From the New York Times, Official Counts Understate the US Coronavirus Death Toll
A coroner in Indiana wanted to know if the coronavirus had killed a man in early March, but said that her health department denied a test. Paramedics in New York City say that many patients who died at home were never tested for the coronavirus, even if they showed telltale signs of infection.
In Virginia, a funeral director prepared the remains of three people after health workers cautioned her that they each had tested positive for the coronavirus. But only one of the three had the virus noted on the death certificate.
Across the United States, even as coronavirus deaths are being recorded in terrifying numbers — many hundreds each day — the true death toll is likely much higher.
More than 9,400 people with the coronavirus have been reported to have died in this country as of this weekend, but hospital officials, doctors, public health experts and medical examiners say that official counts have failed to capture the true number of Americans dying in this pandemic. The undercount is a result of inconsistent protocols, limited resources and a patchwork of decision making from one state or county to the next.
In many rural areas, coroners say they don’t have the tests they need to detect the disease. Doctors now believe that some deaths in February and early March, before the coronavirus reached epidemic levels in the United States, were likely misidentified as influenza or only described as pneumonia.
With no uniform system for reporting coronavirus-related deaths in the United States, and a continued shortage of tests, some states and counties have improvised, obfuscated and, at times, backtracked in counting the dead.
“We definitely think there are deaths that we have not accounted for,” said Jennifer Nuzzo, a senior scholar at the Johns Hopkins University Center for Health Security, which studies global health threats and is closely tracking the coronavirus pandemic.
Late last week, the Centers for Disease Control and Prevention issued new guidance for how to certify coronavirus deaths, underscoring the need for uniformity and reinforcing the sense by health care workers and others that deaths have not been consistently tracked. In its guidance, the C.D.C. instructed officials to report deaths where the patient has tested positive or, in an absence of testing, “if the circumstances are compelling within a reasonable degree of certainty.”…