DES MOINES, Iowa — Monday night, the Iowa Department of Public Health (IDPH) announced the state will be reporting COVID-19 deaths differently in an effort to provide reliable data to Iowans now and in the future.
The new death reporting will not include employment data since it is based on case investigation. The state will work to gather this data for future reporting, but it will no longer be reported in real time on the website. This change will also impact how pre-existing conditions are reported.
During a press conference Monday evening, IDPH's interim Director Kelly Garcia said the changes are being made to provide more reliable death data to the public.
"The methodology does ensure the number of COVID-19 deaths reported will match the official state vital statistics report when eventually published next year, and will provide greater consistency between the number of deaths reported by federal, state, county government agencies," Garcia explained.
For other diseases, the IDPH has relied on the CDC's National Center for Health Statistics (NCHS) ICD-10 national coding on the death record. When the pandemic began, there wasn't a code for the novel coronavirus as the cause-of-death.
To address the lack of a code, the IDPH relied on a combination of a confirmed positive test and case information that determined the person as deceased. The IDPH admits there are challenges with this approach but said it was "the best available solution when the pandemic began."
Since then, Iowa has began reporting antigen test results, specifically at long-term care facilities. Through communicating with counties and local public health officials, the IDPH determined the need to adjust death reporting.
Now there is also an ICD-10 code for reporting deaths from COVID-19, making it easier to not only report deaths but compare them with other causes-of-deaths in the state. The CDC announced the new code last Thursday.
Under the new methodology, a positive PCR or antigen test result will not be required for a death to the attributed to the coronavirus. The state will follow the federal standard of trusting the diagnosis of the health care provider, irrespective of a positive test result.
Deaths will be counted as a COVID-19 death if the NCHS code is listed as the underlying cause of death or a contributing factor to a death.
More information on the difference between underlying cause of death and contributing factor to a death can be found in the related story below.
As Garcia said, this new methodology will make sure the number of COVID-19 deaths match what is being reported in the state's vital statistics report as well as deaths reported by federal, state and county government agencies.
"I absolutely think it's in the best interest of the public because this is the way that we, as a state and every state, record deaths," Garcia explained later.
Being able to go back and look at the data to see what the leading cause of death was during this time will help experts within the vital statistics at the IDPH.
"This change will also allow researchers public health officials and others who who typically do a retrospective review of death to compare that to other types of death. Before this change that wouldn't be possible," Garcia said.
This change in reporting will add 177 more deaths to Iowa's COVID-19 death toll. The website began to reflect this change Monday night, detailing total deaths, underlying cause deaths and contributing factor deaths.
As of Monday night, the new death toll sits a 2,898.
Rather than real-time reporting, deaths will be reported once a day at 7 a.m., according to Garcia. Deaths will be recorded on the day that the individual died as usual.
When asked if she thinks the new death toll is accurate, Garcia said "it's accurate."
"I don't have any pause around the number," Garcia said.
Sarah Ekstrand with the IDPH told Local 5 via email that there are no national standards for reporting deaths. She said they think other states will start shifting to this reporting method as it's the most accurate method of recording deaths.