As of May 18, the Washington State Department of Health (DOH) has reported 18,433 cases of Coronavirus disease 2019 (COVID-19) and 1,001 deaths in Washington state due to the virus.
However, Freedom Foundation research indicates DOH’s reported COVID-19 death total is inflated by as much as 13 percent due to state’s practice of counting every person who tests positive for COVID-19 and subsequently dies, even if the death was not caused by COVID-19.
On Friday, the Colorado Department of Health and Environment revised that state’s total deaths “due to” COVID-19 downward from 1,150 to 878 after local news reported the state was inflating its fatality count in a similar fashion.
The Freedom Foundation has also confirmed DOH intends to start counting “probable” COVID-19 deaths among its totals, which will result in the inclusion of deaths of persons who had not tested positive for COVID-19.
Counting all COVID-19 positive deaths
The data regarding COVID-19 cases and deaths presented on the Washington State Department of Health’s (DOH) website is drawn from several different state databases and reporting systems.
When someone tests positive for COVID-19, the case is reported by public health staff to the Washington Disease Reporting System (WDRS) operated by DOH.
Deaths, however, are more complicated. DOH regulations require all deaths in Washington state be reported electronically via the Electronic Death Registration System (EDRS). This is the system used by funeral homes, coroners/medical examiners, hospitals and others responsible for completing death certificates.
Completing each “cause of death worksheet” involves listing the “immediate cause” of death, the “underlying cause(s)” that initiated the events culminating with the immediate cause of death, and “(o)ther significant conditions contributing to death but not resulting in the underlying cause.” These fields are completed based on the “best medical opinion” of the certifier.
While deaths are reported through the EDRS, the data are ultimately transferred into a DOH database, the Washington Health and Life Events System (WHALES).
To determine the number of COVID-19 deaths, DOH uses name and birthdate to match deaths reported through the EDRS and registered in WHALES to positive COVID-19 cases reported to WDRS. As DOH described it to the Freedom Foundation via email, “Any individual who has a positive COVID-19 test and subsequently dies is counted on the (DOH) dashboards.” (emphasis added)
Obviously, not every person who tests positive for COVID-19 and subsequently passes away dies because of COVID-19.
At the time it responded to the Freedom Foundation’s questions on May 8, DOH dashboards reported 828 total COVID-19 deaths. Of these:
- 681 (82 percent) “list some variation of ‘COVID-19’ in one of the causes of death” on the death certificate;
- 41 (5 percent) of the death certificates do not list COVID-19 as a cause of death, but indicate it was a “significant condition contributing to death.”
- 106 (13 percent) deaths involved persons who had previously tested positive for COVID-19 but did not have the virus listed anywhere on their death certificate as either causing or contributing to death.
Probable vs. confirmed deaths
According to DOH, the number of COVID-19 deaths reported so far include only individuals who have tested positive for the virus at some point.
In its May 8 response to the Freedom Foundation, DOH stated, “All of the deaths currently attributed to COVID-19 had a positive PCR (polymerise chain reaction) test at some point. A PCR test is required in order to classify something as a confirmed case.”
However, some DOH documents appear to contradict this claim and suggest that DOH has included suspected COVID-19 deaths in its totals, and not just cases in which the decedent had previously tested positive.
DOH’s “Preliminary Guidance for Reporting COVID-19 Deaths” provides: “Coronavirus Disease 2019 or COVID-19 should be reported on the death certificate for all decedents where the disease caused, or is assumed to have caused, or contributed to death.” (emphasis in original)
Another DOH COVID-19 fact sheet makes a distinction between “confirmed” cases of COVID-19 in which the patient tested positive and “probable” cases involving any of the following factors:
- “Compatible clinical syndrome AND epidemiologic link with no confirmatory test result; OR
- Positive antigen or serology with compatible clinical syndrome OR epi link; OR
- Death certificate includes COVID-19 with no confirmatory test result”
(emphasis added)
Regardless of whether DOH has previously included suspected COVID-19 in its totals, DOH also informed the Freedom Foundation that, based on guidance from the Council of State and Territorial Epidemiologists (CSTE), it will begin to include “probable” but untested cases of COVID-19 in its count in the near future, which will presumably result in an increase in reported COVID-19 cases and deaths.
Conclusion
Given the extreme measures taken by Gov. Jay Inslee and local officials to combat COVID-19, it is critically important the public be provided with accurate information about the severity of the virus. Most reasonable people will likely assume the number of COVID-19 deaths reported by the state represents people who died because of the virus.
Counting COVID-19-positive persons who died from other causes and including the deaths of persons who have not tested positive for COVID-19 — without disclosing either of these facts on the DOH dashboards the public and media rely on to monitor COVID-19 cases and deaths — calls into question the trustworthiness of government officials directing the COVID-19 response.
It also makes it harder for the public to determine at what point the costs of the continued lockdown imposed by government officials may outweigh the damage done by the virus.
As the Freedom Foundation has previously documented, most of the persons advising Gov. Inslee on the process of re-opening the state are donors to his campaign. Inflating the number of COVID-19 deaths further suggests Washington’s COVID-19 response has become politicized.
