State removes some COVID-19 deaths, clarifies reporting

No deaths reported in Clark County have been removed from the total

OLYMPIA — Washington’s Department of Health (DOH) is clarifying how it reports deaths related to COVID-19. In a new report, published today, the state is breaking deaths down into four separate categories.

In a release on Tuesday, the state said they are making the adjustment to provide “context for decision makers working to stop the spread of the virus.”

Data on the COVID-19 outbreak statewide as of July 11, 2020. Image courtesy Washington State Department of Health
Data on the COVID-19 outbreak statewide as of July 11, 2020. Image courtesy Washington State Department of Health

The DOH concluded that 96 percent of reported deaths were either directly caused by COVID-19, or remain under review. Another 4 percent have been removed from the count after it was determined that, despite a positive COVID-19 test, their death was not caused by the infection.

That reduces the total death count statewide from 1,458 to 1,438, including 34 additional deaths added on Tuesday.

At a press conference on Tuesday, Gov. Jay Inslee called the decision by DOH an “interesting academic debate,” but not one that would impact his decision on how to react to the pandemic.

“I’m glad that the department is being as careful as they can on it,” he said, “but it’s not going to affect our basic assessment on this: we need to act.”

In order to further clarify data on COVID-19 deaths, the state is breaking reports into four categories.

  1. Confirmed Deaths: Deaths that occur among those who have tested positive for COVID-19, and whose death certificates mention COVID-19 as contributing to or causing the death, or a specific COVID-19-like condition (e.g. acute respiratory distress syndrome or pneumonia), without specifically mentioning COVID-19.
  2. Suspect Deaths: Deaths which do not indicate COVID-19 on the death certificate, but which occur among those who have tested positive for COVID-19.
  3. Pending or Missing Cause of Death: Deaths among those who have tested positive for COVID-19 where the death certificate is pending or the cause of death is not yet filled out. Many of these deaths are very recent deaths, out of state deaths that we don’t yet have certificates for or complex deaths still sitting with the local medical examiner or coroner.
  4. Non-COVID Deaths: Deaths that occur amongst those who have tested positive for COVID-19, but who have died of unrelated causes.  This includes homicides, suicides, overdoses, car accidents and other natural deaths where COVID-19 has been ruled out as contributing to the death.

Dr. Kathy Lofy, the state’s public health officer, said the change isn’t expected to greatly impact COVID-19 death counts in the state.

“Of all of the people who have had lab-confirmed COVID who then go on to die, 90 percent of them have COVID listed on their death certificate as their cause of death,” Lofy said.

Another 10 percent have a cause of death listed as something such as heart attack, stroke, or respiratory failure, Lofy said, but it is initially assumed the infection may have played a role in causing the fatal condition.

“But if our local health departments do an in-depth investigation and they learn that, no, this death is really not related,” she added, “we’re now removing those from our death count.”

Of the deaths listed thus far, 89 percent have COVID-19 listed as a cause of death. Four percent were determined not to be COVID-related and have been removed from the state’s count. Another 7 percent are pending, or the death certificate is unclear and requires further review.

Of the 33 reported deaths in Clark County, 26 are considered to have been confirmed as caused by COVID-19, while seven are pending further review. No deaths have been removed from the total thus far. Clark County Public Health says two other deaths have been listed as probably having been caused by COVID-19, but have not been included in the count since they did not have a positive test on record at their time of death.

Statewide, out of 1,458 reported COVID-19 deaths, just over 1,300 are considered to be confirmed, while 67 are suspected and 25 are pending review. Sixty-five reported deaths have been determined to not be connected to COVID-19 and have been removed.

“It would be such a waste if we quibble about whether this number is 1,000 or 1,100,” said Gov. Inslee on Tuesday. “We know that this is a very serious disease. It has killed hundreds of people, it has the prospect to kill thousands more in our state, and we need to act.”

Inslee also announced that his pause on any further moves through the Safe Start Washington reopening phases is being extended another two weeks, until at least July 28, and that there remains the chance some things that have been allowed to reopen could be closed again if cases continue to rise.

“We know one thing, and that’s too many Washingtonians are dying,” Inslee added. “It demands a response, and we’re making sure that it gets it.”

The Department of Health noted in a press release that they are working to report an unprecedented amount of real-time data in as transparent a method as possible.

“This report highlights this complexity by breaking down the ways in which our data collection teams categorize each death, and how they work over time to investigate deaths and categorize them appropriately,” the release reads. “As we’ve highlighted before, the collection and finalization of death data is normally a long process. It may take up to a year to get finalized counts on COVID-19 deaths.”

Inslee also noted that a number of deaths prior to the time when adequate testing was available were likely due to COVID-19, and may never be included in the count.

“It’s just shocking to me that people want to make some argument that it’s going to make a big difference,” Inslee said. “That it’s OK if it’s 1,100 people, but if it gets to 1,105 then we’ll act. This is well beyond this debate.”

To view the state’s situation dashboard on the COVID-19 pandemic, click here.