If you’re following the Oklahoma State Department of Health’s coronavirus reports, you’ve probably seen the daily death figures. They detail where the victims lived and their age range.
You might also notice a note included every day: Few to none of the deaths occurred in the past 24 hours and some can be a month old.
How?
State Epidemiologist Jared Taylor says he had similar questions before he took his current position this summer. Until then, he was patrolling coronavirus data as a researcher. Now he works with a surveillance team, a group of epidemiologists whose full-time jobs are tracking the coronavirus.
“It's not because the health department has these folks doing six different tasks and no one is paying attention to this and, oh, somebody's been dead for a month,” he said.
How the reporting works has some variables.
First, where did the person die? Most die in a medical setting, like a hospital. In that case, the medical professional tasked with record-keeping gives the State Department of Health two reports. One, the death certificate, goes to the department’s vital records division. That happens with all deaths. But with COVID-19 deaths, there’s another that goes into the department’s public health infectious disease system. It notifies the surveillance team of a COVID-19 death.
That shouldn’t take much time, but it is an opportunity for a hiccup. Overwhelmed hospital or nursing home staffs can forget to update the infectious disease database, leading to a delay in that death’s reporting to the state.
Here’s another variable: had the victim already been diagnosed? That’s typical. And if so, that surveillance team already has a case file on the person, so it is simply updated.
If the person had been diagnosed, but died outside of a medical setting, the surveillance team obviously wouldn’t get the death notice from a care provider. However, each infected person in the system is assigned to a surveillance team member who tracks that case either to recovery or to death. It would be their responsibility to find that death, which would lead to a longer delay on reporting.
“And, you know, as you know, this is a database of tens of thousands of cases at this point,” Taylor said. “And some of them are closed and retired … but I mean, they're still scanning a large group of cases and identifying these deaths. And then they have to open that file up, every individual file.”
One of the longest delays would come if the person hadn’t been tested and entered into the infectious disease system, but still had COVID-19 listed on their cause of death on the death certificate. The surveillance team has to investigate.
“We would call a sniff test, right?” Taylor said. “Does this make sense? Is there a listing of symptoms and conditions that would be consistent with them having died of this disease? If yes, the death goes into the reporting system.”
But if not?
“If there's no symptoms listed there, then they may need to go to vital records and try to pull a death certificate and see.”
The investigation would continue.
Taylor says he wants to reiterate this surveillance team is tracking COVID-19 as a full time job, 7 days a week. That’s something outside onlookers, like he used to be, might not realize.
