How medical examiner determines COVID-19 as primary cause of death

Sep 3, 2020, 5:37 PM
COVID-19 cause of death restrictions...
Gov. Gary Herbert addresses reporters via video conference on Thursday, Sept. 3, 2020. The state medical examiner addressed how COVID-19 deaths are determined. Screen grab from KSLNewsRadio.com

SALT LAKE CITY — Are coronavirus death numbers in Utah being overinflated or underreported — or are they accurate? The state medical examiner explained how health departments determine COVID-19 as the cause of death during a news conference Thursday.

“We have this rumor out there that somehow people are dying, but we label it COVID-19 when it’s  something else that they’re dying from,” said Gov. Gary Herbert during the Thursday weekly update. “So we’re mislabeling them for whatever reason, like there’s a conspiracy going on.”

Dr. Erik Christensen, chief medical examiner at the Utah Department of Health, also disputed this — addressing how the state Medical Examiner’s Office (OME) pinpoints COVID-19 as the main cause of death.

This comes as Utah reported four additional COVID-19 deaths Thursday, bringing the state’s total to 414 since the pandemic began.

The U.S. reports more than 6 million cases of coronavirus and about 186,000 deaths attributed to COVID-19 as of Thursday.

Determining COVID-19 as cause of death

The OME is tasked with investigating and reporting all deaths resulting from diseases deemed a threat to public health.

“There has been much discussion about what constitutes a death from COVID-19,” Christensen said. “With so many individuals having advanced stages, as well as comorbid conditions, how can we be sure that people are not just dead from these other illnesses and processes that were already going on in their bodies?”

Christensen said underlying conditions shown to contribute to COVID-19 deaths include respiratory failure, acute lung injury, sepsis, abhorrent inflammatory responses, blood clots and a variety of others.

Potential risk factors involved in coronavirus deaths include diabetes, hypertension and obesity, among others, he said.

When a death is reported, OME investigators take a history of events from reporting parties, including a review of circumstances and events that led up to the death. This includes medical history and issues, exposure to COVID-19, a list of positive test results and the date the tests were given.

After the original report, the OME requests records from hospitals, long-term care facilities, hospice organizations and occasionally law enforcement.

Sometimes a follow-up investigation is done with family members and certifying physicians to gain clarity on what occurred during the person’s final days and hours.

Most of the deaths investigated by the OME are reported to the state health department, which are then reported publicly.

Confident in state numbers

Christensen said almost all cases of death originally investigated as caused by COVID-19 end with the same determination.

“Rarely does the information that we receive outfront turn out not to be the case,” he said. “Which is also true for deaths not related to COVID-19.

A death certificate is changed whenever a death, originally reported as the result of COVID-19, is determined not to be primarily caused by coronavirus, Christensen said.

The health department detects false COVID-19 deaths in about 1% of cases, according to Christensen.

Deaths from trauma and drug intoxication are not reported as COVID-19 deaths, but if the decedent tests positive for coronavirus, it is reported as such, he said.

“All deaths reported in Utah to date have been based on positive test results as well as a history consistent with COVID,” Christensen said.

“The robust system of checks that we have in place to identify the deaths, the investigative review process that we have to ensure that what is reported is consistent with that certification as well as the normal processes of the OME to ensure that deaths from COVID-19 that occur outside the medical-care system are also found and identified,” Christensen said.

All deaths in Utah reported to the OME are thoroughly reviewed in-depth to ascertain whether COVID-19 is part of the cause of death.

Christensen said he is confident in the state’s coronavirus numbers being reported.

Today’s Top Stories


QAnon Utah race...
The Associated Press

Utah’s GOP Congressmen defeat primary challengers

Utah's four GOP congressmen win primary elections, move on to November's general election.
1 day ago
Two people were injured in a two-vehicle crash Tuesday morning in Brigham City....
Mark Jones

Two people injured in Brigham City two-vehicle crash

Brigham City emergency personnel responded to a two-vehicle crash Tuesday morning that sent two people to the hospital.
1 day ago
FILE - Sen. Mike Lee, R-Utah, addresses a crowd during a rally on April 25, 2014, in Sandy, Utah. T...
The Associated Press

Sen. Mike Lee fends off 2 opponents to win Utah GOP primary

Utah Sen. Mike Lee claimed a victory Tuesday night in the state's primary election, defeating two challengers.
1 day ago
Gov. Spencer Cox announced Utah Court of Appeals Judge Jill M. Pohlman is his nominee to serve on t...
Mark Jones

Gov. Cox announces Utah Supreme Court nominee

Utah Court of Appeals Judge Jill M. Pohlman is Gov. Spencer Cox's Utah Supreme Court nominee as announced Tuesday.
1 day ago
Remaining permits for elk and deer hunts this fall will be available to purchase in July....
Mark Jones

Remaining deer, elk permits can be purchased in July

Remaining deer and elk permits for hunts this fall will be available to purchase in July.
1 day ago
A crowd gathers in front of the Utah State Capitol on Friday, June 24, 2022, to protest the U.S. Su...
Becky Bruce

Different abortion law now in effect in Utah

A different abortion law is now in effect in Utah, and it bans abortions after 18 weeks of pregnancy. However, there are several exceptions to this law.
1 day ago

Sponsored Articles

Tax Harassment...
Jordan Wilcox

The best strategies for dealing with IRS tax harassment | You have options!

Learn how to deal with IRS tax harassment. This guide will teach you how to stop IRS phone calls and letters, and how to handle an IRS audit.
spend a day at Bear Lake...
Bear Lake Convention and Visitors Bureau

You’ll love spending the day at Bear Lake | How to spend a day at Bear Lake

Bear Lake is a place that needs to be experienced. Spend a day at Bear Lake.
Curb Appeal...
Price's Guaranteed Doors

How to have the best of both worlds for your house | Home security and curb appeal

Protect your home and improve its curb appeal with the latest security solutions like beautiful garage doors and increased security systems.
Prescription opioids can be disposed of during National Prescription Take Back Day...
Know Your Script

Prescription opioid misuse | How to protect your family from the opioid epidemic

Studies have shown that prescription opioid misuse has increased since COVID-19. So what do you need to know about these opioids?
Follow @ikeyospe...

Tax Tuesday: The Most Common Mistakes People Make When Filing Their Taxes

Fortunately, for most average earners, they will not end up owing overpayments received for the Child Tax Credit in 2021.
Follow @ikeyospe...

Tax Tuesday: How will last year’s child tax credits affect you?

Fortunately, for most average earners, they will not end up owing overpayments received for the Child Tax Credit in 2021.
How medical examiner determines COVID-19 as primary cause of death