Why We Can’t Rule Out COVID-19 Deaths
“They would have died anyway.” Over the past few weeks, the argument has spread on social media that the death of a person with underlying medical conditions who is infected with COVID-19 should not “count” as a death from COVID-19 . Yes, COVID-19 deaths are more common among people with conditions such as heart disease, lung disease, and diabetes. But that only raises the question of how officials determine that a person actually died from COVID-19, especially given that the death rate from the disease is used as a factor in determining when businesses can resume work and people can return to work.
“When we do autopsies, the changes in the lungs are so severe that they really cannot be separated from the effects of coronary heart disease, emphysema, heart disease, diabetes and everything else,” says Duane Wolff, MP. chief medical examiner, Harris County Forensic Science Institute; and assistant professor of pathology, Baylor College of Medicine. “It’s really a disease in its own right.”
The main cause of death is the patient’s cause of death on that particular day.
When it comes to determining the cause of death, there is an underlying cause as well as contributing causes. In those who die from COVID-19, the main cause is often diffuse alveolar damage to the lungs, which leads to the death of patients due to their inability to breathe.
If COVID-19 caused a person’s death on that particular day, it is considered the leading cause of death, and death from COVID-19 is still an early death, whether the death occurred a month or twenty years earlier than otherwise. …
In addition to the underlying cause of death, the death certificate will list contributing factors such as heart disease or diabetes, or any number of other conditions that may have worsened the patient’s condition. These are factors that, although they did not lead to the death of the patient that day, also did not help them.
Simply put, COVID-19 will not be considered a cause of death if a person with a mild illness was involved in a car accident and died, as the illness would not have been the cause of their death that day.
“There will be cases of people dying from COVID-19 but not from COVID-19,” Wolf says.
How cause of death is determined has not changed
It is important to remember that the way in which the cause of death of COVID-19 patients is determined is no different from how healthcare professionals determine the cause of death at different times. As Wolff points out, even in ordinary times, there are situations where the cause of death is determined based on the patient’s medical history, as well as statistical data.
“This is the same process that we used before the pandemic, this is the same process that we will use after the pandemic,” says Wolf.
Wolf’s office in Houston conducted a series of autopsies in which they needed to determine whether the death was related to COVID-19 or not. Their strategy for determining the cause of death is the same as ever.
The way deaths are counted do differ from state to state – some include victims with suspected COVID-19, whose infectious status is not confirmed by a diagnostic test, but who showed common symptoms and had known cases. Other states have more definitions of patients dying from COVID-19, but not from it. However, despite the existence of these gray areas, the process and logic of determining the cause of death is the same as in normal times. After all, determining the cause of death is always difficult.
We probably underestimate the number of deaths
Given the lack of widespread testing, there are certainly unreported deaths from COVID-19. A recent New York Times analysis looked at the number of deaths this year compared to the same period a year ago. They took into account the difference in death rates given the number of confirmed COVID-19 cases and used the results to estimate how many deaths from COVID-19 might still be unrecorded.
Based on this analysis, they estimate 40,000 unrecorded deaths in 12 countries, including countries such as Belgium, France, Spain and Switzerland. They estimate that there are 4,200 more unrecorded deaths from COVID-19 in New York between March 11 and April 25.
So, from a practical standpoint, it is likely that we are dealing with an underestimation of deaths from COVID-19, even though the process of determining the cause of death is now the same as in the past. And this information can be critical in determining where we go next.