ORLANDO, Fla. – During the coronavirus pandemic, misleading theories have taken the internet by storm, fueling misinformation in the wake of the health crisis.
One message making the rounds is a claim that hospitals are logging all deaths as coronavirus-related. We decided to run these claims through our Trust Index to see if there’s any credible evidence that can support or debunk these statements.
Here’s what we found.
Hospitals are counting all deaths as coronavirus-related
Many viral posts suggesting the COVID-19 death toll is inflated is incorrect, according to FactCheck.org.
In fact, medical experts believe disparities are resulting in an undercount. They attribute a lack of testing in underserved communities, difficulty in outreach for the homeless population and uncertainty about whether at-risk patients died from pre-existing conditions and were never diagnosed with COVID-19 and maybe never received proper treatment.
There are other posts circulating that are more specific, claiming “the state” has ordered that “anyone who didn’t die by a gunshot wound or car accident” should be listed as a COVID-19 victim.
Death certificates are a little more complicated than that.
The federal documents often offer more than one section to list a cause of death and what led to it. Although they may vary by state, according to FactCheck.org, there’s no evidence that any state has adopted a “default diagnosis” or “blanket COVID-19” policy.
A quick search of Florida statutes related to coronavirus or public health proves this to be true in the Sunshine State. During the COVID-19 pandemic, medical examiners are the ones certifying coronavirus deaths.
“Normally these COVID-19 deaths wouldn’t be our jurisdiction,” Orange-Osceola Chief Medical Examiner Dr. Joshua Stephany said. "Because this was a state of emergency, for tracking purposes, we’re the only ones reporting these deaths.
Despite the CDC’s guidance on how to report coronavirus-related deaths, Florida has decided to take a stricter approach. Unless it is confirmed the deceased had coronavirus their cause of death won’t include the virus.
“If they have not tested positive they will not be put down as COVID-19,” Stephany said. He explained that if a patient was suspected of having coronavirus, they can be tested after they’ve died, but this is a less common case.
“Most people don’t die instantly from COVID-19,” Stephany explained, citing days of hospitalization or a doctor’s visit precede a coronavirus-related death.
In Florida, the state department of health barred the Medical Examiners Commission from releasing their own information regarding coronavirus-related deaths. According to News 6 partner Florida Today, at times the Medical Examiners data tallied more deaths than the FDOH.
Stephany clarified that at least within his jurisdiction, his office may have a higher death toll because of how they count the data versus the FDOH.
He explained the FDOH reports by county of residence whereas a medical examiner would report by where the patient died, contributing to differing numbers.
“There’s no right or wrong,” he said. “Those deaths are being reported somewhere.”
Hospitals are reporting more COVID-19 deaths to get more money
Hospitals are receiving additional financial support to help handle the health crisis, but there’s not much information linking coronavirus deaths to relief money.
Though hospitals do have the potential to misclassify coronavirus cases and deaths, there’s little evidence to believe this is intentional or financially motivated.
This misleading statement can stem from a meme circulating on social media that claims hospitals get an extra $13,000 if a patient’s cause of death is diagnosed as COVID-19, and the price tag triples when the patient was on a ventilator.
These numbers seem to align with the estimated Medicare payments for coronavirus hospitalizations. The federal health insurance program covers people 65 and older -- the population considered most at risk for contracting COVID-19. These numbers were also the same before coronavirus, according to FactCheck.org. This provides little motivation as coronavirus-related deaths are under more scrutiny as public health officials work to confirm data on the pandemic, meaning there’s more risk to falsely reporting.
It is important to note the Cares Act also provided $175 billion to hospitals and healthcare providers involved in the coronavirus response. This is to help reimburse hospitals for treating uninsured patients with the virus. For perspective, an America’s Health Insurance Plans study shows the average cost to treat a hospitalized patient with coronavirus is $30,000.
If looking for a nefarious reason for hospitals to over-report coronavirus deaths, the risk for medical professionals to do so could have lasting consequences. Such malpractice can result in civil or criminal lawsuits with all medical staff involved.
Hospitals are tallying more coronavirus deaths because they don’t know how to report it
There’s a standard in place to report deaths, and the Center for Disease Control and Prevention provides guidance about what the protocol looks like in reference to the coronavirus.
It explicitly states, “When reporting cause of death on a death certificate, use any information available, such as medical history, medical records, laboratory tests, an autopsy report, or other sources of relevant information.” The document also provides guidance on how to indicate if the deceased is under investigation for contracting COVID-19, strongly encouraging certifiers to test for the virus whenever possible.
Certifiers are also guided to contact their local medical examiner or coroner with questions, as is practice when referring to deaths involving public health.
In Florida, hospitals and family members are required to report these deaths to medical examiners. Medical examiners are also reviewing death certificates and investigating if there are any discrepancies in information before confirming a death was related to COVID-19.
Stephany explained in Florida, the death count is looked at twice because of reporting procedures. Hospitals are required to report numbers to the state and to a medical examiner’s office.
“They’re not counted twice,” he clarified. “They’re reported twice. We’re getting as accurate as we can get.”
Why are death tolls rising, but fewer cases are being reported?
This goes back to death certificate certifiers doing what they can in their power to confirm someone died of COVID-19.
Some states and countries are revisiting their death tolls after a patient was suspected of having COVID-19. For an accurate count during a health crisis, public health officials may confirm coronavirus-related deaths through additional tests done by a medical examiner or other lab tests.
There’s also the occasional hiccup in reporting when it comes to testing. In Orange County, coronavirus numbers seemed to have been skewed due to an influx of recently received test results. The county’s health department director, Dr. Raul Pino, explained the issue was likely due to a backlog at a lab in which they were processed. Instances like these could delay confirming whether a deceased passed away due to illness related to coronavirus.
Stephany said ultimately, it’s a matter of wanting to know whether how many people have coronavirus versus how many people die from it. He says when it comes to deaths, if a person does not test positive they don’t attribute it to COVID-19. There has to be other supporting information like symptoms and respiratory-related hospitalizations as well.
“It all depends how accurate your test is,” Stephany said. “You got to take the false negatives with the false positives. It’s never going to be 100%.”