Undercount

I responded to a cardiac arrest right out of the chute yesterday. Elderly woman recently out of a SNF had been showing signs of delirium according to the family in the last few days, who last saw her alive at midnight. A BLS crew was dispatched for an unresponsive as the only crew available. We had just punched in so we jumped in our rig when our supervisor told us the crew was calling for ALS.

On our arrival, I grabbed my house bag, heart monitor, and our new isolation bag, which holds isolation gowns, face shields, and surgical and N95 masks. After climbing three floors, I enter an apartment and made my way through a living room and a hallway into a bedroom where I could see several people doing CPR. I set the isolation bag down and started gowning up as I asked the EMT what he had. In the room with him where four firefighters all gowned up as well as his partner. “She’s got rigor in her arms and jaw, but she’s warm with no lividity.”

(For nonEMS, a patient after a patient dies, they stiffen and their blood pools through gravity. Rigor mortis with dependent lividity suggests the patient has been dead for several hours and resuscitation is no longer called for. Basic EMTs have less discretion to terminate a resuscitation than a paramedic, who has the ability to apply a heart monitor and confirm lack of heart activity, or flat line.)

That slowed things down. I finished gowning up, went in and checked the patient’s jaw – it was rigid. I ran a six second strip of asystole, confirmed the pupils were fixed and dilated, and then I called the time.

The patient was old, so I doubt the medical examiner took the case. Usually, the body is released to the funeral home. I had to wonder if this patient was one of those who would have tested positive for COVID if she’d had a test. All day it seemed I heard crews going on cardiac arrests.

At the hospital today, I got reports from local services about cardiac arrests for the last weeks. The numbers were three times their normal.

Connecticut had 189 official COVID deaths as of last evening.  How many more people died at home or in hospital EDs who never got tested?

This all brings me to two articles I read yesterday:

Official Counts Understate the U.S. Coronavirus Death Toll

Americans are almost certainly dying of coronavirus but being left out of the official death toll

And this one about how deaths may have been understated in China. They compared the official numbers with data on cremations and burial urns. The official stats showed 2,535 deaths in Wuhan, far less than the number of urns delivered.

WUHAN COVID-19 DEATH TOLL MAY BE IN TENS OF THOUSANDS, DATA ON CREMATIONS AND SHIPMENTS OF URNS SUGGEST.

Italy too, may have severely underestimated their death count.

Italy’s Coronavirus Deaths Could Be Underestimated in Data: Official

It could be the case world-wide:

Official Coronavirus Figures Don’t Reveal The True Scale of the Pandemic

Stay safe out there.

 

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