4:13 PM, Feb 27, 2020


COVID-19 numbers are not perfect, but as good as they can be

Posted at 9:52 AM, Jan 05, 2021

KENT COUNTY, Mich. — Counting COVID-19 deaths has been a difficult process for health professionals, which is why the vial records review process acts as a fail-safe for ‘if’ and ‘when’ physicians accidentally misrepresent deaths involving the virus.

Jeff Duncan is the state registrar and director for vital records with the Michigan Health and Human Services, telling Fox 17 News that even though counting virus related deaths is a mathematical and scientific process, the numbers you see might not be 100 percent accurate.

“I think that there are possibly some anecdotes where people have COVID-19 listed (on their death certificate) where it should not have been,” Duncan said. “It’s not a clean process. It never has been even before Covid-19.”

COVID-19 related numbers are updated daily on the MHHS website per the Centers for Disease Control and Prevention, the National Centers for Health Statistics, and other governing agencies. Fluid numbers usually consist of new cases reported, current death toll, and people who’ve recovered from the virus. Then there’s a process called a vital records review, tallying numbers of people who’ve died from the virus but fell through the cracks of the system.

Duncan explains physicians and medical examiners are solely responsible for writing down an individual’s cause of death on their death certificate. However, sometimes they are wrong.

“We've dealt with a handful of amendments where family members come in,” Duncan said. “In those cases, we turn back to the physician and say, ‘Okay, we need an amended cause of death. Please remove COVID the other hand, there are also cases where COVID is missed on the death certificate and family members or others may seek an amendment to have it added to the death certificate.”

Death certificates are then handed over to the National Centers for Health Statistics and the CDC where they’re processed by a machine. Duncan says the machine codes about 80% of those certificates using a natural language process, able to identify the key words pertaining to Covid-19 written down by the physician. The remaining text that is unable to be coded is then kick out for manual review.

“So there times a week, we take the information on cases that we have in the Michigan disease surveillance system, and we work with the vital record staff in Jeff's area to match that with the death certificates that we have within the department,” said Sarah Lyon-Callo, Acting Bureau Director of Infectious Disease and Infection with Michigan Health and Human Services.

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The vital records review is a process of accountability, a double and triple checking of records for possible inconsistencies, and using mortality data to identify people who’ve died from the virus vs. people who’ve died with other underlying causes and only associated with the virus. Even though there are minor misrepresentations, it’s to their best interest and the populous as a whole, they get the numbers right to the best of their ability.

“We really have a vested interest in getting it right because the answers to why some people die and some do not are in this data that we collect,” Duncan said.