Until Friday, nearly a quarter of the people reported as coronavirus deaths in state statistics didn’t have the virus listed on their death certificates the state Health Department said Friday, adding uncertainty to how many people the virus has killed.
The number of coronavirus deaths in state figures topped 1,000 earlier last week, and the number stood at 1,150 deaths as of Friday afternoon. But officials with the Colorado Department of Public Health and Environment revealed during a call with reporters that the number does not represent the number of people who have died due to COVID-19, the disease caused by the coronavirus.
Instead, the death figure CDPHE has been providing for weeks is more accurately described as the number of people with COVID-19 who have died – for any reason. The number of people who have died and have COVID-19 listed on their death certificate is 24% lower – 878, according to CDPHE’s latest figures.
“We recognize that there certainly has been confusion around this topic,” Dr. Rachel Herlihy, the state epidemiologist, said during the call.
But even this latest revelation does little to clarify the battle over the virus’ death toll, which has become one of the most contentious and politically rancorous fights of the pandemic. A Republican state representative has called for a criminal investigation of CDPHE. The coroner of Montezuma County joined the media call unexpectedly Friday to question state officials about their reporting of death numbers. Politicians and activists across the country have engaged in heated debate about how the pandemic’s toll has been inflated.
The issue drew a pointed response from Gov. Jared Polis at his news conference Friday.
“What the people of Colorado want to know is not who died with COVID-19, but who died of COVID-19,” said Polis, who has rarely expressed such public frustration with his health leadership. “And the numbers are very close, of course. There’s only a few cases that we’re aware of where there is some gray area. But where there is a gray area, we should always use – for reporting – the numbers that come from the physician or the coroner that actually addressed the patient or inspected the body.”
At issue are two systems for reporting COVID-19 deaths, CDPHE said. The one with the higher numbers is an epidemiological surveillance system that tracks deaths of people diagnosed with the disease. The other records causes of death on death certificates by county coroners, doctors or medical examiners.
Dr. Eric France, CDPHE’s chief medical officer, said the state’s surveillance-system reporting is in line with federal guidance and matches how other states are also reporting deaths, allowing for a quick apples-to-apples comparison across states. Death certificate data also gets reported to the federal government, but it can take weeks or months for those numbers to trickle in. Having uniform surveillance definitions across states is vital for tracking the spread of the virus and allocating resources, France said.
“Having that standard measure so that I can be confident that the way we’re measuring it and the way it’s being measured in Texas or Florida is the same really is important for the whole nation in how it manages this pandemic,” he said.
The conflict between the two systems boiled over this week after the Montezuma County Coroner’s Office disputed the state’s claim of a third fatal case of the coronavirus in Cortez, as reported Tuesday by The Journal. Also, state Rep. Mark Baisley, R-Roxborough Park asked 18th Judicial District Attorney George Brauchler to investigate whether CDPHE broke the law by classifying several deaths at a Centennial senior living facility as coronavirus deaths, as first reported by 9News.
Deavers said Tuesday the person tested positive for COVID-19, but an investigation by him and the pathologist determined the cause of death was ethanol toxicity. His blood alcohol content was .55, Deavers said. A BAC of .3 is considered lethal.
“COVID was not listed on the death certificate as the cause of death. I disagree with the state for listing it as a COVID death, and will be discussing it with them this week,” he told The Journal.
Both men accused CDPHE of changing death certificates to add COVID-19. But CDPHE officials denied it, saying there was confusion about the reporting systems. Death certificates are not public records under Colorado law.
“We do not change death certificates and have not changed death certificates,” said Kirk Bol, the head of CDPHE’s vital statistics program.
The answer clearly didn’t satisfy Deavers.
“You guys record every COVID case that dies, whether that is the cause of death or not,” he said. “To my knowledge, you don’t do that with influenza, is that correct?”
Herlihy said influenza is reported differently but there are other diseases where the same dual-system reporting occurs. “Most of the time, the cases … do line up very closely. But there can be slight discrepancies,” he said.
To add to the confusion, Bol said he expects the numbers from the two reporting systems to “converge” over time. That’s because death certificates can sometimes take weeks to complete. So, it’s possible some of the deaths in the gap between the two systems might not have a death certificate yet.
Overall, France said, far too many people are dying from COVID-19 and that it is important to remember that “every number has a name.”
Polis said he would order CDPHE to clarify its public death-reporting, though he called the idea of criminal charges for state health officials, “inappropriate.”
“Nobody behind a desk should ever second guess a coroner or an attending physician that lists a cause of death on a certificate,” Polis said. “The department will tell you they have to report that higher number to the CDC. They have to report under federal guidelines the number that have had COVID and died. But we should also make public the people who have died from COVID. And I’m going to make sure that they do that in a way that engenders the full confidence and support of the people of Colorado.”
The Journal contributed to this article.The Colorado Sun is a reader-supported, journalist-owned news outlet exploring issues of statewide interest. Sign up for a newsletter and read more at coloradosun.com.