With new questions and answers evolving around COVID-19 coming out of the medical community almost daily, questions arise about the cause of death of people who died at home, and if they were COVID-19-related. If COVID-19 related, were they tested and included in the Dutchess County death counts?

According to Dutchess County’s Communication Director Colleen Pillus, the answer is yes. “Any positive results received by the medical examiner are included in the Dutchess County Data Dashboard,” she told A Little Beacon Blog by email.

According to Medical Examiner Dr. Dennis Chute, those who die at home and test positive for COVID-19 are being counted. Dr. Chute explained the process to A Little Beacon Blog by way of Colleen: “If an individual dies at home, the death is called into our office and a medicolegal death investigator takes the call, usually from the police dispatcher. If the decedent was on hospice, then our office releases the case, does not respond to the scene, and the death certificate is done by hospice.”

“If the individual is not on hospice care,” he continued, “then the medical examiner responds to the death scene, and either the medical examiner or the private medical doctor must sign the death certificate. In these cases, the medical examiner will decide whether to bring the decedent to the medical examiner's office depending on the circumstances and medical history. In non-hospice cases, if the history is consistent or suspicious for COVID-19, but if there has not been a premortem test done, we will take a specimen for COVID-19 testing.”

Since the week of March 12, 2020, there has been approximately 20 cases tested at the medical examiner’s office. [UPDATE 4/30/2020]: Of the 20 people who died at their homes since March 12, 2020, seven of them tested positive for COVID-19, said Colleen, who received the number from the medical examiner’s office.

We are also awaiting an answer about whether the number of deaths at home is higher than the period compared to the previous year. [UPDATE 4/30/2020]: Colleen has responded that she does not at this time have the comparative data on those who died at home during the same period the previous year. “That would take some significant time to pull, and I am not sure when someone at the ME’s (medical examiner’s) office will have the opportunity to do so.”

Heart Attacks and COVID-19

Recently heart attacks and strokes are being studied as doctors are understanding more about how the disease attacks the body. An article at Kaiser Health News has pulled together two sources, Politico and ABC News, following the question of heart attacks as it pertains to New York and patients here.

Politico published on 4/25/2020 that the first recorded death of COVID-19 was of a woman from San Francisco, CA, who died of a massive heart attack, according to the autopsy conducted by the county medical examiner on February 7, 2020, but not signed until April 23, 2020. According to the article, she “had no coronary heart disease or clotting that would have caused a heart attack.” She was “mildly obese and had a mildly enlarged heart.” She had evidence of the coronavirus infection in her heart, trachea, lungs and intestines, and originally complained of flu-like symptoms in the days before her death.

The Kaiser article also reported on an ABC news report looking at how New York City became the epicenter of the coronavirus on March 20, “but city records analyzed by ABC News suggest a crisis swelling far earlier, signaled by a sudden uptick in cardiac arrest cases that experts now say were likely linked to the virus. Emergency calls for cardiac arrest began to climb in mid-February, in close-knit neighborhoods of Brooklyn and Queens, some of the same local areas that would soon form the "epicenter of the epicenter" of America's coronavirus pandemic. (Pezenik, Katersky, David and Dastmalchi, 4/27)”

Uptick In Home Deaths In U.S. Since March 2020

The Yale School of Public Health conducted an analysis of federal data for the Washington Post, which revealed a spike in deaths during March through April 4, 2020. The Washington Post published those results on 4/27/2020 and included a variety of graphs showing the data for different states, including New York, New Jersey and Michigan.

According to the article: “The analysis also suggests that the death toll from the pandemic is significantly higher than has been reported,” said Daniel Weinberger, a Yale professor of epidemiology and the leader of the research team. “It’s really important to get the right numbers to inform policymakers so they can understand how the epidemic is evolving and how severe it is in different places,” Weinberger said.

The article goes on to suggest that the “national tally also shapes the public’s perception of how serious the disease is, and therefore how necessary it is to continue social distancing despite economic disruption.”

However, it was also noted by the Washington Post: “The excess deaths are not necessarily attributable directly to COVID-19, the disease caused by the coronavirus. They could include people who died because of the epidemic but not from the disease, such as those who were afraid to seek medical treatment for unrelated illnesses, as well as some number of deaths that are part of the ordinary variation in the death rate.”

As more data comes out, clearer answers to questions like these will come.