Iowa reporting change adds 177 to virus death toll, may rise

DES MOINES, Iowa (AP) — Iowa has started reporting the COVID-19 deaths of people who were diagnosed with the virus but not tested, a change that boosted the state’s death toll by 177 on Tuesday and could add hundreds more to the count.

Iowa Department of Public Health Interim Director Kelly Garcia announced Monday night that Iowa now accepts clinical diagnoses from doctors and other medical professionals and not just positive virus tests when attributing a death to the coronavirus.

The change immediately increased the state virus death toll by 6.5%, to 2,898 from 2,721, and will be even more impactful once the new reporting system has accounted for all virus deaths.

The new reporting process removed 433 deaths from the system but added 610 to provide the net gain of 177. However, many of the 433 deaths removed could be added back in once the proper coding methodology is applied to the individual cases, IDPH spokesman Matt Highland said.

Garcia said the new methodology will be consistent with the way the CDC reports deaths nationally, enhancing accuracy of reporting as counts will be tied directly to official death records.

“That’s part of the accuracy here and the reason to make this change because it is a more fulsome picture of exactly what happened surrounding that death rather than a case investigation which had bits and pieces and accurate to the best of our knowledge, but this is really relying on the full medical record,” she said.

Since March, Iowa only counted a death as a COVID-19 case when there was a positive PCR test, which detects the virus’ genetic material, and the death was reported to state public health authorities through a death record or case investigation. This excluded cases in which a death was reported and matched with a positive antigen test, which detects specific proteins from the virus, or a physician listed COVID-19 as a cause of death but no positive PCR test reported.

The revised method is based on the CDC’s National Center for Health Statistics cause-of-death coding, which requires a death to carry an internationally recognized death classification that lists COVID-19 as the cause or a contributing factor to death, Garcia said. Coding is based on the registered death record completed by the health care provider. The new methodology does not require a positive PCR or antigen test result.

This methodology ensures that the number of COVID-19 deaths reported will match the official state vital statistics report, when eventually published, and will provide greater consistency between the number of deaths reported by federal, state and county government agencies, Garcia said.

The state has applied the new methodology retroactively to deaths reported to the state since March, resulting in the net increase in the number of deaths attributed to COVID-19.

Garcia acknowledged that the new coding will take approximately seven days to complete and return to the state, which will increase the time between when a death is reported to the state and the date it is published on the website.

Iowa has recently experienced a high number of deaths and last Friday reached a record high of 84 deaths reported in a single day, one day after 70 deaths were reported.

The seven-day rolling average of daily deaths in Iowa has risen over the past two weeks from 30 deaths per day on Nov. 23 to 45 deaths per day on Dec. 7, according to researchers at Johns Hopkins University. Those numbers were compiled before the state updated its database.

Prior to the update, the state had the 20th highest per capita COVID-19 death rate at 86.3 deaths per 100,000 people.

The department couldn’t immediately provide the number of deaths reported in the previous 24 hours excluding the newly added cases.

State data shows 1,395 new virus cases had been identified since Monday. The number of hospitalized patients increased to 900 and 111 people were admitted to hospitals in the previous 24 hours, up from 94 the day before.

Garcia also announced that the state is removing employment data from its online COVID-19 dashboard because the data was based on case investigation rather than finalized data.

“We will work with vital statistics to more accurately gather this data for future reporting, though it will no longer be reported in real time on the website,” she said.