Rumors of COVID-19 deaths being over-reported likely untrue

IDAHO FALLS — Rumors, misinformation and conspiracy theories surround COVID-19, leaving many people to wonder if the reported number of deaths is accurate.

The Idaho Department of Public Health and Welfare is reporting 27 COVID-19-related deaths in the state as of Monday afternoon. That number pales in comparison to the total 21,942 COVID-19 related deaths the CDC is reporting in the United States.

A rumor making the rounds on social media is claiming those numbers are inflated, that unless a person died by a car crash or a gunshot wound, coroners and medical examiners are instructed to list the cause of death as COVID-19.

Eastern Idaho Regional Medical Center Infectious Disease Specialist Dr. Todd Bagwell said the rumor is untrue.

“I heard this conspiracy theory thing. No, no one is getting any pressure from anybody (to report a certain way), that’s for sure,” Bagwell said.

But not all public officials agree with Bagwell.

“I am concerned about the statistics we’re receiving from the news media,” Jefferson County Coroner LaVar Summers told EastIdahoNews.com.

He said coroners can list a death as being due to COVID-19 even if the deceased never tested positive for the virus.

“It’s strictly a judgment call,” Summers said.

So what kind of guidelines have coroners and medicals examiners been given on COVID-19?

EastIdahoNews.com obtained the guidelines, which were jointly issued by the U.S. Department of Health and Human Services, CDC, National Center for Health Statistics, and the National Vital Statistics System. The document is called the Vital Statistics Reporting Guidance and does, at least partially, confirm that coroners can indeed make a judgment call on the cause of death — an informed judgment call.

“When reporting cause of death on a death certificate, use any information available, such as medical history, medical records, laboratory tests, an autopsy report, or other sources of relevant information. Similar to many other diagnoses, a cause-of-death statement is an informed medical opinion that should be based on sound medical judgment drawn from clinical training and experience as well as knowledge of current disease states and local trends,” the guide instructs.

Bagwell said a death certificate has multiple lines for the cause of death and underlying conditions.

“When you see a death certificate, it’s got four lines or four things you’ve got to fill out. You’ve got the immediate cause of death complicated by this, complicated by that,” Bagwell said.

The cause of death reporting guidelines states COVID-19 should be listed if it played a role in the death. However, it also notes that an underlying cause of death, such as pneumonia or other respiratory illness, should be listed higher on the death certificate than COVID-19 if they are present.

However, a person does not need to have tested positive for COVID-19 for the virus to be listed on the death certificate.

“In cases where a definite diagnosis of COVID-19 cannot be made, but it is likely (e.g., the circumstances are compelling within a reasonable degree of certainty), it is acceptable to report COVID-19 on a death certificate as ‘probable’ or ‘presumed,'” the guide states.

There is still some uncertainty on if deaths where COVID-19 was only a contributing factor and not the primary cause of death should be counted in the total number of COVID-19 deaths.

“If the certifier placed cancer as the cause of death and COVID-19 as a contributing factor, we currently are not certain how that would get coded because of the newness of the situation. We are seeking clarification from the National Center for Health Statistics,” Idaho Department of Health and Welfare spokeswoman Niki Forbing-Orr said.

Bagwell said he believes the number of deaths being reported is accurate. He said it is more likely that a small number of COVID-19 deaths have gone unreported than the total number of deaths has been over-reported.

“I think we’re probably catching most of the deaths,” Bagwell said. “I think there’s probably a rare instance where someone gets sick and dies at home and we wouldn’t know about it.”