,000.
There's another reason why it's hard to determine how deadly omicron is: Delta hasn't completely disappeared. While omicron cases began surfacing in Virginia in early December, by the week of Christmas, delta still represented about one-third of the cases in the state. A small number of delta cases persisted through January.
The state health department does not perform whole genome sequencing on every COVID case - which determines the variant - so in many cases, it is impossible to know what variant infected the person.
"Certainly both variants can lead to death," Darby said.
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