Georgians are dying, and it’s not just from COVID-19.

Metro medical examiners report they are busier than ever, but can’t point to a single cause.

Provisional death count data from the Centers for Disease Control and Prevention shows about 12,000 Georgians have died from COVID-19 in 2021, more than in all of 2020. And, according to FBI crime data released Monday, homicides in Georgia rose from 477 in 2019 to 576 in 2020.

But metro medical examiners say COVID-19 and a rise in violent crime does not fully explain the number of bodies they’ve seen.

“It was challenging. Our caseload went up significantly, and it wasn’t just COVID,” Cobb County Medical Examiner Christopher Gulledge said. “We had an increase in drug overdoses, we had an increase in suicides, we had an increase in homicides. I mean, we had an increase in everything.”

COVID-19 deaths are typically handled by hospitals, not medical examiners, who investigate the cause of “sudden unexpected” deaths, as well as the victims of homicides, suicides and fatal wrecks.

Gulledge said the rise in deaths in all categories that his office saw last year has carried into 2021. According to records Gulledge provided to the AJC, death investigators in Cobb County performed 95 autopsies in August, a record month for the agency.

Gulledge cautioned against attributing August’s record highs to COVID-19.

“Caseload itself also went up in August, but that doesn’t necessarily indicate that we’re having an increase in COVID deaths,” he said.

Patrick Bailey, the director of the medical examiner’s office in DeKalb County, said the county has increased the number of investigators in his office, allowing for them to take on cases they otherwise would have deferred to the Georgia Bureau of Investigation.

At the beginning of September, DeKalb medical examiners had investigated 1,668 deaths so far this year, about 8% more than at the same point in 2020. DeKalb’s monthly workload is averaging 28% higher than in 2019, when 1,950 cases were reported for the entire year.

In Gwinnett County, the medical examiner’s office reported handling 1,482 cases in the first eight months of 2021 compared to 1,386 during the same time period in 2020, a 7% rise.

Cobb County death investigators handled 2,177 cases in 2020, a 35% increase over the number of cases handled in 2019. So far in 2021, the medical examiner’s office is about 6% off that pace in total cases. But through August, the agency has conducted 535 post-mortem exams, 15 more than it did during the first eight months of 2020.

In Fulton County, the medical examiner’s office is seeing fewer deaths, but is on pace to perform more post-mortem exams: 1,279 were conducted in the first eight months of 2021 versus 1,492 in all of 2020.

Smaller Georgia counties can send bodies to the GBI for examinations. The state agency, headquartered in DeKalb County, recorded 15% more deaths (6,616) in 2020. State pathologists performed 4,229 death examinations, 17% more than the previous year. The rise in numbers continued in 2021. Through Aug. 31, the GBI performed 3,075 post-mortem exams, more than 6% higher than the first eight months of 2020.

Only Cobb and DeKalb’s medical examiner offices have released 2020 annual reports, which detail exactly how people are dying and the causes, for the cases that they handle.

“Natural” deaths were cited in half of the 1,186 post-mortem exams performed by the DeKalb medical examiner’s office in 2020, a 32% increase over 2019. Only 42 were attributed to COVID-19. Accidents, including drug overdoses, accounted for another 29% of deaths in 2020, up 27% over 2019. Homicides increased about 8%. Suicides fell in DeKalb County, down to 66 in 2020 from 98 cited in 2019.

Drug overdoses were the most common fatal accident recorded in DeKalb County. According to the medical examiner’s 2020 report, 138 deaths were attributed to drugs, 108 to motor vehicle accidents. Another 51 died in falls and seven died in fires. Homicides accounted for 154 deaths in 2020, 135 were by gunfire.

DeKalb County medical examiner cases in 2020

"Natural" was the leading cause of death in DeKalb and other counties. Such deaths include heart attacks, strokes and other natural causes. (Source: DeKalb medical examiner)

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Cobb medical examiners saw an increase in deaths across the board last year.

“(2020) was definitely a very challenging year,” Gulledge said. “This year has been equally challenging, although a little bit less so in the sense that the ability to become vaccinated has lessened a lot of it.”

According to the Cobb medical examiner’s 2020 report, that office looked at 930 bodies to determine a manner of death, 27% more than in 2019. Natural causes accounted for 42% of all fatalities; more than half were attributed to heart problems. Accidents, mostly drug overdoses, were next with 40%, followed by suicide, 12% and homicide, 4%. Only 13 deaths were attributed to COVID-19.

In Cobb, homicides more than doubled, from 19 in 2019 to 41 in 2020. Drug overdoses considered accidents were up more than 50%, fatal wrecks 26% percent. Suicides increased 31%, the 113 recorded in 2020 were the highest since at least 2013.

The reason for the surge in deaths is difficult to pin down.

”There was no strong relationship between the COVID-19 case rate and the Cobb County Medical Examiner’s Office case load on a weekly basis‚” the agency’s 2020 annual report concluded. “Although endocrine, respiratory, and alcoholism-related cases were higher than average in 2020, there did not appear to be any close relationship with the COVID-19 curve.”

-- AJC reporters Adrianne Murchison, Zachary Hansen and Tyler Wilkins contributed to this article.

Read the DeKalb County Medical Examiner 2020 Annual Report
Read the Cobb County Medical Examiner 2020 Annual Report
More people in Georgia have died from COVID-19 in 2021 than in all of 2021, according to provisional data from The Centers for Disease Control.

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