Garfield Coroner explains lag in COVID death reporting, as mortalities increase
Glassmire says COVID definitely the main cause of most of county’s deaths to date
An early November death in Garfield County that has since been attributed to COVID-19 highlights the challenges in ultimately making that determination, and why state and county statistics on COVID deaths don’t always match up.
Garfield County Coroner Rob Glassmire said in response to questions from the Post Independent about the discrepancy that, in that particular case, his office was summoned to the scene Nov. 12 when a man in his early 50s was found dead by his roommates.
The cause of death was unknown and suspicious, so that’s why the coroner got involved, he said.
“The roommates of the person indicated the decedent had a cough, fever, etcetera, but he had no COVID-19 diagnoses,” Glassmire said.
Through the ensuing autopsy and the pathologists findings, it was determined to be a COVID-19 death. But that information didn’t come forth until last week, the coroner said.
“Typically, the forensic pathologist gets us his reports in 3-5 weeks depending on when toxicology gets back from the lab,” Glassmire said. “That is why that case took a little longer.”
Also, when the first of two COVID-19 deaths at the Colorado State Veterans Nursing Home in Rifle was reported to the state after that death occurred Nov. 25, the coroner was not notified.
“We became aware of that death through public health on Nov. 30,” Glassmire said of the lag time involving reporting of that and other deaths that have occurred at long-term care facilities.
Those facilities don’t typically notify the coroner of natural deaths. “We have since communicated and they know to call us on the COVID-related deaths,” Glassmire said.
Reporting COVID deaths
The coroner, which is an elected office in Garfield County, also explained the state and county discrepancies in COVID-19 death reporting during the weekly public health update that was part of the county commissioners meeting on Monday.
A week ago, the county was still reporting six deaths related to COVID-19, while the Colorado Department of Public Health and Environment (CDPHE) was reporting 10 deaths in the county.
Garfield County Public Health on Monday confirmed five new COVID-19 related deaths in the county, bringing the total to 11. As of Tuesday, another seven deaths believed to be COVID-related were pending the coroner’s investigation.
The newest deaths in Garfield County occurred between the second week of November and the middle of last week, according to a Monday news release from the county. More pending cases have been added to the list since then.
Two individuals who recently died were a male and a female in their early 60s, and another was a male in his mid-70s, according to the county’s release.
A male and female, both in their 90s and residents of the Rifle Veterans Home, also ultimately died due to COVID-19 related illness. The Veterans Home remains in lockdown after a coronavirus outbreak now involving numerous residents and staff was reported there in early November.
The latest individuals who died were not related, according to the statement from Garfield County.
Glassmire explained to the commissioners that the cause of death must be verified by the coroner’s office before being reported on the county’s COVID-19 online data page.
That’s why there’s often a lag in the two reporting platforms, he said.
Until this week, Garfield County had not reported a new COVID-19 death since Nov. 12; the county’s sixth at the time.
In total, eight COVID-related deaths in Garfield County were reported to the state between Nov. 30 and Dec. 6, Glassmire said.
The youngest was age 53, and the oldest was 98, he said. Five of the last 10 were male, and five were female, he said.
“My guess is the holidays played a role in the delay,” Glassmire said in a follow-up response to the Post Independent.
“In many of the hospital or care facility deaths, the coroner’s office doesn’t respond,” he said. “We review medical records, consult with the patient’s treating doctor, and talk with families.
“With COVID-19, as well as other causes of death, we want to make sure that the disease in question played a role in the person’s death,” Glassmire added. “In many deaths this is well documented by the medical records and family statements.”
Cause or contributing factor
In most of the Garfield County COVID deaths to date, the individuals likely would not have died when they did, were it not for having contracted the virus, Glassmire also said during the commissioners discussion.
The state does make a distinction in the way COVID-related deaths are reported, between those “due to COVID” and “deaths among cases” of COVID, which gets to the presence of underlying health conditions among COVID patients.
That’s an important distinction, Glassmire said, but it’s also important to note that the coronavirus disease was a contributing factor, nonetheless.
In most of the county’s cases, “we can say that, had they not gotten COVID, they would not have died today,” he said, referring to the date of death indicated on a death certificate.
Of the 16 deaths in the county attributed to COVID-19, “I do feel that at least 13 of those people would still be with us today if they hadn’t gotten COVID,” Glassmire said.
When CDPHE reports a COVID death before the coroner has certified the cause of death, that information often comes directly from a family member or a reporting facility, such as a nursing home or hospital, when there’s a known coronavirus connection, he explained.
Initially, that gets reported by the state as the more general “death among cases,” and only moves to the “due to COVID-19” category once the local coroner issues the formal cause of death certification, he said.
“Even if it turns out not to be COVID, it would show up (as a death among cases) first,” Glassmire said. “So, we’ve adjusted our reporting to show that.”
Of the official deaths in the county, six were residents of a long-term care facility, Glassmire also said.
Most did have “other significant health conditions,” he acknowledged. But that turns out to be the case in almost all natural deaths, Glassmire said.
“With any natural death, there’s usually some other condition in that person’s medical history, or that had gone undiagnosed,” he said. “Even young people who die tend to have other conditions, or were immune-compromised.”
Glassmire was also asked how many suicides Garfield County has seen this year during the pandemic, given the heightened concerns about people being isolated and possibly suffering from mental health problems.
To date, Glassmire said there have been 14 certified suicide deaths this year. That number for all of 2019, before the pandemic was declared, was 25.
“That was an unusually high year for us in terms of the number of suicides,” Glassmire said.
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