AUSTIN (KXAN) — It’s been several days since temperatures rose back above freezing in parts of Texas, but damage from devastating winter storms is on display across the city.

The Texas Department of State Health Services said it’ll likely take several more weeks before the state has an idea of how many deaths are related to last week’s historic winter storms, NewsNation affiliate KXAN reported.

There are reports across the Lone Star state of deaths related to the storm.

These include a Williamson County man who died of hypothermia, and an 11-year-old boy in the Houston area who died during an extended power outage.

But before the state can formally tally a death total, the conditions of those deaths have to be validated by medical examiners — a process that will take time.

In Travis County, for example, how long it takes the medical examiner to complete an autopsy report varies from case to case, though on average the report is ready 30 to 90 days after receiving a body. During that time, relevant information – such as toxicology – is gathered and given to the pathologist, who then determines the cause and manner of death, a county spokesperson said.

DSHS explained that the state’s disaster epidemiologists will review the information from medical examiners across Texas to determine how many deaths were actually related to the winter storm.

Additionally, DSHS plans to look through media coverage of the storms to identify deaths that medical examiners may not have listed as disaster-related.

“This process takes awhile to complete and it will likely be weeks before we have a preliminary number to share.”

TEXAS DEPARTMENT OF STATE HEALTH SERVICES SPOKESPERSON

When these local statistics are submitted to the state, DSHS said the deaths will be grouped based on whether they are directly, indirectly, or possibly related to the storm.

According to DSHS:

• Direct —Refers to a death caused by the environmental force of the disaster (e.g., wind, rain, floods, or earthquakes) or by the direct consequences of these forces (e.g., structural collapse, flying debris).
• Indirect— Refers to unsafe or unhealthy conditions, or conditions that cause a loss or disruption of usual services that contributed to the death. Unsafe or unhealthy conditions may include but are not limited to hazardous road conditions, contaminated water supplies, scattered debris. Disruptions of usual services may include but are not limited to utilities, transportation, environmental protection, medical care, or police/fire.
• Possible— Refers to a death that occurred in the disaster-affected area during the disaster period. The cause of death appears to be directly-related or indirectly-related to the event but for which there is inadequate information available to make that determination at the time of recovery.

A spokesperson for Travis County told KXAN that the county’s medical examiner received 86 cases (bodies) between Feb. 13 and Feb. 22. Of these, 64 were from Travis County and 22 were from places outside the county that do not have medical examiner’s offices.

That is a higher number of cases than what the Travis County Medical Examiner’s Office saw during the same time frame in the year prior: 70 cases (this includes cases from both Travis County and outside counties). But in 2020, temperatures were not nearly as cold as they were this month and the region was not yet aware of any local COVID-19 transmission.

As of Wednesday, a Travis County spokesperson confirmed that only one of the 86 deceased individuals from last week had yet to be identified.

“It is not possible to state at this time how many cases received by the Medical Examiner’s office were a direct result of the winter storm.”

TRAVIS COUNTY SPOKESPERSON

The details of these deaths can be challenging to parse.

For example, a woman experiencing homelessness in Austin was found dead in a tent on February 15 at the state-sanctioned homeless encampment, according to Austin police. First responders who were called to the site were told someone had suffered cardiac arrest, then arrived to find the woman already dead.

According to the National Weather Service, the highest temperature that day at Austin-Bergstrom International Airport (four miles away from the camp) was 23 degrees and the lowest temperature was nine degrees. Another resident of the camp told KXAN his guess is that the woman died of hypothermia.

Travis County will need to identify this woman’s body, then determine whether heart failure, hypothermia, or something else was the cause of her death. That process could take weeks to months.

It is the medical examiner’s job to determine someone’s cause of death. However, Travis County noted in a response to KXAN that the examiner does not associate or link the total number of deaths to any particular event.

While the community may be used to receiving daily updates on COVID-19 death totals from Austin-Travis County, a Travis County spokesperson explained even for COVID-19 deaths, final autopsy reports still take between 30 to 90 days to complete.

KXAN asked the Travis County Medical Examiner’s Office: is it possible the public may never know exactly how many people died in Travis County as a result of these winter storms?

“The medical examiner’s office will make final determinations of the cause and manner of death of each individual who was examined by our office during the period of the storm,” a Travis County spokesperson responded.

The spokesperson also cautioned, “how the cause and death are related to the storm may be a matter of interpretation.”

“For example, a car accident that occurs because of driving on icy roads may ultimately be determined to have a cause of death of blunt force trauma, with the manner as an accident. Some may ‘relate’ that death to the storm, although the cause and manner of death shown on the death certificate may not reflect that.“

travis county spokesperson

Commander Mike Benavides with Austin Travis County EMS explained that their medics — in a winter storm or in any other instance — do not have the authority to determine someone’s cause of death. ATCEMS employees can only share if a person was involved in a particular incident and obtain a pronouncement of death at the scene.

Benavides explained that police officers and firefighters each have terms they use for when they believe a person is obviously dead, and when ATCEMS arrives at the scene, medics decide either to begin, continue, or end efforts to resuscitate the person. When the ATCEMS employees don’t believe the person can be resuscitated, they call the medical director to obtain a pronouncement and time of death.

A person’s cause of death is not always what bystanders may assume, Benavides said.

For example, he suggested that if a person fell and died after walking on an icy sidewalk, it may be difficult for anyone watching to tell if it was the slippery ice that killed the person or a cardiac event that caused the person to fall.

Benavides has seen news reports from around Texas in the past week suggesting that people “froze to death” at home.

“I think it’s kind of a leap to say, because it was cold outside or it was freezing, to say they froze to death,” Benavides said.

“Is it possible? Absolutely,” he continued. “Did it happen like that? No clue.”

“That’s why the medical examiner’s role in this is important, because the medical examiner and law enforcement are the ultimate determining authority for cause of death.”

There are certain instances, like when a person has a gunshot wound to the head, where the cause of death may be obvious to medics. But even then, Benavides emphasized, it is up to the medical examiner to do the evaluation on the cause and manner of that person’s death.

While ATCEMS doesn’t currently have any kind of formal alert asking staff to be on the lookout for people who may have died during the winter storms, Benavides said, “we know that’s always a possibility with any type of natural disaster.