COLORADO SPRINGS—Dr. Leon Kelly, deputy medical director of El Paso County Public Health and El Paso County Coroner spoke with Complete Colorado Monday to address an internet-based rumor that death certificates are being falsified and seasonal flu and other respiratory deaths are being misclassified as COVID-19 deaths because hospitals get paid more when a patient dies of coronavirus.
“I know this is a growing controversy, although from our perspective it probably shouldn’t be. We’re doing everything the way we’ve always done it when it comes to certifying death.”
Kelly says that the idea that death records are being falsified is “well within the ballpark of ‘the earth is flat’ and ‘we never landed on the moon’ bottom-level government conspiracy-theory stuff.”
According to Kelly, the system of checks and balances prevent death certificates from being changed without the participation of several levels of government.
“Nobody can tell anybody else how to handle death certificates,” said Kelly. “In fact, not even at the state level can they change death certificates or amend them without working with the coroner or medical examiner.”
While coroners deal with unattended and in-home deaths, in the case of the coronavirus it’s rare to see such cases.
“The folks that we’re talking about, with COVID-19, are almost always going to die in the hospital,” Kelly said. “If we have a history that’s consistent with COVID-19 respiratory symptoms we will typically test not only for influenza virus, but all the other viruses that go along with respiratory symptoms, and then we also test for COVID-19.”
For natural deaths, people with heart disease, lung disease or infections that doctors have diagnosed, the standard of practice is to have their death certificate signed by physicians in the hospital. Mixing seasonal influenza deaths with COVID19 is unlikely thanks to the depth of post-mortem investigations.
“By the time we say someone has died of COVID-19 it’s been investigated by the hospital, it’s been diagnosed in the laboratory, it’s been investigated by a team of epidemiologists and it’s also been investigated by a team of coroners,” Kelly said.
When a COVID-19 death is reported to the death certificate system it is referred to the state by the attending physician. The state then informs the local epidemiologist and the coroner. Every COVID-19 death is investigated by at least two outside agencies; the public health department and the corner or medical examiner, says Kelly.
“All of these systems are in place as they always have been and we are following those protocols,” Kelly said. “The thing I need people to understand, if they think that the federal government decides what you put in the death certificate, is that every state death certificate certifying system is based on counties or regional medical examiners, so there’s complete 100% local control.”
Kelly is confident that these protocols are being followed and there is no reason to believe the internet rumors.
“I can only speak to my own jurisdiction of course, but as a professional medical examiner who spends a lot of time with my colleagues around the country, I can assure you that they have the same attitude and are following the same practices,” said Kelly. “Even if the hospital got paid more money, the corner certainly doesn’t, and the public health department doesn’t, so we would have no motivation to contribute to that.”
Kelly is very optimistic about El Paso County’s future and is looking forward to reopening the county in phases, as quickly as is reasonable under the circumstances.
“As of today [Monday] we have 20 individuals in the hospital that are COVID-19 positive that are being treated,” said Kelly. “We have a few more that have come in and we’re still waiting on the results of those tests. That is certainly well within the realm of our hospitals being able to care for those patients.”
