COVID-19 vaccines could one day end the pandemic. But at the moment, cases — and deaths — continue to rise. So does misinformation about the disease.
One comment often seen on social media is that deaths are being attributed to COVID even when the patient died of something else. Dr. Sonal Shah, a hospitalist at Southern Illinois Healthcare, says some of that confusion may come from death certificates having two fields.
Part one is the field where doctors enter the cause of death.
“With COVID patients, there are three different sections on this part one. COVID is always listed in that part one in those three sections, if their death was related to COVID,” Shah says.
If a patient dies before being admitted, they are still tested in some situations.
“If they are concerned for if the patient had covid, symptoms, fever, shortness of breath, and they did not get tested, they get tested after death,” Shah says.
On part two of the death certificate, doctors detail the patient’s other conditions — even if they were not the direct cause of death. Like heart problems or a lung disease known as COPD.
“So like our patients, when we have them, we have a part two, and we list that if they had also high blood pressure, high cholesterol, COPD, coronary artery disease, those kinds of things we list in the part two,” Shah says.
If a patient died of something other than COVID — say, a car accident — then that death would not be counted with the Illinois Department of Public Health’s COVID deaths.
If anything, that could lead to an undercounting of COVID deaths, says Josh Miksanek, an emergency room physician with Southern Illinois Healthcare.
He gives the example of an elderly patient hospitalized for COVID, who is discharged to a nursing home and dies of an infection or other illness contracted there. Miksanek says that death wouldn’t be counted as COVID-related — even though it could be traced back to the original hospitalization.
“Man, it seems like that started ... the downward spiral,” Miksanek says, referring to the initial COVID hospitalization. “And so, you know, in America, we're not counting COVID deaths that are people that die 30, 60 days out from COVID.”
Another bit of misinformation downplays COVID’s danger, while comparing it to the flu. Miksanek says people should actually have more confidence in reports of COVID deaths, which are confirmed by testing.
“If you look at the way flu deaths are determined, we don't determine flu deaths, like we do COVID deaths,” he said. “If you go to the CDC website, they do actuarial calculations. They take pneumonia deaths, they take all kinds of respire deaths, they take a percentage of deaths during flu season, and they attribute those to the flu.”
Illinois had just over 2,500 deaths in the 2018 flu season, according to CDC data. As of Dec. 9, the state has recorded more than 13,000 COVID deaths.
Miksanek says while both COVID and flu tend to be more dangerous for older patients, COVID deaths include younger people as well.
He’s in his late 30s, and he recalls a conversation with an elderly woman who was being admitted to the hospital for the flu. She asked why he wasn’t wearing a mask.
“Oh, I'm exposed to flu every day, I'm not worried about the flu,” he says. “You know, I'm young, statistically, I'm not going to die of the flu. And it doesn't scare me at all.
"But COVID does scare me. Because even being relatively young and healthy, there are definitely many people in their 30s that get very sick. It's not like everyone is going to get sick, it's just ... it's too hard to really predict who's going to get sick.”
Shah and Miksanek can’t address every bit of misinformation about COVID. But there are places to get the facts online, including the CDC and World Health Organization, or major health groups like the Mayo Clinic and Johns Hopkins.
This story was produced by Side Effects Public Media, a news collaborative covering public health.