New York City Mayor Bill de Blasio said Wednesday that doctors will begin including suspected COVID-19 deaths into their death totals, even if the patient was never tested for the virus.
“Mayor Bill de Blasio said Wednesday the city would begin counting victims (suspected of having coronavirus) who weren’t tested, including those dying at home whose symptoms fit certain parameters,” The Associated Press reported.
The much-criticized mayor has suggested the city is currently undercounting COVID-19 deaths, pointing to a higher number in ambulance calls and corresponding deaths.
“It’s just horrendous,” de Blasio told reporters. “The numbers speak for themselves. This used to be a very, very rare thing in New York City and suddenly it’s jumped up. The only thing that’s changed is COVID- 19.”
As highlighted by Dr. Harlan M. Krumholz in a piece published at The New York Times on Monday, doctors have seen a plummet in heart attack and stroke patients at their facilities since the start of the pandemic. Dr. Krumholz suggested the massive drop is caused by folks experiencing non-COVID related symptoms being too afraid to go to the hospital, where they might catch the virus, to seek treatment.
“The most concerning possible explanation is that people stay home and suffer rather than risk coming to the hospital and getting infected with coronavirus,” the physician explained. “This theory suggests that Covid-19 has instilled fear of face-to-face medical care. As a result, many people with urgent health problems may be opting to remain at home rather than call for help.”
Dr. Deborah Birx, a leading voice in the White House coronavirus task force, acknowledged Tuesday that the United States is recording COVID-19 deaths in a “very liberal” manner.
“I think in this country, we are taking a very liberal approach to mortality. And I think the reporting here has been pretty straightforward over the last five to six weeks,” Dr. Birx told reporters at a press briefing.
“If someone dies with COVID-19, we are counting that,” she emphasized.
“There are other countries, that if you have a pre-existing condition, and let’s say the virus called you to go to the ICU (intensive care unit) and then have a heart or kidney problem,” explained the doctor. “Some countries are recording that as a kidney issue, or a heart issue, and not a COVID-19 death.” In the U.S., she added, “we’re still recording it” as a COVID-19 death.
However, Dr. Birx suggested COVID-19 deaths in January and February were likely underreported, due to a lack of testing. “When there wasn’t testing in January and February, that’s a very different situation and unknown,” she explained.
Guidance from Center for Disease Control and Prevention (CDC) says doctors should code all deaths as COVID-19 if “the disease caused or is assumed to have caused or contributed to death.”
“COVID-19 should be reported on the death certificate for all decedents where the disease caused or is assumed to have caused or contributed to death,” reads the CDC guidance issued in March. “Certifiers should include as much detail as possible based on their knowledge of the case, medical records, laboratory testing, etc. If the decedent had other chronic conditions such as COPD or asthma that may have also contributed, these conditions can be reported in Part II.”