Is the COVID-19 death toll exaggerated?


Traumatic events and fake news almost always go hand-in-hand. The COVID-19 pandemic proves to be no different. While the world is trying to process the fast paced, hard hitting news being thrown at them at 600 miles per millisecond, they are also forced to pick out the fabricated tales that go along with traumatic events.

There are conspiracy theories that have circled the globe through the rumor called social media. The most recent one was when a website called Great Game India reported that a 30-year medical examiner veteran, Dr. Annie Bukacek claimed the death toll numbers linked to COVID-19 were exaggerated.

The website “whistleblower” claimed that an email was issued instructing medical examiners to count the death as COVID-19, even if they only believe that was the cause. According to Bukacek, a positive result is not needed.

If one were to watch Bukacek’s video, they would be enraged that the “fear mongers” are spewing this false information to scare the public. Keep in mind, the Great Game India website is known for conspiracy theories.

However, Sally Aiken, a medical examiner by trade and the current residing president of the National Association of Medical Examiners said it is not so black and white.

“As most people are aware, people [with a] pre-existing disease like heart failure, and COPD, seem to be at higher risk for death due to COVID-19,” Aiken said. “If those individuals are positive for COVID-19 and have symptoms, COVID-19 is typically being listed on the death certificate as the cause of death, with their other diseases listed as contributory.”

Aiken noted that since the COVID-19 is so new, it is a learning process for everybody involved.

“As we learn what the natural disease risk factors for COVID-19 death are, it is not a conspiracy, or any different than what occurs during non-COVID-19 times,” Aikens said. “If someone dies of Influenza A or B, contributory causes are often listed on the death certificate as well.”

Aiken then addressed the rumor that medical examiners are listing COVID-19 as the cause of death on even non-COVID causes.

“As to what the post refers to as “asymptomatic carriers” of COVID-19---as most people are aware, very few asymptomatic people in the US have been tested for COVID-19,” Aiken explained. “In the vast number of cases, living individuals are being tested because they have symptoms. Medical examiners and coroners are doing the same thing.”

“We are performing autopsies on homicides, suicides, traffic accidents, etc. These decedents are not being testing for COVID-19 as a matter of course. Medical Examiners and Coroners are testing decedents who had symptoms, but were undiagnosed during life. MEs and Coroners are not identifying any “asymptomatic carriers”, because we aren’t testing for them, as it is not pertinent for death certification.”

Even though an autopsy is not an exact science, medical examiners perform an investigation that includes reviewing the medical records, test results and the autopsy.

“It is judgment based,” Aiken said. “Medical Examiners are well-practiced in looking at the overall health history, and making a determination about the underlying cause of death. In some cases, an underlying natural disease process, such as diabetes, or heart failure, places those that get infected with COVID-19 at risk for death. In those deaths, COVID-19 would likely be listed as the cause of death, with the other natural disease listed as “contributory” on the death certificate.”

“Often the cause of death is not one thing, but a combination, so that option of “contributory” has been on the death certificate since its inception,” Aiken continued. “As most are aware, some individuals with underlying health problems, and higher age, seem to be at greater risk for death with COVID-19. By including these diseases on the death certificate, it becomes a more useful public health document for defining risks. No one is trying to inflate numbers of deaths.”

Aiken said it might be difficult to connect how the various causes relate to one another at death, and sometimes, judgements are wrong. She gave an example of a stroke victim who also tested positive for COVID-19.

One might wonder how a stroke and COVID-19 would be related. Aiken explains that dehydration from COVID-19, or the inability to take blood pressure medications could have put the patient at risk for a stroke.

According to Aiken, there is “emerging evidence that COVID-19 infection may have unexpected effects on blood vessels, and circulation, making infected people susceptible to stroke.”

Another fallacy in Bukacek’s claim is that during the pandemic, Coroners and Medical Examiners would not be the ones signing the death certificates in COVID deaths that are hospitalized. Aiken said that it is the treating physician who would sign the hospitalized deaths.

Aiken also believes that the death toll numbers will be under-reported, instead of over-reported. She said this fact will materialize as the deaths occurring in homes, and not the hospital, increase.

So, whether one believes the CDC is exaggerating the death toll, or like Aiken, believes the number are under-reported, people still need to practice social distancing. Nobody wants to add to the death toll.