The real number of deaths is higher—but no one knows by how much.
The U.S. Centers for Disease Control and Prevention is well aware that the figures – which keep going up – do not tell the full story.
Deployed by public health agencies, that data could help cities across the country and throughout the world properly prepare for the surge in hospitalizations and deaths that could occur as the disease strikes elsewhere. As it turns out, doctors and scientists believe, it was an underestimation of potential COVID-19 fatalities in New York City that has wrought serious consequences.
"We did the best we could with what we had,” said one emergency department doctor in Philadelphia, speaking on condition of anonymity. “We didn’t have much and that’s a fact. I’m confident we saw patients who died of COVID before we could test. We suspected it, but couldn't confirm it so the death certificates never contained COVID as the cause.”
A man waits to enter a COVID-19 testing center at the Elmhurst Hospital Center in Queens, New York, USA, on March 30, 2020.With limited resources reserved for the severely ill, many are dying before getting tested or while test results are pending, city officials said, and there simply is no opportunity to conduct post-mortem testing – something routinely done in normal times.
“We are helping because we have experience in death and know about management and storage of dead bodies, but these cases are not the usual cases that come to us,” said Sally Aiken, chief medical examiner in Spokane, Wash., and president of the National Association of Medical Examiners. "There is no swabbing of deceased individuals anymore and unless the medical examiner has knowledge of a confirmed coronavirus test, then they aren’t being marked down as having coronavirus,” said Levine, whose committee has oversight for the Office of the Chief Medical Examiner.
To try and get a more accurate picture of the crisis, the CDC last week issued updated guidance for certifying deaths due to COVID-19 – protocols similar to those in place for pneumonia and influenza. According to the new directions, if a patient has died from pneumonia, for example, but was also tested positive for COVID-19, someone is required to specify whether COVID-19 played a role in the death and whether it was actually the underlying, primary cause of death.
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