No one would say a year ago that 149 deaths in the first three weeks of a single illness in San Bernardino County could be considered a good sign.
But on the face of it, this could be due to the death toll in the coronavirus.
Unfortunately, infectious disease experts say that the number of deaths reported in recent months – and the 0.6% death toll listed on the country’s website – are likely to be much less than the actual death toll. This is especially true for the period before Friday 22 January and Saturday 23 January, which together cover 33 of the deaths, and thereafter counted seven days with a total of one death.
Since November 1, when the winter virus began, San Bernardino County has had nearly 200,000 new cases. Statistics that have proved accurate across the country indicate that between 2,000 and 4,000 of the people will not survive their illness. But the country has reported only 516 deaths since November, meaning hundreds or thousands of deaths are unlikely to be reflected in the statistics yet.
According to experts, the count could contain misconceptions about how dangerous the new coronavirus is.
“I just hope people who do not take the virus seriously now will not regret it later – ‘I wanted you to tell me how deadly it is,'” said Andrew Noymer, an UC Irvine epidemiologist specializing in . in mortality due to infectious diseases. “Consider yourself a notice: it’s quite deadly.”
Provincial officials acknowledge that deaths during the winter storm could not appear in statistics for months.
“We also experienced a delay when things went bad in July, and it took almost 6-8 weeks before some deaths were reported later,” country spokesman David Wert said in an email. . ‘will not have a true picture of all deaths in November / December that took place until March. ”
The province hopes to catch up soon from December 15 to January 7, according to a notice on the coronavirus dashboard. As a result, a number of deaths are expected to increase by a large amount over the next week as they are processed and recorded in the dashboard data ‘, reads the notice posted on Saturday 23 January.
Overloaded hospitals and record recorders are also leading to delays in other provinces, but statistics suggest it is currently on a different scale in San Bernardino County.
“These delays are normal, although they are often long,” Noymer said. “The compilation of death certificates is a bureaucratic process. It just takes a long time.
For example, Orange County still received death certificates for COVID-19 deaths that occurred in July and October, three months later, Noymer said.
Why more deaths are expected
Nationwide, the number of deaths due to COVID-19 is about 1.5% of the number of confirmed cases.
“But when the cases swell and the deaths fall sharply behind, there is a period in which the number is much lower than 1.5%,” Noymer said. “It looks like San Bernardino County is going through the period now.”
In the summer, the Centers for Disease Control found that the typical time between symptoms and a COVID-19 death nationwide was about two weeks, and that the average time between death and reporting death was just over a week. wash. Others analyzing coronavirus data found that there was a three-week delay between cases and deaths.
If the number of people dying from COVID-19 were between 1% and 2% of the number of known cases, and the delay between cases and deaths remained at three weeks, San Bernardino County could be expected to be approximately 825 to 1,650 would report deaths so far in January.
Instead, it reported 159 – less than a fifth of the expected minimum.
The formula was much more accurate in other provinces of Southern California.
Riverside County, which does not update numbers over the weekend, reported 792 coronavirus deaths as of Friday. It is at its lowest point of its expected range of about 760 to 1,520 deaths by Friday.
Los Angeles County reported 4,553 deaths, near the mid-expected range of about 3,025 to 6,050 deaths.
Orange County had an expected range of about 630 to 12.65 deaths and reported 672.
How to report a death
San Bernardino County typically takes two to three weeks to report a COVID-19 death, Wert said.
“Given the overwhelming burden on hospitals at the moment and the slowdown in the process in general, it is safe to assume that this period has increased,” he said. “… In general, there are several steps involved by various parties, all of which are currently inundated with COVID support duties so that things are delayed.”
First, the provider overseeing the care of a deceased person must complete a death certificate, he said. The provider must testify to the fact, cause and manner of someone’s death, which in addition to COVID-19 can be difficult for the elderly or people with serious health conditions.
Wert processed the coroner’s office, which is also backed up, depending on circumstances.
Records are then processed by County Vital Statistics, which can take up to eight weeks, Wert said. This office validates information, and often contacts relatives or others for missing information.
Finally, records go to the Department of Communicable Diseases for Public Health. Each case must be accompanied by a positive test, and the country determines whether the person died of COVID-19. Someone who had the disease but died of something else is not counted.
“If it is still unclear, the country is conducting another medical examination,” Wert said.
The process is similar in Riverside County, where Wendy Heatherington, head of Riverside County’s public health epidemiology unit, confirms every reported coronavirus death.
It can take up to two weeks to validate deaths that come from the office of the coroner or vital administration office. Although the number of deaths has risen, she remains inside the window, but it requires more work.
“I do more on weekends than in September,” she said.
Yet she said so many people are dying that the system could be overwhelmed, which may explain why another country has fallen behind.
“Yesterday (Wednesday) key staff members sent more than 83 deaths while I got five times a day in September and October,” she said.
It is understandable that the process will be lengthy, said Brandon Brown, a UC Riverside associate professor with a background in epidemiology.
“Like everything during pandemic times, many people involved in public health, including important reports, are completely overwhelmed because most public health departments were already underfunded before COVID-19,” he said.
But the delay has a consequence, and he said: “We can underestimate the true mortality rate of COVID-19.”