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Number Of Harris County At-Home Deaths Has Increased Since Coronavirus Outbreak Began

The Harris County medical examiner’s office had 58 at-home death cases between April 3 and 10 this year — more than double the 28 cases in that week in 2019.


This photo shows one of the rooms where medical examiners conduct autopsies.
Photo: Courtesy of the HCIFS
This photo shows one of the rooms where medical examiners conduct autopsies.


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Officials are closely watching what's happening in COVID-19 units at hospitals — the availability of ICU beds and ventilators — but almost a quarter of coronavirus-related deaths in Harris County have happened at home, according to the county’s medical examiner.

And since the start of the pandemic, at-home deaths have been on the rise, raising questions about whether those numbers could be higher.

Data shared by the Office of the Medical Examiner shows 86 at-home death cases in the first two weeks of April. That's compared to just 52 deaths in the same time period a year ago — an increase of 65%.

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From April 3-April 10 this year, the number of at-home deaths was 58 — more than double the 28 cases in that week in 2019. The office’s caseload since February is up 33% over last year.

The medical examiner’s office doesn’t handle all at-home deaths — only cases where there’s uncertainty about the cause of death. Some cases in recent weeks were suicide or heart attacks, and others been confirmed as COVID-related.

But causes for the majority of these deaths were still pending as of Friday. And with COVID-19 testing kits shortages around the country, the question is whether enough of those bodies are being tested for the disease.

Dr. Rebecca Fischer, an epidemiologist at Texas A&M, said getting an accurate count of those at-home deaths is important to researchers, because COVID-19 is a new disease they don't understand yet.

It's important to families, too, she said.

"The family members that suspect that their loved one passed away due to this, but they don't get to see them counted in the media, that's really got to be a devastating blow to those family members," Fischer said.

Getting the full picture also matters from an emergency management perspective, as well as for painting an accurate picture of the virus’ impact.

"The community knowing, ‘okay, if we missed this one, did we miss five? And did we miss 10?’" Fischer said. "So you're talking about the general public wanting to know, ‘are you really doing a good job? Are you really counting everybody?'”

But Harris County Deputy Chief Medical Examiner Dr. Dwayne Wolf said the number of deaths tends to ebb and flow, and that he felt numbers have been relatively consistent.

A spokesperson for the medical examiner's office later said that, if there was an increase in at-home deaths, it could be connected to the stay-at-home order, which has pushed people not to leave the house.

The Harris County Institute of Forensic Sciences — which houses the medical examiner’s office — partnered with the Houston Health Department at the beginning of March to test bodies for COVID-19, according to a Houston Health Department spokesperson. The city’s laboratory, which is handling 60-to-80 COVID tests a day and returning results within around 24 hours, is also testing specimens for surrounding counties.

"Not only do we have the resources, but a lot of the reason we have the resources is because our health departments use that information,” Wolf said. “They understand that when somebody's dead at home from COVID, that there's a public health reason to know that, for the people who are living around that person, and for the people who that person interacted with before they died."

In New York City, where the COVID-19 death count has topped 10,000, officials have had to adjust their counting methods after reporting showed they weren’t including probable COVID deaths that occurred at home.

Wolf said he did not believe that was an issue in Harris County.

“In New York, it's so prevalent in the population, and the numbers are so big, that they're not able to do autopsies, they're not able to do the kind of investigations,” Wolf said. “But our operation here, both including investigation and the pathology side, are not so overwhelmed that we’ve had to change anything about how we’re approaching these cases. If there's a reason to be doing the testing, we're doing the testing."

So far, the Harris County medical examiner’s office has tested 46 bodies for COVID-19. Thirteen of those tests came back positive as of Wednesday. Wolf said the office has been able to test all of the cases it suspects could be related to the coronavirus.

For now, the medical examiner's office is pushing back on the idea that a rise in at-home deaths could be COVID-related.

"There's been some speculation about people with heart disease or other medical ailments having nothing to do with COVID not going to the hospital and dying at home. And that could be. So again, if we're seeing a big increase in natural deaths, time will tell, that may be the case," Wolf said. "But I don't think we're missing a whole bunch of people dying from COVID at home."

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