Hospital emergency rooms and urgent care visits for cold-related illness more than doubled in the last week of January, and at least six more people died, state health data shows, as Marylanders shoveled themselves out from under piles of snow and ice.

From Jan. 25-31, 391 people visited the emergency room for cold-related illnesses, compared to 170 from Jan. 18-24, data from the Maryland Department of Health indicated. Visits particularly spiked on Jan. 25, when snow and ice showered much of Maryland.

During the same period, the medical examiner’s office reported six cold-related deaths, Maryland Department of Health spokesperson David McCallister said in an email. The state report data shows eight fatalities. It is unclear why there is a discrepancy.

There have been 35 cold-related deaths in Maryland this year, McCallister said. Three were in Baltimore; two occurred in Prince George’s County; and Baltimore, Garrett and Washington counties all added one more. Baltimore leads the state in cold-related deaths with nine. Baltimore and Prince George’s counties have had six each.

Notably, state data shows Anne Arundel County as having no cold-related deaths. On Jan. 28, Portia Latrice Jones, 44, slipped on ice in Truxtun Park and died from the cold, Anne Arundel County Police said.

McCallister said the reports include only cold-related deaths the state medical examiner’s office has determined. The Office of the Chief Medical Examiner said the cause and manner of Jones’ death were still pending.

There were 75 cold-related deaths in Maryland from November to March last winter, the most this decade. State data shows there were 30 cold-related deaths around this time last year.

The weather forecast shows frigid temperatures persisting well into next week, with a chance of light snow Friday. State health officials suggest residents set their thermostats to no lower than 55 degrees; decrease clutter in homes so air can flow throughout; and check on neighbors, friends, family and older adults.