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Shadow deaths of the virus

Copyright © 2020 Albuquerque Journal

Landon Fuller, 11. (Courtesy of Katrina Fuller)

Landon Fuller, an outgoing 11-year-old from Hobbs, loved to make people laugh. He enjoyed sports, riding his bike around the neighborhood with his friends and attending church with his parents and two older sisters.

The shuttering of schools and the stay-at-home orders implemented to minimize the risk of spreading COVID-19 were hard on him, his mother said, and he often asked to go out and play or accompany his parents to the grocery store.

“For Landon, it was the end of his world,” said his mother, Katrina Fuller.

On April 23, almost six weeks after his last day in a classroom, Landon took the gun his father carried to protect himself from rattlesnakes while working in the oil fields. He rode his bike to a field a little way from his family’s home, and he killed himself.

Landon’s death was one of more than 2,300 unexpected deaths being analyzed by the Office of the Medical Investigator since the first case of COVID-19 was confirmed in New Mexico in early March. That is nearly a 20% spike in unexpected deaths, which usually includes car crashes, suicides, homicides and some natural deaths.

Dr. Heather Jarrell, the interim director of OMI, attributed the increase to “indirect causes of COVID.”

And health officials suspect those numbers include a rise in suicides.

National experts have warned there could be more suicides during the pandemic due to increased financial stress, isolation and other factors.

Since her son died, Katrina Fuller said, she has struggled to get out of bed and complete routine chores. She cries frequently while talking about her son and about what happened.

She said she doesn’t want to politicize his death, but she does want to raise awareness about a need for more support, socialization and mental health care during this time when people have been isolated and home-bound.

As an educator, Katrina said, she was well-versed in the signs of suicide and depression and never saw any hints that Landon was planning suicide. She said although she and her husband, James, tried to hide their financial strain and stress from the kids, their worries spread easily through their small three-bedroom house.

In the weeks after Landon’s death, Katrina said she found an entry in a journal he was keeping as a school project chronicling the time of the pandemic.

“His words were ‘I’m going mad staying at home all the time, and not being able to go to school and play outside with my friends …,’ ” Katrina said. “If I had read that I would have been able to empathize because I felt like that too.”

Morgue is full

There’s clear visual evidence of a rising death toll.

During a Board of Medical Investigators meeting last month, Jarrell said the morgue is at capacity and the office has brought in three refrigerated trucks that are parked outside. About 60 additional bodies are being stored in them. Similar trucks are being used in San Juan, McKinley and Doña Ana counties, she said.

The rise in deaths goes beyond those who have died from COVID-19, the disease caused by the novel coronavirus. Officials have so far reported 513 deaths from the illness.

While Jarrell said OMI doesn’t yet have data on the cause of the recent unexpected deaths, there’s a project underway within the office to pin down exactly what has caused the sudden jump.

Refrigerated mobile morgues outside the OMI-New Mexico Scientific Laboratories are used to store bodies since the morgue is overflowing. Similar trucks are being used in San Juan, McKinley and Doña Ana counties. (Adolphe Pierre-Louis/Albuquerque Journal)

Suicide has emerged as a likely factor, she said. OMI investigators have linked some recent suicides with depression worsened by social isolation or job losses.

“I don’t have any other explanation for the increase in cases,” Jarrell said in an interview. “I think there’s been an increase in suicides. I know there’s been an increase in our caseload.”

OMI launched 2,356 death investigations from March 15 through June 15, Jarrell said. That’s about 360 additional deaths compared to the same period last year, when the office had 1,997 such investigations. From Jan. 1 through March 14, the office responded to 1,726 deaths compared to 1,719 the year before.

So far OMI has confirmed a person had COVID-19 in 27 of its unexpected death investigations in the last three months. Jarrell said that number may increase as more deaths are analyzed.

Another possible explanation for the increase in deaths is that people, nervous about the virus, have put off going to a doctor, which could ultimately lead to death if the patient is having a heart attack or stroke, she said.

There also could be some procedural issues that could explain some of the increase, for example, if a primary care physician wasn’t available to sign a death certificate so OMI took jurisdiction of a body it normally wouldn’t, Jarrell said.

Feared outcome

For several months, mental health professionals have predicted that the pandemic could lead to an increase in suicides.

In one research paper in April, doctors wrote about several factors that could become triggers. Adults with underlying mental illnesses, including depression, could become further at risk of suicide because of social isolation, according to a paper published on the Public Health Emergency COVID-19 Initiative.

There’s also evidence that economic hardship can lead to an increase in suicides.

An article in the Journal of the American Medical Association titled “Suicide Mortality and Coronavirus Disease 2019 – A Perfect Storm?” suggests that the pandemic and the world’s response to it – which has included drastic social distancing measures – could contribute to a rise in suicides for years.

Local advocates and people who work with those who have mental illnesses said that they’ve seen some side effects as well.

“We’re seeing a lot more anxiety,” said Annette Minnich, the president of the board of the Albuquerque chapter of the National Alliance on Mental Illnesses and a facilitator of group sessions.

And Nancy Mance, the program coordinator at OMI’s Grief Services Program, said the pandemic has caused loss, which can add to a person’s grief.

“I certainly would say all the losses that people are experiencing with COVID-19 – people are losing jobs, people are losing social connection, people are losing their identity. And those losses are certainly things that contribute to grief,” she said. “Grief is always about loss. It can be really tangible, like when somebody dies. Or it can be really intangible, like ‘Who am I if I am not working.’ ”

There are resources available to those who are struggling, she said. NAMI offers several virtual sessions and courses for those with a mental illness, as well as their family members.

Support via Zoom

Survivors of Suicide Loss, a volunteer support group led by people who have lost someone to suicide, moved its four-times-a-month, in-person meetings to the virtual space of Zoom when the coronavirus came to New Mexico.

Joe Thompson, the group’s president, said it often takes people several months after losing a loved one before they’re ready to seek help.

“I can tell you I’m receiving so many inquiries through our website,” he said. “It makes sense, given that folks are isolated, they don’t have that contact, it’s not as easy for people to engage their support systems … In our Zooms we’ve seen some new faces.”

Katrina Fuller and her husband have attended virtual support groups, and she said it helped to be able to talk to others who are going through the same thing. They and their 13-year-old daughter are also seeking counseling.

Katrina has also found solace in writing letters to legislators, both local and national, and the governor, urging them to address the “related shadow deaths of the virus.”

“In my grief and search for understanding and a new purpose to life, I feel the need to bring awareness to this unnecessary, tragic side effect of the pandemic and social distancing,” she wrote. “Please let me know what can be done or how I can help. I cannot have my son back, but I will do anything so another family does not have to suffer as we have.”

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