Rick Hill, a retired high school principal, plays a key role in tracing deaths linked to the ongoing COVID-19 pandemic. As an elected justice of the peace (JP) in Brazos County and leader of the Texas Justices of the Peace and Constables Association (JPCA), it’s part of his job to help determine just how many Texans the virus has killed. Hill spent decades as a science teacher before running for his position, and is well known in the community for his time as a commentator on local football games. But he has no medical training.
All but 15 of Texas’ 254 counties rely on JPs without medical backgrounds and little training to respond to reports of homicides, suicides, and deaths at home—including those linked to the coronavirus. But during the pandemic, Hill said it’s been hard for JPs like him to decide whether to attribute a home death to COVID-19, especially when test results are unavailable. In an interview, Hill told the Observer that he, a mentor to others statewide as JPCA president, recently advised another JP to exclude COVID-19 as a contributing cause of death even though the deceased man had tested positive, because he also had a history of alcohol abuse and liver damage. “To me there’s a difference between dying from COVID and dying with COVID,” Hill said. He acknowledged that a physician might have listed the virus as a contributing factor, especially since the Centers for Disease Control and Prevention (CDC) says people with such underlying conditions are high risk. In fact, Hill’s methods are at odds with recommendations made by Texas’ JP training center, and by health officials seeking a more complete count of the death toll.
As of late March, state data counts more than 47,000 COVID-19 deaths. But in dozens of rural and suburban counties across Texas, COVID-19 deaths appear to have been dramatically undercounted last year, according to an ongoing study of deaths reported nationwide conducted by researchers at Boston University School of Public Health. Other studies previously suggested that 20 to 30 percent of COVID-19 deaths nationwide may have gone unreported in the first six months of the pandemic. But the new study, based on CDC data from deaths reported at the county level in 2020, suggests that many rural and suburban counties in Texas and in other states that rely on coroners or JPs appear to have much larger undercounts compared to states that use medical examiner systems.
