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How are COVID deaths counted? Some say politics come into play

“To me that’s the ultimate test, if there’s COVID in there, should it have been used to determine that the cause of death was related to COVID?”

NEW ORLEANS — When COVID-19 deaths in the U.S. went beyond 500,000 this week, there was a lot of attention paid to that figure. It also prompted some people to question how COVID deaths are determined.  

An online and often political debate raises a recurring question:  If a COVID victim had an underlying health condition, did that person die “from” COVID or is it more accurate to say that person died “with” COVID?  

Some claim the COVID death toll is inflated and the media uses that to cause undue concern. 

“It makes me angry when I say my mom died from COVID that they feel the need to clarify that or to question that.  I don’t think they would appreciate me questioning why their mother died,” Joan Soboloff said. 

Her mother, 97-year-old Myra Soboloff, died in late December. Joan says before her mother died, she tested positive for COVID just one week earlier.

She says there’s no question her mom died from COVID.

“She was eating fine, all of her internal organs were working fine, all of her vitals were great.  She got COVID on Monday, December the 21st, then she was dead the following Monday.  So, there are no ifs, ands or buts,” Joan said. 

On her mother’s initial death certificate, a physician listed the cause of death as “senile degeneration of the brain."  COVID-19 was not mentioned.  

After persistence from Joan in the form phone calls and emails, the same doctor sent a letter to New Orleans’ office of Vital Records looking to correct several items, including the immediate cause of death.  The doctor stated the immediate cause of death should be COVID-19.  Joan says these facts aren’t political, they’re personal.  

“I’ve been questioned as to why I was fighting so hard to get it clarified, and yeah, politics does come into it and it shouldn’t.  It’s my mom. She died.  It should say what she died from on her death certificate and it should be accurate,” Soboloff said.   

“To me that’s the ultimate test, if there’s COVID in there, should it have been used to determine that the cause of death was related to COVID?” said Dr. Edward Trapdio, an epidemiologist and associate dean for research at the LSU School of Public Health. 

Dr. Trapido said there are strict guidelines when deaths happen in hospitals, but physicians do have some discretion in making those judgments.  That said, Dr. Trapido says the focus for physicians is on care, not what’s making headlines.

“They’re so busy, they’re not going to think, what are the political implications of whether I call this COVID or not," he said.

Dr. Trapido says the current estimate of half-a-million COVID deaths in America is accurate, but the actual figure is likely higher.  

For Joan Soboloff, the most important number is the one attached to her mother.  Joan says a new death certificate for her mother will be sent to her in about four weeks.    

The doctor on the death certificate works for the Ochsner Health system.  Due to patient privacy laws, Ochsner Health said it could not comment.

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