Every county in Kansas has lost residents to COVID-19, but Cowley County has the highest virus-related death rate in the state for a county its size.
This was true even before the current surge in cases that started in July, which account for 10 of the 118 total deaths as of Friday.
Cowley County’s death rate from COVID-19 is 3.38 per thousand people. In math terms, that means that for every 1,000 residents living here, more than three of them had died from the virus.
That rate is well above the statewide rate of 2.00 and higher than all the similar-sized counties that range 10 percent smaller or bigger in population: Finney, Ford, Harvey, Lyon, Miami, Montgomery, Crawford and Geary. All have seen fewer deaths throughout the pandemic.
With 118 fatalities, Cowley is one of 10 counties in the state with more than 100 COVID-related deaths, and all but one of those counties — Crawford — are much larger: Sedgwick, Johnson, Shawnee, Wyandotte, Saline, Reno and Butler.
The median age of those dying from COVID across the state is 79. In Cowley County, males make up 58% of the 108 deaths. The youngest person to die from COVID in Cowley County known to the CourierTraveler is 36.
In interviews with health officials and analyzing data, several factors appear to be in play in Cowley County’s high death rate: health and age of residents, nursing home outbreaks and mask mandates.
Most of the deaths occurred before vaccinations became widely available, but vaccination rates are no doubt a factor now as more people die amid the delta variant surge.
Thomas Langer, Cowley County’s public health officer, thinks the explanation for Cowley’s high death rate is fairly simple: the county’s population is older and less healthy compared to most of the state.
Indeed, the latest census estimates show that people 65 and older make up 18.8 percent of Cowley County’s population, compared with 16.3 percent statewide.
And Cowley County residents on average are less healthy than their fellow Kansans, according to the latest health rankings found at the Kansas Health Institute.
Cowley ranked 84th of 104 counties in health factors, which includes things like smoking, obesity and physical inactivity.
“We have known for years that the general health of our population is less healthy than other counties, as we have ranked in the bottom 10 to 20 percent statewide,” Langer said earlier this year. “It is a fact that if a person is obese and diabetic and contracts COVID, they run a higher risk of death as a result.”
In reviewing demographics and health profiles of the other counties, health and age appear to be factors, but the picture is not crystal clear. For example, Montgomery County is older (20.3 percent of residents are 65 and older) and even less healthy with a ranking of 101.
But that southeast Kansas county, home to Coffeyville and Independence, had recorded 98 deaths for a lower death rate of 3.11.
Of the nine counties in discussion here, Lyon County, home to Emporia, had the next highest death rate behind Cowley and Montgomery counties. Lyon had seen 90 total deaths for a 2.80 mortality rate. Lyon County is younger (15.6 percent of residents are 65 or older) and healthier with a ranking of 53.
The fewest deaths occurred in Geary County (home to Junction City) with 52 fatalities and a rate of 2.80 deaths per 1,000 residents. With a military base, Geary County’s population skews quite young, which might help explain its much lower death rate.
The medical director at William Newton Hospital, Dr. Treasure Wehner, said that she does not have an answer for Cowley County’s relatively high death rate.
Interviewed earlier this summer, before the delta variant surge, Wehner said there was a time when local COVID patients could not be sent to Wichita hospitals because they were full, but “from what I could see, people were getting good care here.”
Wehner is also a family doctor at the Community Health Center in Cowley County in Winfield. Finding answers to the death rate will take some serious investigation, she added.
“It will happen at some point, but I think it is inappropriate for me to point a finger” at any particular cause at this time, Wehner said.
Masks a factor?
Only two of the nine counties — Cowley and Ford — never adopted a countywide mask mandate.
In Ford County, however, Dodge City makes up 81 percent of the county’s population. That city did impose a mandate for three months during the fall and winter surge of the illness.
Eighty-five people have died in Ford County for a death rate of 2.48.
Another caveat is that Montgomery County’s mask mandate was not really a mandate. County commissioners there did not opt out of the governor’s face-covering order in July 2020, but the county’s emergency manager said the order would not be enforced and was more of a recommendation.
Montgomery County has the second highest death rate behind Cowley.
One county that kept a mask mandate for much of the pre-delta variant days of the pandemic was Crawford County. Home to Pittsburg State University, the share of people 65 and older is smaller than in Cowley County (15.8 percent). But its health ranking of 90 is close to Cowley County’s 94.
As of Friday, Crawford County had seen 101 COVID-19 related deaths, which translates to 2.59 deaths per 1,000 residents.
County commissioners there — at the recommendation of the local public health officer who is also an emergency room doctor — accepted the governor’s statewide mask mandate in July 2020 and kept it in place through March 2021.
That county last year also approved a local order mandating distancing rules and masks for certain employees at local businesses.
“I do think a lot of the people in Crawford County did really buy into how serious this was and did comply with wearing of masks and getting tested,” public health director Teddi Van Kan said earlier this year.
In Cowley County, the City of Winfield was the only jurisdiction to impose or allow a mask mandate. The order lasted from July until May.
Efforts to learn how many deaths and cases occurred by city or zip code, which might indicate how well Winfield’s mandate worked, are ongoing. Langer, the local public health officer, said that information is not immediately available to him and that it would take time to sort through the data.
A Kansas Department of Health and Environment spokeswoman said it does not release information by zip codes or cities due to privacy concerns.
A study published in June by the journal of the American Medical Association reported that Kansas counties with mask requirements reduced deaths by 500 and hospitalizations by 1,500 across the state.
Cowley County, however, was not among the 15 counties included in the study because it was considered in “partial compliance” due to Winfield’s order, researcher Donna Ginther said.
Ginther directs the institute for Policy and Social Research at the University of Kansas. She suspects that cases here would have been higher without Winfield’s mask requirement.
She also said that the presence of the Winfield Correctional Facility might have led to more cases and deaths because prisons were associated with community spread.
At WCF, 439 inmates and 91 staff members have been infected since the pandemic begin, according to corrections officials.
Nursing home deaths
Ginther said the virus finding its way inside long-term care facilities would definitely increase deaths, which indeed occurred in Cowley County.
According to the CDC, at least 42 deaths have occurred among local nursing home residents.
At Presbyterian Manor in Ark City, 18 residents with COVID died. The 18th death occurred in mid-December. The manor at the time said an inspection by state officials had found no disease-control deficiencies. It was the second such finding in a month.
“You can do everything right, and the virus can still find a way into your community,” said executive director Sarah Griggs at the time.
Cumbernauld Village in Winfield has seen 11 deaths connected to the virus. Administrator Linda Voth questioned the accuracy of the death statistics. She said a102-year-old resident tested negative the day before she died, but the death certificate listed COVID as a cause.
Voth also said the numbers can skew both ways; some coroners will say an elderly person died of natural causes unrelated to COVID. Others will list a patient who died two months after having the virus as a COVID death.
Langer said that the information on the certificate of death is placed there by the coroner or attending physician at the time of death.
Before July, Medicalodges in Arkansas City was the only local nursing home that did not have any residents die or even test positive for COVID-19.
“We’ve worked really hard; we’ve not had a single positive resident,” administrator Lori Hughes said before the delta surge. “When it gets in a facility like this, it’s really hard to stop it.”
Hughes’ words proved prophetic. Medicalodges was hit with a least 26 cases — mostly among residents — within two weeks earlier this summer.
Three of them had died, according the latest CDC report.
CourierTraveler Reporter Judith Zaccaria contributed to this report.