Iowa alters COVID-19 death calculations and remains silent on care-facility deaths

By: - December 8, 2020 12:05 pm

The average daily number of newly confirmed COVID-19 cases in Iowa is up 50% from two weeks ago, and up almost 67% from one week ago, according to the latest data from the New York Times and Washington Post.(Credit: National Institute of Allergy and Infectious Diseases, Rocky Mountain Lab)

The state of Iowa is revising its reporting of COVID-19 deaths to better conform to federal standards, resulting in Iowa’s total death toll from the pandemic increasing by 177.

Kelly Garcia, director of the Iowa Department of Human Services and the Iowa Department of Public Health, announced the change Monday night. She said IDPH will now record and report COVID-19 deaths based on the International Classification of Diseases death code for COVID-19, as assigned by the Center for Disease Control and Prevention. The CDC bases its assignment of that code to records completed by health care providers.

The change in methodology has resulted in Iowa’s COVID19 death toll increasing by 177, from 2,723 to 2,898.

For several months, the number of both infections and deaths reported by IDPH has conflicted with numbers reported for Iowa by the Center for Disease Control and Prevention and media outlets such as the New York Times. Typically, the numbers reported by IDPH have been lower, and in some cases they have conflicted with other information reported by IDPH.

Kelly Garcia is the director of the Iowa Department of Human Services and acting director of the Department of Public Health. (Photo courtesy of DHS)

“We’ve recognized a need to adjust our death reporting,” Garcia said Monday. She said the state did not change its methods earlier because there was no statistically significant difference in the death counts, and the old system allowed for faster collection of data.

Under the previous methodology, she said, the state recognized a COVID-19 death when a positive test result for the virus was matched to a death certificate. And because each case had to be matched to specific kind of test — a PCR test — deaths that were clinically diagnosed with no such test, and deaths that were matched only to a positive antigen test, were not counted.

Under the new system, only the COVID-19 cause-of-death coding is required for the state to recognize it as a COVID-19-related death, regardless of whether the person was known to have tested positive for the virus.

Garcia said this change should make IDPH’s data more consistent with deaths reported by county and federal agencies, and will provide a more accurate picture of COVID-19’s impact on Iowa.

“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.”

The new methodology is being applied retroactively to the COVID-19 cases since the beginning of the pandemic.

Garcia also reaffirmed the department’s refusal to state how many Iowa nursing home workers have been infected with, or killed by, COVID-19 during the pandemic.

Although the state discloses the number of infected employees working in state-run care facilities, and even ties those infections to the specific facilities where those individuals work, it will not state how many individuals working in any of the state’s 400-plus corporate-owned nursing homes have been infected or died over the course of the pandemic.

The department collects that data, but merges it with resident data and publicly reports only the combined totals.

In the past, the state has suggested it doesn’t disclose the statewide number of deaths in corporate-owned facilities to protect the privacy of the individual workers, but it hasn’t explained why state workers aren’t afforded that same level of protection with regard to the detailed infection data routinely published by the Iowa Department of Human Services, which Garcia also heads.

“As the operator of the facility, I sit in the role of being able to disclose that information,” Garcia said Monday, referring to the six care facilities managed by DHS. “We have worked really closely with families, guardians and advocates, as well as with our attorney representation. And so any one of our private facilities can release that information, and they often do, but we as an agency — and we have plenty of information that we’ve reported, too, and we’re happy to share our statutory constructs — it really does prohibit us from giving that information out.”

Also on Monday, Garcia said a COVID-19 death occurred at one of the six state-run care facilities, but she declined to name that facility, citing privacy concerns. In October, however, DHS publicly acknowledged that a resident of the Glenwood Resource Center had died, saying that while the person had not shown symptoms of COVID-19, the death was being investigated to determine whether the virus was a factor.

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Clark Kauffman
Clark Kauffman

Deputy Editor Clark Kauffman has worked during the past 30 years as both an investigative reporter and editorial writer at two of Iowa’s largest newspapers, the Des Moines Register and the Quad-City Times. He has won numerous state and national awards for reporting and editorial writing. His 2004 series on prosecutorial misconduct in Iowa was named a finalist for the Pulitzer Prize for Investigative Reporting. From October 2018 through November 2019, Kauffman was an assistant ombudsman for the Iowa Office of Ombudsman, an agency that investigates citizens’ complaints of wrongdoing within state and local government agencies.

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