When the Pennsylvania Department of Health issued its daily COVID-19 update on Thursday, the state’s death toll appeared to drop by more than 200 fatalities from the previous day.
The reason, according to state Health Secretary Dr. Rachel Levine, is that some presumptive fatalities — deaths attributed to COVID-19 without official test results — warrant further investigation from coroners and state health officials.
State officials have decided not to publicly report these figures as they prepare to let certain counties ease up on stay-at-home orders, Levine said.
“In the spirit of transparency, we have wanted to report” more data publicly, Levine said at her daily press briefing Thursday. “But at times, there are things we need to review and revisit the way data is being analyzed. This is one of those times.”
Coroners across Pennsylvania have warned that a widespread shortage of COVID-19 tests may lead the state to undercount fatalities related to the disease.
The county-level elected health officials can test bodies for COVID-19 if they can have the equipment, but they can also list COVID-19 as a “probable” cause of death on a death certificate if they know the deceased person had symptoms of the disease or close contact with someone who did.
State health officials first announced on Wednesday that they would include these presumed fatalities with confirmed fatalities in the state’s COVID-19 death toll.
But according to Levine, “further review has determined that we need more information before we could attribute them as deaths to COVID-19.”
The decision to exclude presumptive fatalities from the state’s death toll could affect the state’s death toll by a magnitude in the hundreds.
The Department of Health reported more than 1,622 COVID-19-related fatalities on Wednesday. By Thursday, the figure was 1,394.
Levine said the agency will continue to include presumed COVID-19 cases in its daily updates, since those account for less than 2 percent of the state’s cases overall.
Pennsylvania’s total COVID-19 case count stood at 37,053 Thursday.
That figure includes 36,665 confirmed cases of people who tested positive for the disease, as well as 388 probable cases — people who have not been tested for COVID-19, but who have symptoms and close contact with someone who is known to have it.
Even though the state will continue to publicly report presumed cases, officials will rely only on confirmed cases as they embark on a targeted reopening plan beginning in May.
Gov. Tom Wolf outlined a multi-tiered plan Wednesday that will allow Pennsylvania counties to gradually reopen businesses and lift stay-at-home orders if they see fewer than 50 new cases per 100,000 people over a 14-day timeframe.
Infectious disease experts have warned that states may be vulnerable to new COVID-19 outbreaks if they don’t have the infrastructure to identify and contain new cases quickly.
Levine said Thursday that Pennsylvania officials are eager to ramp up the state’s testing capacity, even though test kits and equipment remain in short supply nationwide.
Following guidance from the Center for Disease Control and Prevention, physicians across Pennsylvania have so far limited tests to people with severe symptoms of COVID-19, such as lung pain and difficulty breathing, while also giving priority to healthcare workers and senior citizens.
But Levine told a panel of state Senators Thursday that the state will start to relax its testing standards “and start to look at anyone who might have symptoms.”
State officials are also finalizing a plan to identify and isolate residents who may have had close contact with COVID-19 patients — a method of infectious disease control known as contact tracing.
Epidemiologists say that contact tracing will help Pennsylvania contain new COVID-19 outbreaks. But Wolf said Tuesday that the state did not have any plans for such a system, or an idea of how much it might cost.
Levine said the program would be led by the Department of Health with help from county health departments, which are in six of Pennsylvania’s 67 counties.
The effort would rely on a corps of public health nurses and volunteers to contact people who may have been exposed to COVID-19 and urge them to self-quarantine to prevent spreading the disease.