States find several undeclared deaths Covid-19

Ohio in February announced more than 4,000 additional deaths while reconciling its data, and Indiana added about 1,500. Smaller revisions have also recently come from Virginia, Minnesota and Rhode Island. On Thursday, West Virginia authorities said medical providers had not properly reported 168 deaths to the state’s public health department.

“Nobody likes surprises and nobody likes the wrong data, because that’s the reason for the decisions,” said Ayne Amjad, a West Virginia state officer.

These issues highlight ways in which Covid-19 can continue to challenge US data reporting systems. Like many countries, the US is trying to track pandemic events as they happen, and much of this effort has required speeding up the way in which are the deaths. reported.

In West Virginia, death reporting would usually require waiting several weeks for death certificates to be completed, said Dr. Amjad. But the state last year asked health care providers to also complete a one-page report for Covid-19 deaths to create a faster record. The state discovered a recent drop in the number of deaths in December and January, using death certificates to establish that the 168 death reports were not completed correctly, Dr. Amjad said.

She said the reporting problems were at about 70 locations, especially hospitals and long-term care facilities. A Covid-19 increase like the one that hit the US this winter may slow reporting, she said, but she and Gov. Jim Justice found the reporting errors unacceptable. The United States has recorded more than 530,000 deaths from Covid-19, about half of them since Thanksgiving, according to data compiled by Johns Hopkins University.

On Tuesday, Minnesota health officials said an audit found that four private labs failed to report lab results, leading to another 138 deaths. They were recorded on death certificates, a health department spokesman said.

An Indiana audit found 1,507 historic deaths, most of them in 2020, state officials said in early February. The death certificates were used to verify these deaths, said a spokeswoman for the state health department. Shortly afterwards, a problem with unreconciled mortality led the Ohio Department of Health to find 4,000 undeclared Covid-19 deaths.

In Virginia, there was a system problem that recently led the state to add about 900 deaths. Officials there realized that the number of deaths they reported did not appear to be on the rise, and death certificates helped correct the error, said Virginia state epidemiologist Lilian Peake. “We realized something was wrong,” she said.

These state remedies do not fill major gaps in what researchers believe is a significant number of Covid-19 deaths. This is underlined by a large gap between known deaths in Covid-19 and excess deaths, or deaths above average levels in recent years.

Misreporting of Covid-19 deaths was particularly likely at the beginning of the pandemic, when tests were rare and doctors completing death certificates were less familiar with the disease, according to public health experts. They also identified some excess deaths from other problems, such as people avoiding hospitals during health emergencies.

“We’re kind of stuck with this underreporting, especially at the beginning of the pandemic,” said Robert Anderson, head of the mortality statistics branch at the National Center for Health Statistics, which is part of the Centers for Disease Control and Prevention. .

Correlating first-line surveillance data with death certificates can improve data in both systems and sometimes lead to rewritten certificates, Mr Anderson said. But changing death certificates is not easy, he said. The person who completed the death certificate – often a doctor – must agree to change the file.

“We see some deaths that were not Covid before they were attributed to Covid when it was modified, but it is a relatively small number,” Mr Anderson said.

Great changes at the state level can create at least temporary and artificial, swellings in the data that Johns Hopkins and others knit together to show daily trends.

This briefly happened with the backlog of mortality data in Indiana and Ohio before they were updated, which Johns Hopkins tracks and reflects in his records when possible. Instead, there is another large artificial bomb, with 469 deaths, in Iowa on December 11, since that state changed the way it reports the deaths of Covid-19.

“This is the challenge, and that’s why we need to work to improve our national surveillance,” said Jennifer Nuzzo, an epidemiologist and senior researcher at the Johns Hopkins Center for Health Security.

Write to Jon Kamp at [email protected]