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SARS-CoV-2 (COVID-19) Experience at an Academic Medical Examiner's Office
Insights
Medical examiner offices saw increased workload during the COVID-19 pandemic, despite investigating few COVID-19 deaths. This rise in cases was likely due to pandemic-related conditions, not direct COVID-19 fatalities.
Area of Science:
- Forensic Pathology
- Public Health
- Epidemiology
Background:
- The COVID-19 pandemic caused significant global morbidity and mortality.
- Medical examiner/coroner offices often do not jurisdiction over COVID-19 deaths, as they are typically classified as natural causes.
Purpose of the Study:
- To review the experience of a medium-sized academic medical examiner's office during the initial 15 months of the COVID-19 pandemic.
- To analyze changes in case types and workload volume.
Main Methods:
- Retrospective review of cases from a single academic medical examiner's office.
- Comparison of data from the first 15 months of the pandemic with the preceding 15-month period.
Main Results:
- A significant increase in total reported deaths, scene investigations, autopsies, natural deaths, accidents, homicides, and drug-related deaths was observed.
- There was a decrease in the number of suicides.
- The office performed 5 autopsies with COVID-19 as the primary cause of death, 4 as a contributory cause, and 28 with positive COVID-19 tests where it was not contributory.
Conclusions:
- The COVID-19 pandemic led to a substantial increase in the workload of this academic medical examiner's office.
- The increased workload was primarily secondary to pandemic-related conditions rather than a high volume of investigated COVID-19 deaths.
Introduction:
The coronavirus disease of 2019 (COVID-19) pandemic has resulted in a great deal of morbidity and mortality worldwide. Since most deaths related to COVID-19 are currently considered natural, and they tend to occur following a clinically recognized illness, many medical examiner/coroner offices within the United States do not take jurisdiction over the majority of COVID-19 deaths.
Methods:
In this review, we present the experience of a medium-sized medical examiner's office affiliated with an academic medical school institution, over the first 15 months of the COVID-19 pandemic.
Results:
Compared to a 15-month period that immediately preceded the pandemic, our office experienced a significant increase in the total number of reported deaths, scene investigations, full autopsies, natural deaths, accidents, homicides, and drug-related deaths, but a decrease in the number of suicides. Overall, our office performed 5 autopsies during the study period where COVID-19 was considered the primary cause of death, 4 cases where COVID-19 was considered a contributory cause of death, and 28 cases where COVID-19 testing was positive, but COVID-19 was not contributory to death.
Discussion:
The COVID-19 pandemic was accompanied by a sizeable increase in work volume within our academic medical examiner's office. Although this increased workload was not related to a large number of COVID-19-related deaths investigated by the office, there were numerous areas of increased workload that were likely secondarily related to the conditions associated with the pandemic.
