MONTGOMERY, Ala. (WSFA) - Alabama passed a grim milestone Thursday, reporting more than 5,000 thousand Alabamians have lost their lives to COVID-19 since the pandemic started.
This week alone the Alabama Department of Public Health has confirmed more than 200 deaths, however some date back seven to eight months. State Health Officer Scott Harris, says it’s a lengthy process to confirm COVID-19 as a cause of death
“Every one of the deaths that we have reported to us is something we have to investigate,” Harris stated. “In some cases we have to look at medical records, even talk to medical providers, and sometimes families or medical examiners.”
COVID-19 is a notifiable disease, meaning those deaths must be reported to authorities. Cause of death investigations can be blurred when someone dies of a condition brought on by COVID-19, like pneumonia, or dies at home. Despite allegations of overcounting COVID-19 deaths, Harris says the numbers are correct.
“We have career epidemiologists who are long term public health professionals with a PhD, and what they do in their job is they count things correctly, that’s what they’re really good at.”
Some patients who are admitted for COVID-19 treatment remain in the hospital for lengthy stays, long after they’re COVID-19-negative. UAB refers to those patients as “COVID convalesced,” meaning they are no longer contagious but remain very ill from complications brought on by the virus. At the time of publication, UAB was treating 82 COVID19 convalesced patients.
Dr. Jeanne Marrazzo, UAB’s director of infectious diseases, says for those convalesced patients who don’t survive, determining the cause of death can be a challenge.
Marrazzo described a patient she treated who fell into this category. The patient was admitted with COVID-pneumonia and moved into the intensive care unit a week later. They continued to deteriorate and suffered from adult respiratory distress syndrome, or RDS. More than 10 days later the patient developed pneumococcal pneumonia due to the ongoing stress to their lungs.
“They’re getting multiple antibiotics, they can get complications from the antibiotics that we can’t prevent, and you are now trying so hard to keep them going and hopefully alive,” she explained. “Now you’ve reached the end of the month, and after 30 days they have a cardiac arrest or they have an episode of septicemia, or septic shock, from an infection that they acquired as the consequence of being so sick and in the ICU. That COVID diagnosis that drove them into the hospital so long ago may not show up on their death certificate.”
Situations like these are causing providers and epidemiologists to reexamine death certificates to determine if COVID-19 was properly labeled as the cause of death.
“Attributing deaths to COVID is going to be a real skill,” Marrazzo acknowledged. “It’s another reason that I think the toll of this pandemic on our families, our communities, everybody is really not going to become clear until we’ve had a chance to get our heads above water and go back and fix these sources.”