CORONAVIRUS

Counting change adds more than 170 COVID-19 deaths in Iowa

State changes method to align with federal classification

This transmission electron microscope image shows SARS-CoV-2, the virus which causes COVID-19. Research into the link be
This transmission electron microscope image shows SARS-CoV-2, the virus which causes COVID-19. Research into the link between high blood pressure and COVID-19 is ongoing. (NIAID/TNS)

DES MOINES — Linn County will see a jump in the number of deaths attributed to COVID-19 under a new method state officials announced Monday of recording the deaths that will lead to a net increase across Iowa.

Kelly Garcia, interim director of the Iowa Department of Public Health, told reporters Monday night that the state will start recording COVID-19 deaths according to federal cause-of-death coding, which is based on the death record completed by the health care provider.

The change will result in the net addition of 177 more COVID-19-related deaths in Iowa as of Monday evening, pushing the state total for the pandemic to 2,898.

About 16 percent of the statewide increase comes from Linn County, where the number of deaths as of Monday evening rose from 173 to 201 under the new method.

Johnson County deaths attributed to COVID-19, however, decreased from 41 to 39.

“We’ve recognized a need to adjust our death reporting,” Garcia said.

Under the old system, the state recorded a COVID-19 death when a positive test result in the state system matched up with a death certificate.

Under that old system, if an individual’s death was deemed COVID-19-related by a physician but the deceased did not have a positive test on file, the state did not record that as a COVID-19-related death.

Under the new system, only the COVID-19 cause-of-death coding is required for the state to recognize it as a virus-related death. A matching positive test is not required any longer.

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Garcia said the change will provide better consistency in reporting between county, state and federal government public health agencies, and will better enable researchers in the future to examine the impact of COVID-19 in Iowa.

The new system also better aligns with how deaths related to other diseases are recorded.

“This information will be helpful for national comparisons, and I believe it will also be helpful when we compare causes of death over the course of the entire 2020 calendar year,” Garcia said. “When you look back in years to come, one year out, five years out, 10 years out, this change will allow us to see an apples-to-apples comparison of deaths.”

With the change, the state’s public data will change Tuesday morning, Garcia said. The new recording system will be applied retroactively to the start of the pandemic in Iowa in March. Many counties will see an increase in total COVID-related deaths, while some will see a net decrease.

Scott County’s COVID-19 deaths rose by four from 99 to 103, and Black Hawk County’s went up from 156 to 159.

But in Woodbury County, the deaths dropped from 140 to 126 as of Monday night. Polk County’s total dropped from 357 to 353.

The decreases result from cases where a person had a positive test and then died, but the physician did not determine COVID-19 was a cause of death. Under the old system, the state recorded that as a COVID-19 death. Under the new system, that will not be recorded any more.

The federal government and some other states already have been using cause-of-death coding to record COVID-19 deaths. Garcia said Iowa did not change its method earlier in the pandemic because she said there was not a statistically significant difference between the methods and because the old system enabled the state in real time to also gather more information, like the deceased’s profession.

Garcia said that is one trade-off of the new system: that extra information will no longer be available in real time. Researchers will have to accumulate that information at a later time.

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Garcia said confirmed COVID-19-related deaths will still take time to be reported to the state because the reporting process can take up seven days. But the data will continue to be updated daily, she said.

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