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How are coronavirus deaths determined in Missouri?


Nearly 800 Missourians have died from COVID-19, according to data from the state’s health department. But how is Missouri tracking those numbers? 

In Missouri, most deaths have occurred in the St. Louis area: 444 in St. Louis County and 124 in the city of St. Louis, as of June 3. Nearly 50 people have died in Jackson County and Kansas City combined. 

More than 107,000 people have died in the U.S. 

As some states have become entangled in disputes regarding COVID-related death counts, The Missouri Times sat down with the Department of Health and Human Services Director Dr. Williams to discuss how Missouri handles these cases. Below is a conversation between The Missouri Times (TMT) and Williams (RW), with the health director’s responses edited for clarity.

TMT: What is the process for determining if a death is related to COVID-19? 

RW: If there’s not a question when an individual dies — for example, there’s a 77-year-old in a nursing home who got COVID-19 and died of pulmonary disease — the doctor treating the patient signs a death certificate. 

Any time there’s a question, however, an autopsy is done, and the cause of death is then determined by the medical examiner. 

TMT: Could these deaths look similar to anything else? In Colorado, one county is disputing whether a man’s death was related to alcohol or coronavirus. 

RW: It’s important to note the difference between a COVID-related death or if COVID was just present at the time of death. If you were in a car accident and killed, but you just so happened to have COVID-19, we wouldn’t count that in our data. 

The thing medical examiners and doctors have to be aware of: A person had COVID-19, but is that what really killed them? 

TMT: That seems like it could get confusing at times. 

RW: Yes, it can. The average age of death in Missouri is 77. And for the majority of deaths, I think it’s probably pretty clear cut. Where it gets trickier is in younger people in which you would expect that degree of morbidity so you have to check: Was there something else going on? 

TMT: Is there a process to dispute a cause of death? 

RW: In these cases, a dispute would go to a medical examiner. If a doctor signs a death certificate that says it’s COVID-19, and a family says, ‘No, it wasn’t COVID-19’ — and this happens not infrequently in other cases as well — classically, the arbitrator is the medical examiner or coroner. 

EDITOR’S NOTE: For up-to-date information on coronavirus, check with the CDC and DHSS.