NEW ORLEANS --
The bodies are not being dragged from crushed houses and toppled buildings now, but almost two years after Hurricane Katrina, many in the medical community think the massive storm is still killing.
In overcrowded hospital emergency rooms and other medical facilities, the buzzword is death.
"We all think the death rate is up," said Dr. John Thompson, director of forensic neuropsychiatry at Tulane University Health Sciences Center. "Look at all the things people are living with: tremendous stress, the dust and mold still in houses and buildings, financial worries, fear of crime. There are bound to be both psychological and physical stresses."
Even a new state report on local deaths since Katrina did not dispel doubts of many who say an in-depth federal analysis is needed.
The Louisiana Department of Health and Hospitals said its report - based on preliminary data for January through June 2006 - found no significant increase in deaths in the New Orleans area.
"The only slight increase was in Orleans Parish for the first three months of 2006," said Dr. Raoult Ratard, state epidemiologist and the report's author.
New Orleans medical officials say that jump, from 11.3 per 1,000 deaths to 14.3 per 1,000, - a leap of more than 25 percent - was anything but slight. Moreover, the report does not take into account evacuees who died away from the city and were returned for burial.
"Our death rate was already high, that's huge," said Dr. Kevin Stephens Sr., director of the New Orleans Health Department. "That alone is a flag that we are facing some real problems here."
Some New Orleans doctors questioned the population figures used to determine the death rate. DHH secretary Dr. Fred Cerise said he was comfortable with the population data, which he said came from the Census Bureau and the Centers for Disease Control.
But just how many people are living in New Orleans has itself been a post-Katrina controversy. Katrina struck Aug. 29, 2005, and the city was abandoned. The official death tolls in New Orleans stands at about 1,100.
With 80 percent of the city flooded, many people did not begin returning until mid-2006. Latest estimates place the population at about 255,000, about 200,000 fewer than pre-Katrina.
DHH officials said deaths have not been listed as Katrina-related since the end of 2005, except for bodies found under storm wreckage. But Orleans Parish coroner Dr. Frank Minyard said he believes the hurricane is responsible for many more deaths.
"There is no doubt in my mind that Katrina is still killing our residents," Minyard said this week. "People with pre-existing conditions that are made worse by the stress of living here after the storm. Old people who are just giving up. People who are killing themselves because they feel they can't go on."
Lamar Dumas, a 60-year-old Katrina survivor who had always been in good health, died unexpectedly in May, his daughter said.
"I think it was the hurricane, I really do," said Tanja Nicholas. "He saw dead bodies floating the flood water, his house flooded and was all messed up. He'd never had heart problems, never been sick and suddenly he was dead."
Dr. Ronald Kessler, professor of health care policy at Harvard Medical School and head of a group that has monitored 3,000 exiled Katrina survivors, said Nicholas could be on to something.
"There are high rates of mental health problems among the survivors and previous research has found that mental disorders are predictors of earlier death rates," Kessler said. "So putting the two together in New Orleans is not surprising."
He said psychological autopsies - which try to reconstruct an individual's mental and physical state before death - might help in determining exact causes of death.
Local mental health professionals say they are encountering more people with psychological problems.
"We're seeing triple the number of people with mental health problems as we were before Katrina," said Leah Hedrick, social worker at Ochsner Hospital. "Depression, suicidal, anxiety, abuse of drugs and alcohol, and along with that comes a lot more physical problems."