Montana’s experience with the COVID-19 pandemic passed a grim milestone Wednesday, with state public health officials reporting the 2,000th Montana death attributed to the virus.

The marker came the same day the state’s pandemic statistics dashboard recorded Montana’s millionth COVID-19 vaccine dose, which was administered Tuesday. Fifty-three percent of Montanans 12 and older are now considered fully vaccinated against the virus, compared to 65% of people nationally.

As of Sept. 29, the state has recorded 149,824 total cases of COVID-19 since the pandemic began last year. That count includes 2,001 cases resulting in death, 135,842 in which patients have been deemed recovered, and 11,981 classified as active.

Those numbers indicate that the fatality rate for Montanans diagnosed with COVID-19 is about 1 in 75. About 1 case in 20 has been severe enough to require hospitalization.

Yellowstone County, which includes Billings, has recorded the most COVID deaths in Montana at 329.

John Felton, CEO of RiverStone Health and Yellowstone County’s public health officer, said those sustained losses have worn down health care workers, some of whom have decided to leave the field. 

“We had our first death in mid-April of last year, and since then it’s just been death after death after death,” he said. “That sort of trauma just wears people out.”

He said whereas last fall’s surge came before vaccines were widely available, the new surge wrought by the Delta variant comes after several months of widespread vaccine availability. 

“That sense that there’s a light at the end of the tunnel is missing,” Felton said.

Felton said he’s frustrated that so many Montanans have chosen not to get vaccinated, which has contributed to the strain on the state’s health care system.  

“There’s also, quite frankly, among health care workers and public health workers … a bit of anger about it, feeling like we don’t need to be here.”

John Dahl, who owns Dahl Funeral Chapel in Billings, said COVID has has kept him and other Yellowstone County funeral homes much busier than normal, especially in the last four to six weeks.

“We’re losing people much sooner than we should be,” Dahl said. “We serve a lot of families on the Crow Reservation, and last year they were hit harder than anybody. Friends of mine, families that I’d served for years, were experiencing multiple losses — losing both parents months apart. That’s happened several times.”  

Yellowstone County, the state’s largest, isn’t alone in its loss. The 2,000 deaths have taken Montanans from across the state, with each of 56 counties recording at least one death. After Yellowstone in the ranking, Cascade County (Great Falls) has tallied 210 deaths and Flathead County (Kalispell) has recorded 153.

The office of Gov. Greg Gianforte called the 2,000-death mark a “​​a solemn, tragic milestone” in a statement issued Wednesday.

“The governor joins all Montanans whose hearts go out to the family, neighbors, and friends of those we have lost to the virus,” the statement read. “As the governor has said repeatedly, vaccination remains the best solution to protect ourselves and our loved ones from the virus, and we continue to make progress with the millionth dose of vaccine administered in the state yesterday.”

The governor has supported vaccination efforts but hasn’t voiced support for public mask-wearing in recent months, even as the U.S. Centers for Disease Control and Montana health care associations have called masks an important tool to reduce the virus’ spread. Last month, Gianforte promoted an emergency rule that discouraged school districts from mandating masks in classrooms, citing respect for parental rights. He also signed a law earlier this year that aims to prohibit discrimination based on vaccine status, and which has the effect of preventing businesses and some health care providers from requiring their employees be vaccinated against COVID-19 and other diseases. That law has been challenged in court by the Montana Medical Association, which argues that it keeps hospitals and private physicians from providing safe medical care to their patients.

Research published by the state health department this month indicates that vaccinated Montanans are catching the virus, being hospitalized by it, and being killed by it at much lower rates than people who haven’t received the COVID-19 vaccine. With just over half of Montanans 12 and older vaccinated in the week ending Sept. 4, for example, the state saw more than four times as many COVID-19 cases and nearly five times as many hospitalizations among unvaccinated people.

The running COVID-19 death tally presented on the state dashboard represents data that’s routinely fine-tuned as public health scientists conduct follow-up investigations and reconcile reports submitted from across the state in an effort to make the numbers as reliable as possible. Because that process takes time, detailed data on the pandemic’s death toll is at this point publicly available only through the end of last year, and even those figures are still considered preliminary.

Acknowledging concerns in some corners about pandemic deaths being potentially overstated,  a study published by the state health department in June examined death certificates of 1,279 resident and non-resident COVID-19 deaths recorded in Montana in 2020 to check whether they had been properly counted as part of the virus’ toll

While many patients recorded as COVID-19 deaths were officially listed with a different immediate cause of death, the scientists conducting the study concluded that the virus was either a significant contributor or part of a direct chain of events leading to death in more than 99% of the death certificates they examined. For example, a patient considered a COVID-19 death could have died from acute respiratory distress syndrome, or lung failure, caused by a case of pneumonia resulting from a COVID-19 infection.

That study’s finding also underscore another key point about the pandemic: The death toll has fallen hardest on Montanans who were already vulnerable as a result of other health conditions. High blood pressure and diabetes were each recorded as a factor in about 1 in 5 of the state’s 2020 COVID-19 deaths. Chronic lung disease was a factor in about 1 in 7. Dementia was a factor in about 1 in 9.

Of the 2020 deaths, the vast majority, 83%, were among people older than 65. Nineteen deaths were recorded in Montanans under the age of 40, most in patients with at least one other contributing condition. Twenty percent of the state’s recorded COVID-19 deaths were among American Indians, who make up about 6% of Montana’s population.

Another health department study, released in March, said the 1,104 resident deaths attributable to COVID-19 in 2020 ranked the virus as the third-leading cause of death for Montanans last year, behind heart disease (at 2,365 deaths) and cancer (at 2,114).

In comparison, that study indicates that Montana averages about 280 deaths annually from suicide, 193 from motor vehicle accidents, and 164 from influenza and pneumonia.

The state’s overall mortality rate from all causes last year was 14% higher than over the prior five years, the health department’s scientists wrote, saying that represented about 1,900 extra deaths. They also said 2020 was the first year Montana recorded more deaths than births since the state began keeping records in 1908.

An earlier version of the county death count map in this story displayed incorrect figures. The map has been updated. 

latest stories

Public school enrollment shows fall uptick

Public school enrollment dropped 2.4% in Montana during the pandemic. Now, preliminary data from the Office of Public Instruction indicates that the number of K-12 students in the state not only rebounded this fall but is slightly higher than pre-COVID levels.

Eric Dietrich is a journalist and data designer and the founder of the Long Streets economic reporting project. His reporting focuses broadly on Montana’s governance and economic opportunity, with particular focus on the state budget and tax policy. He also contributes data reporting across the MTFP newsroom. Before joining the MTFP staff in 2019, he worked for the Great Falls Tribune, Bozeman Daily Chronicle, and Solutions Journalism Network and also earned an engineering degree from Montana State University. Contact Eric at edietrich@montanafreepress.org, 406-465-3386 ext. 2, and follow him on Twitter.

Billings native Amanda Eggert covers environmental issues for MTFP. Amanda is a graduate of the University of Montana School of Journalism who has written for Outside magazine and Outlaw Partners. At Outlaw Partners she led coverage for the biweekly newspaper Explore Big Sky. Contact Amanda at aeggert@montanafreepress.org.