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Kentucky missed more than 700 Covid-19 deaths from October to January for the same reason Ohio missed 4,000: One state employee stopped reconciling death certificates with reports from health departments using an antiquated system, reports Deborah Yetter of the Louisville Courier Journal.

"Two separate streams of information about deaths — one from health departments and the other from death certificates — must be reviewed and reconciled. The task is time-consuming and currently is performed by a human, not a computer," Yetter reports.

"Reports of Covid-19 cases already often delayed. On Monday, Beshear announced 11 new deaths and 50 more from the audit, though none were from March. . . . Timely reports are important if health officials hope to convince a sometimes-skeptical public of the need for precautions to reduce infection, such as requirements to wear masks and limit sizes of gatherings, said Dr. Kraig Humbaugh, commissioner of the Lexington-Fayette County Health Department."

"We want to be as accurate as possible," Humbaugh told Yetter. "We want to count those that are Covid deaths, and not count those that are not."

Kentucky and Ohio officials said the problem arose late last year as coronavirus cases and Covid-19 deaths "began to pile up and workers became overwhelmed," Yetter reports. "Some death reports lag behind simply because it takes time to compile, review and forward the information to public health officials in Frankfort."

They get the data in two ways, Yetter notes: "Health departments rely on epidemiologists — specialists in identifying diseases — to review information from individual cases and reach a conclusion about whether a death resulted from Covid-19," and many health departments have lagged behind. "Death certificates are filed separately with the state Vital Statistics Branch by sources including local coroners, hospitals, doctors or nursing homes. Sometimes a death certificate reports an individual had Covid-19, though it may it may not have been reported by the health department."

Sometimes, causes of death are difficult to determine "in a state with high levels of disease, such as heart and lung ailments, diabetes, cancer and other conditions which can also prove fatal and likely are complicated by Covid-19," Yetter writes. "At the state Department of Public Health, a committee of experts reviews individual cases in question in order to decide whether they should be listed as deaths from Covid-19." That's one reason deaths are often listed weeks or even months after they occur.

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