During the first year of the COVID-19 pandemic, skeptics questioned whether the death count numbers were being inflated by U.S. health officials to make the situation look more dire than it actually was. Were all these people dying from COVID or with COVID?
Feeding the skepticism was the fact that a large share of the early deaths attributed to the coronavirus occurred in nursing homes, where most residents are already in poor health and often approaching the end of life. Plus, Congress created an incentive for hospitals to diagnose COVID-19 since the reimbursement rates from Medicare were higher for treating it than other ailments.
Now two years into this contagion, rather than overcounting COVID-19 deaths, it’s looking as though the exact opposite may be true. Instead of 800,000 deaths from the virus in the United States, the real number could be closer to a million.
That’s the conclusion of an investigation by the USA Today Network of newspapers and Documenting COVID-19, a project based at Columbia University that has compiled an exhaustive database of documents related to the pandemic. The collaboration found a spike in deaths overall the past two years throughout the country that exceeded the official COVID-19 death count by about 25%. When the researchers tried to find out why, they discovered that the cause of death listed on death certificates, particularly when a person dies at home, can be inaccurate, especially in rural, less populated areas.
The discrepancies can be a result of lack of resources, lack of experience or lack of will from the coroners and medical examiners.
In Lafayette Parish in Louisiana, when someone dies at home, the office of the chief death investigator usually writes down as cause of death whatever the family claims. In 2020, that parish had more than 400 deaths above what would occur in a typical year. Less than a third of those were attributed to COVID-19.
In Cape Girardeau County, Missouri, the coroner had not pronounced in 2021 a single person dead from COVID-19 in the 80,000-person county as of mid-December. The coroner there, who does not conduct death investigations himself, told the reporters that he does not record COVID-19 as a cause of death unless the family provides proof that the person who died had been diagnosed with the virus.
These two examples may be the extreme, but the investigation says the problem is rampant, and it’s not just with COVID-19. The country’s patchwork system for determining and recording cause of death results in an inexactitude that prevents the nation from tracking precisely what is killing many people.
Argue, if you will, about whether COVID-19 has been over- or -undercounted. There should be no argument, though, that an accurate cause of death is an important piece of information for medical, societal and economic reasons.
Early on in the pandemic, some families were reluctant to acknowledge that their parent or spouse or sibling died from the coronavirus. They almost seemed ashamed of it, and coroners may have been willing to go along with what they perceived as a harmless deception.
Now the trend may be in the opposite direction, with families pressuring coroners to attribute the death to COVID-19 as word spreads about the funeral assistance money offered by the federal government. Family members can be reimbursed up to $9,000 for these costs if they can show COVID-19 as a cause of death.
Coroners and medical examiners should not be participating in either fraud or fiction when it comes to such an essential aspect of their job. It can’t be that hard or that expensive to ask about a deceased person’s medical condition prior to death and to administer a post-mortem COVID-19 test.
Contact Tim Kalich, editor and publisher of the Greenwood Commonwealth, at 662-581-7243 or tkalich@gwcommonwealth.com.
