With the pandemic of COVID-19 we have seen things become politicized in a way and to a degree they never should. It’s not the first time we have witnessed this. Think back to the politization of vaccines we have witnessed by many. Currently, COVID-19 potential treatments have been politized with hydroxychloroquine. Some opinions are changing as more data and evidence is coming out. This is leading to options based on science, experiments and real data, not hunches or politics. But, desperate times cause for desperate measures. And, at the beginning we were definitely in desperate times.
Now, Governors are giving “guidance” to Medical Examiners and physicians on filling out death certificates. This is scary ground! A medical examiner is a trained physician. And, in many instances a pathologist with specialized training. A close friend and colleague of mine recently received “guidance” from one state to list the primary cause of death on death certificates as “COVID-19” if confirmed that they had the disease by testing OR “probable COVID-19” if suspected to have the disease but not tested. Yes, you read that right...suspected but not tested!
The cause of death section of a death certificate is designed to elicit an opinion. In some instances this might vary among individual physicians because it is an opinion. This is how a pathologist, especially a forensic pathologist, is trained and this is how the CDC explains a death certificate should be completed.
Keep in mind there is also a section on the death certificate for underlying causes. This is a section below the immediate cause of death for disease felt to initiate the final event. Making COVID-19 the primary cause of death in anyone who dies and has tested positive is without a doubt inaccurate in some cases. For instance, let’s say someone has a heart attack and dies. The cause of death is a myocardial infarct. However, if they had tested positive for COVID-19 upon admission, or before, physicians are being instructed that the cause of death should be COVID-19. This can be inaccurate and flat out wrong as COVID-19 could potentially be listed as an underlying cause, not the immediate cause of death.
I understand this is being done to help collect data, but it will definitely cause an overestimation of deaths due to COVID-19. In addition, it will cause some deaths to be contributed to COVID-19 that aren’t (remember the “guidance” of those suspected to have the disease but not tested).
Even more worrisome is how some state governments are instructing trained physicians on how to fill out a death certificate. The cause of death is an opinion that should be completed by an educated trained physician. Not a politician by proxy. This is now politicizing the pandemic even more and the data to help learn, study and make future decisions. Manipulating data is bad science! In fact, it’s not science!
I have no issue with politicizing healthcare policy. Just make it a healthy debate. But science, data, treatment and physicians trained judgment and autonomy should never politicized.
