Since the summer, there have been more deaths per capita in Massachusetts than in nearby states, and it’s not clear why.

Dr. David Hammer, an infectious disease specialist at Boston University School of Public Health, said: “I think if anything, many Massachusetts hospitals have learned how to better manage COVID-19 patients, and we see lower mortality rates. Should. ” Health and therapist at Boston Medical Center. “I just can’t explain why the figure is so high [than in nearby states]”

Other experts shared Hammer’s surprise. State-of-the-art hospitals in the state, high rates of insurance coverage, and relatively low rates of COVID-19 transmission over the past few months, all provide strong protection. Some speculate that this The massive death toll in long-term care facilities, where 270 casualties occurred last month, could be part of the explanation. Others pointed to the conscience of time, or random opportunity. But basically, relatively When comparing New Jersey, Connecticut and New York, it is difficult to explain the loss of high life here, the nearby states that follow similar paths otherwise by epidemics.

The states’ methods of calculating COVID-19 deaths and reporting to the public vary, Massachusetts officials said.

“While we’ve been looking for trends for weeks, as we keep an eye on our data, it’s important to note that states have different policies for determining Covid-19 deaths, which created discrepancies when comparing different states like New York and New Jersey. Tory Mazola, a spokeswoman for the Massachusetts COVID-19 Command Center, said in an e-mail on Friday.

States usually follow the national Criteria classifying some COVID-related deaths as “confirmed” and others as “probable” – a designation that means a combination of a person’s symptoms, previous testing, exposure to the virus, or death certificate notes, concludes to public health researchers At least part of the Covid-19 died.

New York does not report the death of a potential COVID-19, while three other states do. However, Johns Hopkins University data used in Globe’s analysis includes potential cases reported by New York City, the state that is responsible for most cases and deaths in that state. Furthermore, deaths in confirmed cases accounted for more than 97 percent of the total deaths reported in Massachusetts, and due to potential discrepancies in reporting, the gap between deaths here and elsewhere in the region is quite clear.

Massachusetts, such as New York, New Jersey and Connecticut, reported cases reported in April, followed by peaks in daily deaths. States also seem to be recovering from their fatal first wave at about the same time: total deaths in the four states fell 69 percent from June to July, according to figures compiled by Johns Hopkins and analyzed by the Globe.

From there, however, Massachusetts made stagnant progress while three others rushed forward. Mortality rates in those states fell below 2 per 100,000 in August, and remained low in September, despite some fluctuations.

Massachusetts saw a 60 percent drop in deaths in September from June, while the death rate was higher than in other states, including the experience of summer infections and hospitalized waves.

Comparing mortality in many states can still be difficult for a number of reasons, said Jennifer Nuzo, an epidemiologist at the Johns Hopkins Center for Health Security. He said even small differences in the timing of new cases or reporting methods could translate into large, largely indescribable disparities in mortality and mortality.

“But in terms of death predictors, it’s very consistent. Age is probably the most important factor,” Nuzo said. Because and how long it takes to move to more sensitive groups. ”

When data was released showing Massachusetts’ mortality rate compared to other Northeastern states, some experts speculated that A weakness in the state’s early epidemic response could still hamper its recovery efforts: long-term care facilities, home to most Massachusetts residents who died in COVID-19, remain vulnerable.

“The numbers definitely seem to,” said Helen Jenkins, an epidemiologist at Boston University. “My question would be that Massachusetts is still doing poorly [long-term-care] Next? “

Of the more than 2,000 possible and confirmed COVID-19 deaths during the epidemic in Massachusetts, about two-thirds have come out of long-term care facilities. By comparison, 40% of deaths in COVID-19 nationally are associated with such settings, although some states attribute deaths more separately than Massachusetts. New York, for example, does not associate a CWID-19 death with a nursing home with a nursing facility, if a resident dies in a hospital rather than a nursing facility.

“Mortality rates per thousand in nursing homes in Massachusetts have risen sharply due to a lack of better deadlines. [state] The population, “said Alex Brill, a fellow at the American Enterprise Institute, said Washington, D.C. Brill and fellow researcher Benedict Ippolito thought Massachusetts was just one of four states that had” particularly bad results in nursing homes. ” Connecticut and New Jersey also fell into this category, although they deviated less than national standards.

An investigation by the Globe Spotlight team found that the needs of nursing homes and other long-term care facilities were largely ignored in response to the early epidemic in Massachusetts, instead focusing on hospitals. State officials have since taken steps to rectify its initial missteps, but advocates say they still have a long way to go, with hundreds of elderly care facilities dying of Covid-19 every month.

“This is not the end for the elders,” said Al Norman, a longtime advocate for seniors. Norm said the elders they work with are afraid to get into group care settings, but often feel like they have nowhere to go. “We’re not really doing that right now in terms of providing options for the elderly,” he said.

“Count the deaths in each nursing home and it will touch 10 or 11 staff,” said Elizabeth Dugen, an associate professor of gerontology at Boston University in Massachusetts. “For many Massachusetts residents, worries about Covid-1 have eased over the summer, while widespread feelings of grief and fear have long been felt in long-term care communities,” he said.

“We have the world’s leading medical care, but no attention has been paid to the care of the elderly. We don’t think about nursing homes as part of the health care system, “he said. “We could have done better. We should do better. “

A spokesman for the state’s COVID-19 Command Center, Mazeola, said: “The Baker-Polito administration has taken significant steps since March to take the necessary steps to protect our most vulnerable seniors during this ongoing epidemic, including additional protection for older adults. The infection is under control. “

“Covid-positive cases in long-term care facilities have dropped by almost one percent and deaths by more than 90 percent since the outbreak of the epidemic, and we continue to closely monitor the impact of the virus on these facilities.”

Mesola also highlighted the state’s efforts to implement public health and raise awareness in “high-risk communities” such as Chesia, Everett, Larens and Framingham.

But Jaukins, a BU epidemiologist, said there is at least one aspect of the state’s approach: time for officials to determine where deaths are coming from and why, in recent weeks, case counts and other key indicators have moved forward.

“There’s a lot of flow in Massachusetts at the moment,” Jenkins said. “It simply came to our notice then. It’s time to pause, to reflect. “

Dasia Moore can be reached at [email protected] Follow him on Twitter daijmoore.