Throughout the coronavirus pandemic, deaths have been the statistic that has seemed the most immutable.
Other numbers, particularly infection rates, are subject to a variety of factors: lag in results being reported, limits to the availability of testing and the question of whether symptoms ever get bad enough to prompt a test at all.
All those caveats mean the 23,928 cases identified in the state as of Sunday represent an undercount, possibly a dramatically lower figure than the true infection rate.
By contrast, the death toll has often been viewed as a reliable statistic. Though it also tends to lag reality, most experts see it as a more solid – and final – figure to measure the virus’s toll.
But death, too, has its caveats, and officials and experts are now looking at whether there could be deaths attributable to the coronavirus that so far have not been counted.
This week, Louisiana is expected to begin releasing statistics on the number of people whose deaths are suspected to stem from COVID-19, even if they were never tested, a development experts welcome.
“I do think it’s important to capture what will ultimately will be recorded as the true impact of this pandemic in human costs,” said Susan Hassig, an epidemiologist at Tulane University. “Having as much clarity as we can is very valuable, even if it’s not a definitive diagnosis.”
The effort to more fully measure the toll of the coronavirus comes as other areas, such as New York City, have started adding probable COVID-19 deaths to their official counts.
While state officials say the number of suspected deaths will not change Louisiana’s count dramatically — at least not immediately — experts say it’s important to get as concrete an understanding as possible.
Currently, Louisiana’s official death toll counts only victims who tested positive for the coronavirus and didn’t die from an obviously unrelated reason, such as a car crash.
So far, there haven’t been any deaths excluded because they were due to non-medical issues, said Dr. Joseph Kanter, with the state Department of Health.
The state is now aware of 12 suspected coronavirus deaths that are not in the official statistics, all but one of them from New Orleans or Jefferson Parish.
Jefferson Parish Coroner Dr. Gerry Cvitanovich said that, early in the outbreak, when tests were scarce, he was wary of using tests that could have gone to identifying cases among the living simply to confirm undiagnosed victims in the morgue.
Since the CDC issued new guidance recently on how to determine whether the coronavirus was likely a contributor to a death, the office has been sending investigators to talk to doctors to help figure that out.
As a result, Cvitanovich said he believes there may have been some COVID-19 cases early in the outbreak that his office missed and likely will never be included in the official count.
“It is important to know (how many died) epidemiologically, but how accurate are we going to be? I don’t know,” Cvitanovich said.
Cvitanovich, like others whose work involves tallying the lives taken by the virus, was wary of feeding into conspiracy theories that the death count was being inflated to exaggerate the impact of the virus. There would be no reason to do so, he said.
“If anything, we’ve undercounted,” he said.