As coronavirus surges, Houston confronts its hidden toll: People dying at home

The rise in at-home deaths may also reflect people who are afraid to go to the hospital because of COVID-19, and who die of heart attacks, strokes, diabetes and other conditions not tied to the coronavirus, Faust said.

Ultimately, Faust said, public health experts trying to assess the toll from COVID will need to study how many excess deaths there are in a particular region and whether the demographics of those who died are different from what one might expect. “If there’s a huge spike in at-home deaths but no real spike in overall deaths, it’s just sort of rearranging deck chairs.”

Such an analysis takes time, in part because death certificates are not submitted instantaneously.

Dr. Peter Hotez, dean of the National School of Tropical Medicine at the Baylor College of Medicine in Houston, said the surge in at-home deaths reflects the nature of the way COVID-19 attacks the body. Early on, he said, doctors were focused on respiratory symptoms, but case studies in New York and elsewhere showed the virus also causes serious heart problems that can lead to sudden deaths.