Health Officials Explain Lag in Virus Death Total

YOUNGSTOWN, Ohio – As of April 28, Mahoning County Public Health reports 803 confirmed COVID-19 cases in the county, with 237 hospitalizations and 81 deaths, up from 67 the day before.

Since data began being captured around mid-March, state and local public health officials have noted there is a lag in deaths being reported. 

“I know we had a large increase in deaths yesterday, but that does not mean we had that many deaths within the last 24 hours, but it has to do with the reporting and the actual filing of the death certificate. We also had a number of probable cases included with that,” said Tracy Styka, public information officer for the department.

Erica Horner, Mahoning County Public Health director of nursing, says delays also occur when death certificates are recorded with the vital statistics department at Youngstown City Health District.

She adds that delays occur in reporting COVID-19-related deaths that are confirmed cases versus probable cases.  

“A known positive is someone who has already been tested and we would know quicker because they’ve already been tested. It’s on the death certificate right away,” Horner explains. “If the doctor of record writes on the death certificate probable COVID cause of death, we won’t know until that certificate is recorded with vital statistics.”

The Centers for Disease Control began tracking probable deaths from COVID-19 – it’s also asking states to do the same – on April 15.

“ODH is going back and reviewing death certificates and when they see a COVID or COVID-related listed on a death certificate, that is being inputted to the disease reporting system as a probable,” says Erin Bishop, Youngstown Health Commissioner. 

On its coronavirus website, Ohio lists both daily confirmed and probable cases, which are clinically diagnosed when a patient has not been tested for the disease but displays symptoms of the virus that can’t be attributed to other health issues.

Among the symptoms are  fever, chills, headaches, pneumonia, acute respiratory distress without explanation. Patients must also have been in contact with someone who tested positive or were considered a probable case of COVID-19 within 14 days of symptoms.

Ohio Department of Health director Dr. Amy Acton has described COVID-19 cases being different than influenza or other viruses in that it has a longer incubation period, up to two weeks before symptoms present. The disease also typically requires four weeks of hospital care, including intensive care treatment for severe cases.

Those times are similar locally, said Dr. James Kravec.

“The majority of presentations are mild and are not admitted to hospital,” says the chief clinical officer for Mercy Health-Youngstown. “For those who are admitted to hospital, we’re seeing the majority are not in the ICU and will recover and go home, but we are seeing some [staying longer in the hospital].”

Kravec, who is also medical director for Mahoning County Public Health, says a few months ago people who were sick with respiratory diseases like pneumonia  would be on ventilators for a couple of days, but with COVID-19, people are in the ICU longer and on ventilators for longer periods of time. 

“We do know the death rate being reported, but we do have people recovering and we have some great, great stories of people of all ages recovering,” Kravec says.

Mercy Health will resume nonessential surgical procedures Monday, following Gov. Mike DeWine rescinding the halt earlier this week. The soonest such surgeries can be performed is Friday.

Kravec says protocols for restarting surgeries have been in development for a while and doesn’t see a problem with procedures being put in place. He  says protocols will continue to change as things move forward.

Diagnostic screenings and radiology testing also will begin May 4, with all patients being given health screenings before entering the medical centers.

“This is about getting health care for patients for health and wellness and quality of life,” Kravec says.

Copyright 2021 The Business Journal, Youngstown, Ohio.