Santa Clara County’s COVID-19 fatalities dropped by nearly a quarter Friday as the county recast its methodology for counting deaths throughout the pandemic.
The downward correction follows a similar move in Alameda County in early June and brings the overall number of COVID-19 fatalities to 1,698 people, down from 2,201, county officials said Friday.
For the last year and a half, health officials have tracked and publicized “deaths with COVID,” said Assistant Public Health Officer Dr. Sarah Rudman, meaning that anyone who had coronavirus when he or she died was considered part of the death toll. In other words, even if a county resident had cancer or was hit by a car but tested positive when receiving medical care or after being pronounced dead, he or she was added to the county’s tally.
But now officials will only count those for whom coronavirus is listed as part of the cause of death on the death certificate, a change Rudman says is possible as information about individual deaths is more readily available now that the pandemic’s worst surge has passed.
“There were a number of reasons that our process in the height of the surge was the right decision for the time: The high numbers of deaths coming in, the lag in receiving information about why or how someone might have died, and the need to get real time information to the public to help people understand how to stay safe,” Rudman said Friday. “Now we’re able to do that deep review of the death certificates to make those detailed assessments.”
The “vast majority” of deaths that occurred during the winter and summer surges have been confirmed to be from COVID, Rudman said. But in the spring — as COVID rates were lower and many of the most medically vulnerable residents had been at least partially vaccinated — the county has discovered bigger gaps between those who died with COVID versus those who died from COVID, she said.
Although the old method was permissible under state guidelines for local health jurisdictions, the new one brings it in line with how the California Department of Public Health has long publicized deaths. According to the state’s data dashboards, individuals for whom the cause of death is unrelated to COVID-19 but still tested positive are added to the state’s case count but not death toll.
Santa Clara is the second Bay Area county to make such a change. Last month, Alameda announced a similar 25% drop when it began counting cases differently, though Health Officer Dr. Nicholas Moss said at the time he was not aware of any other counties using the same definition.
Rudman would not say whether Alameda County’s decision influenced Santa Clara’s, but in a news release announcing the change, the county noted that “the updated definition aligns with the approach that many other counties are taking statewide.” Both counties have still recorded the most deaths in the Bay Area.
Dr. Peter Chin-Hong, a UC-San Francisco epidemiologist, believes that Alameda and Santa Clara’s overcounting is an easier problem to overcome than undercounting, which has eroded public trust in places like India and Canada and made it more difficult to track the pandemic.
At this stage in the vaccine rollout, however, overcounting COVID deaths gives more ammunition to those wary of vaccines or spreading misinformation, he said — making the counties’ new definitions all the more critical. The U.S. Centers for Disease Control and Prevention, for instance, has taken pains to point out that about 25% of “breakthrough” COVID-19 fatalities among fully vaccinated people were either asymptomatic or not related to the illness.
“Right now, as we’re trying to accurately reflect why someone died, naysayers will say, ‘They died from COVID even though they had the vaccine,’” Chin-Hong said. “It’s really super important — now more than ever — to disentangle who’s really dying from COVID.”