Shari Rudavsky, Indianapolis Star
Published 6:02 p.m. ET April 20, 2020
The older, sicker residents in Indiana nursing homes make the environments particularly susceptible to the coronavirus. But there are other reasons why the disease has been so lethal there.
Indiana likely will see its coronavirus death count jump later this week when the state starts adding presumptive positive deaths to its tally.
Until now the state has included in its official count only the deaths of people who tested positive for the virus known as SARS-CoV-2, Indiana State Health Commissioner Dr. Kris Box said.
In some instances of death, however, the people never had a documented positive test, so the doctor listed COVID-19 only as an underlying cause. Now, the death count will be adjusted to include those individuals as well, Box said.
This will provide a more accurate tally of how many people owe their deaths to the virus, she said.
“This will cause our death numbers to show an increase that’s higher than what we’ve typically seen,” she said. “These are not new deaths. Rather we are capturing the deaths that have occurred really since this pandemic began.”
Each day the state lists how many deaths have been reported to state officialsin the past 24 hours. Not all of those deaths, however, occurred in the past day.
For instance, the seven new deaths reported Monday occurred in a five-day period between Wednesday and Sunday. In the past, some deaths have been reported as long as two weeks after the person died.
Earlier this month the Centers for Disease Control and Prevention issued guidance that allows providers filling out death certifications to report COVID-19 as probable or presumed if “the circumstances are compelling within a reasonable degree of certainty.”
In some cases, Box said, a patient’s symptoms, X-ray, and chest scans may all support a COVID-19 diagnosis even in the absence of a positive test. Because false negatives occur, a doctor may be confident the disease was to blame even if the test did not confirm it. In such instances that death will now count as a COVID-19 death.
This applies only to deaths, however. People with mild or moderate disease who either have not been tested or who received a negative result, even if they have symptoms consistent with the disease, will not be treated as though they are positive by public health officials.
The state receives notification of these milder cases only when there is a positive result. In those instances, the state reaches out to the person to ensure that he or she is self-isolating. They also do an investigation and let close contacts of the person know that they may have been exposed, Box said.
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