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COVID-19 deaths in Washington could be higher than reported

EMTs transfer a patient out of the acute care COVID unit at Harborview Medical Center. (Photo by Karen Ducey/Getty Images)

The number of deaths from COVID-19 could potentially be higher than is currently reflected in state data. That’s because state health officials have identified more than 3,000 deaths from things like pneumonia and other respiratory illnesses from early on in the pandemic in people who were never tested for the virus.

“It’s going to be extremely hard to figure out if any of these were COVID-related,” said Katie Hutchinson with the Washington State Department of Health, which is currently investigating those deaths.

Those 3,000 or so deaths date back to January 1, prior to the first confirmed case of COVID-19 in Washington. They are not currently reflected in the state death toll, which as of late Thursday stands at 1,044.

The state has disputed claims that its COVID-19 death total is inflated by as much as 13%, as reported by the Freedom Foundation. The report raised eyebrows after the Colorado Department of Health and Environment revised its total deaths due to COVID-19 by about 12%.

Jamie Nixon with Washington state’s Department of Health reports there are three cases included in the state’s death data that are not COVID related. They’re investigating another 25-30 cases that are likely not COVID related.

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“The process for identifying, recording, and registering COVID-19 deaths is complex and involves multiple data systems. The conclusions reached by the Freedom Foundation are based on a source of data that is very early in the death reporting, coding and processing sequence for legally registering deaths in WA,” Jamie Nixon with the state health department wrote in an email to KIRO Radio, explaining that meant the numbers used in that report were based on data that had not yet been finalized.

However, the state admits that near real-time data is not fail safe and the number we see on the website dashboard every day is likely not entirely accurate.

“Our goal from the very beginning from the outbreak has been to get our data out as quickly as possible to provide information in as near real time as possible, even if the data are preliminary,” Hutchinson said. “The decision to provide our data in near real time was initiated very early in the outbreak to ensure that the most current information was made available so immediate decisions could be made to inform Washingtonians.”

Hutchinson explained that their normal process for final death data takes up to 18 months from start to finish. But they’re now posting that data within a day of a death.

Essentially, a death record that includes a person’s name, death date, and birth date is uploaded into the state’s Electronic Death Registration System (one that funeral homes and medical certifiers use), Hutchinson explained. That information is cross checked daily against the state’s communicable disease database of positive coronavirus cases. The information is preliminary, not final, and is thought of as the processing zone for death certifications. It’s not final until it’s registered in the Vital Records system.

Missing is the official cause of death, information that could take months to officially confirm.

This means that if a person tests positive for coronavirus and then dies of cancer, they’re considered a COVID-19 death until the cause of death is made official.

“We will be removing them over time from our death count,” Hutchinson said. “This is part of our normal process for reporting preliminary information. We know that the quality of information improves over time.”

Hutchinson said they believe as time goes on and the reporting improves, it’s more likely they’ll learn that they’re under counting deaths due to COVID-19. It may take up to a year to get final counts on COVID-19 deaths.

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“We do have some deaths that are being reported that are clearly from other causes,” Hutchinson said.

Currently, fewer than five deaths are related to other causes, in this case they’re related to gun shot wounds. There are no deaths due to car crashes or any other kinds of accidents. Hutchinson said there are another 20-30 deaths that are not as obvious. The cause of death is listed as cancer, stroke, Alzheimer’s disease or renal failure.

“It’s unclear whether COVID played a role in these deaths,” she said. “We’re reviewing these deaths along with the local health jurisdictions to try to assess and understand the role that COVID might have played in the death.”

They also have a number of certificates where it’s really unclear how the person died, so it might read “unspecified natural causes,” for example. As more information comes in, those certificates will change. It might take six to 12 months to get clarification on cause of death.

At this time, the state is only reporting deaths that are identified to a COVID-19 positive case. There are currently just under 100 cases that are listed as probable COVID-19, but they haven’t been able to link them to a positive case.

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