Are you worried about the Coronavirus?

[TooPatient]

Can I ask this group a question? If you had to go for a blood test would you go to a hospital or a lab? My thinking is a lab because there would be less people. Either way I am nervous and to be candid, I feel so guilty about even feeling nervous. Its pre-op for surgery that if needed will be cleared as an emergency (its not me, but I will be taking my elderly Mom for the testing for a situation that is being closely monitored).

If I had to go, I would go to the smaller hospital near me as the Dr offices are closed. Just the ER is open and it is almost empty. The building is being scrubbed clean and all patients are routed through the ER doors. In the several hours I sat there waiting for DH, only one other person went in.

If you have something like that in your area, it might be the cleanest place to be right now. Don't feel guilty being worried! I was very relieved that my Dr decided to hold off on my quarterly blood work.

ETA: the small hospital is ER and imaging on the first floor, Dr. offices on the 2nd, and PT/supply/offices on 3rd. Most of the top two floors are closed. Basically just the lab open there.

 

[facetgirl]

If I had to go, I would go to the smaller hospital near me as the Dr offices are closed. Just the ER is open and it is almost empty. The building is being scrubbed clean and all patients are routed through the ER doors. In the several hours I sat there waiting for DH, only one other person went in.

If you have something like that in your area, it might be the cleanest place to be right now. Don't feel guilty being worried! I was very relieved that my Dr decided to hold off on my quarterly blood work.

ETA: the small hospital is ER and imaging on the first floor, Dr. offices on the 2nd, and PT/supply/offices on 3rd. Most of the top two floors are closed. Basically just the lab open there.

Thank you @TooPatient. I'm in an area hit pretty hard and I'm so worried. Dr wouldn't see her but we found a surgeon through a connection and he feels surgery is in order and she needs blood work. I haven't ventured out in weeks and the thought of going into a hospital is just putting me over the edge (which is why I feel guilty ... she is the one with the injury and I love her dearly). Maybe I am being paranoid. Alternative is a lab near her house. I may call them, maybe they are taking one person at a time. Thanks for commenting with your advice.

 

[Karl_K]

Can I ask this group a question? If you had to go for a blood test would you go to a hospital or a lab? My thinking is a lab because there would be less people. Either way I am nervous and to be candid, I feel so guilty about even feeling nervous. Its pre-op for surgery that if needed will be cleared as an emergency (its not me, but I will be taking my elderly Mom for the testing for a situation that is being closely monitored).

I would be more comfortable at a Lab
Call and ask about their intake procedure and find one your comfortable with.
Here many of them are doing this: Register by cell phone with car windows closed, you wait in your car until they call you on your cell to come in and only the patient can go in and they have the draw station right inside a door. In and out in under 5 minutes and the only contact is with the person doing the draws. Everything cleaned between patients.
One of them here rented more space has multiple stations set up this way and can really move people through even with all the cleaning.
It is probably the cleanest way of doing it.

 

[TooPatient]

I would be more comfortable at a Lab
Call and ask about their intake procedure and find one your comfortable with.
Here many of them are doing this: Register by cell phone with car windows closed, you wait in your car until they call you on your cell to come in and only the patient can go in and they have the draw station right inside a door. In and out in under 5 minutes and the only contact is with the person doing the draws. Everything cleaned between patients.
One of them here rented more space has multiple stations set up this way and can really move people through even with all the cleaning.
It is probably the cleanest way of doing it.

Nice! Definitely worth a call to see if something like this is available. That sounds like a great way to keep people isolated.

@facetgirl is the blood work something they can do day of the surgery? My neurosurgeon did a full blood panel just before my surgery. If they are doing it again anyway, they might be willing to accept older blood work plus the day of as acceptable if you ask about it. (Not sure your specific situation so it may not work, but never hurts to ask!)

 

[Karl_K]

Nice! Definitely worth a call to see if something like this is available. That sounds like a great way to keep people isolated.

A lot of people who have used it have asked if they could keep it that way after all this passes.
It is really much nicer than waiting in a waiting room in my opinion.

 

[TooPatient]

A lot of people who have used it have asked if they could keep it that way after all this passes.
It is really much nicer than waiting in a waiting room in my opinion.

Yes! Especially when half the people are there sick and half are immunocompromised.

 

[facetgirl]

I would be more comfortable at a Lab
Call and ask about their intake procedure and find one your comfortable with.
Here many of them are doing this: Register by cell phone with car windows closed, you wait in your car until they call you on your cell to come in and only the patient can go in and they have the draw station right inside a door. In and out in under 5 minutes and the only contact is with the person doing the draws. Everything cleaned between patients.
One of them here rented more space has multiple stations set up this way and can really move people through even with all the cleaning.
It is probably the cleanest way of doing it.

Thank you for this great advice. I do think I would be more comfortable with this and she may as well.

Nice! Definitely worth a call to see if something like this is available. That sounds like a great way to keep people isolated.

@facetgirl is the blood work something they can do day of the surgery? My neurosurgeon did a full blood panel just before my surgery. If they are doing it again anyway, they might be willing to accept older blood work plus the day of as acceptable if you ask about it. (Not sure your specific situation so it may not work, but never hurts to ask!)

I'm going to see if that is an option as well, thank you! Getting more info on her situation tomorrow.

 

[missy]

Can I ask this group a question? If you had to go for a blood test would you go to a hospital or a lab? My thinking is a lab because there would be less people. Either way I am nervous and to be candid, I feel so guilty about even feeling nervous. Its pre-op for surgery that if needed will be cleared as an emergency (its not me, but I will be taking my elderly Mom for the testing for a situation that is being closely monitored).

I would add the doctor's office option. It is what I just did. I needed blood work and instead of going to a lab (as suggested by the rheumatologist) I went to my endocrinologist's office (the rheumatologist's office located in the hospital is closed for the time being due to Covid 19) and the endocrinologist took my blood and is sending it to the rheumatologist. Or rather I will be sending it to him when all the results come back.

Is there a doctor you or your mom see who is open for business who is not located in a hospital?
That would be a safer option I think.

Good luck to you and your mom @facetgirl.

 

[facetgirl]

Lab Corp does as you suggest @Karl_K! I can wait in the car and then they will meet us. I decided to stay in the county and go to a location with far less cases for the town. She does not really understand the extent of what is happening with Covid and just wants to go to what is convenient- the hospital. I had a good call with her today about what we can vs should do. I'm also going to call her primary care dr in the am @missy to see if they will just do it there. Blood flow to her foot is compromised so there is enough stress about what that could all mean let alone this testing- so thanks everyone for helping me through some options here.

 

[AGBF]

Lab Corp does as you suggest @Karl_K! I can wait in the car and then they will meet us. I decided to stay in the county and go to a location with far less cases for the town. She does not really understand the extent of what is happening with Covid and just wants to go to what is convenient- the hospital. I had a good call with her today about what we can vs should do. I'm also going to call her primary care dr in the am @missy to see if they will just do it there. Blood flow to her foot is compromised so there is enough stress about what that could all mean let alone this testing- so thanks everyone for helping me through some options here.

I am so glad that you found a good solution, facetgirl.

 

[House Cat]

Can I ask this group a question? If you had to go for a blood test would you go to a hospital or a lab? My thinking is a lab because there would be less people. Either way I am nervous and to be candid, I feel so guilty about even feeling nervous. Its pre-op for surgery that if needed will be cleared as an emergency (its not me, but I will be taking my elderly Mom for the testing for a situation that is being closely monitored).

I would try the lab and see if they are doing any kind of screening out front first. You can call as well and ask. Most doctor’s offices around here have a nurse outside to screen for Coronavirus symptoms and won’t let anyone inside who has had symptoms for 48 hours.

 

[Arcadian]

I'm surrounded by LabCorp offices and they have first hour of the business day for Seniors and people with vulnerabilities. You can also wait in your car and they text you when its time to come in for your test (I did that last time I was there) I think most labs operate in a similar fashion, but double check the ones nearest you to be sure.

 

[Karl_K]

@TooPatient How is your hubby doing?
Prayers are outgoing.

 

[facetgirl]

I'm surrounded by LabCorp offices and they have first hour of the business day for Seniors and people with vulnerabilities. You can also wait in your car and they text you when its time to come in for your test (I did that last time I was there) I think most labs operate in a similar fashion, but double check the ones nearest you to be sure.

Lab Corp was wonderful. Thanks again to all who suggested different ways to make this a bit easier. I was able to check in while in my car, they texted me when it was time to come in and there was only one other person there in a different room. Really set me and my Mom at ease and the staff there was very attentive.

 

[House Cat]

These Are The Dangers Of Visiting Even One Friend During The COVID-19 Pandemic

Visiting even one friend can undo all the good work that social distancing has accomplished.

www.forbes.com

 

[TooPatient]

@TooPatient How is your hubby doing?
Prayers are outgoing.

He isn't having any bad drops in oxygen, but is complaining frequently about feeling like he is being smothered. I think part of it is that he is watching too close and thinking about his breathing non-stop. He is at 95-96% most of the day with chunks at 97-98 and moments of 93-94. The smothering feeling is mostly when his oxygen is good. I pulled out a spirometer and he is using it a few times per day. Lowest today was 900 but highest was 1700. He seems to be getting better. I just have to get him to quit thinking about it long enough for him to recognize it and relax some.

How are you doing? I saw your update a day or two ago about almost needing to call the ambulance. I hope that has passed and you are comfortable at home now!

 

[Karl_K]

He isn't having any bad drops in oxygen, but is complaining frequently about feeling like he is being smothered.

Breathing exercises will help with that as well as a cold cloth on face.

10 Breathing Techniques for Stress Relief

If you're looking to practice breathing exercises, these are proven to work for lowering stress, meditating, and improving breathing function.

www.healthline.com

 

[Karl_K]

How are you doing? I saw your update a day or two ago about almost needing to call the ambulance. I hope that has passed and you are comfortable at home now!

not to bad, had a good nights sleep.
Side is pretty sore and im weak but overall not that bad.

 

[Slickk]

I am just leaving this here. I have watched it twice, read through the comments on various news articles... What say you??

ETA: Video is 10 minutes.

 

[lyra]

I'm not believing that video. It's hearsay to begin with, and what is the purpose of it? Also she wanted this video to go viral, why? She mentions it a few times. I think it's fear mongering mixed with some basic truths. IMO.

 

[AGBF]

not to bad, had a good nights sleep.
Side is pretty sore and im weak but overall not that bad.

I just saw this. I posted in another thread that I was anxious not hearing from you. Sorry to nag you! I am glad you slept, but sorry the pain persists.

 

[AGBF]

He isn't having any bad drops in oxygen, but is complaining frequently about feeling like he is being smothered. I think part of it is that he is watching too close and thinking about his breathing non-stop. He is at 95-96% most of the day with chunks at 97-98 and moments of 93-94. The smothering feeling is mostly when his oxygen is good. I pulled out a spirometer and he is using it a few times per day. Lowest today was 900 but highest was 1700. He seems to be getting better. I just have to get him to quit thinking about it long enough for him to recognize it and relax some.

How are you doing? I saw your update a day or two ago about almost needing to call the ambulance. I hope that has passed and you are comfortable at home now!

I am sorry for all he (and you) have gone through, TooPatient. Karl appears to be an amazing resource on breathing tips. Pricescope has so many functions besides being a place to learn about diamonds.

Gente hugs,
Deb

 

[missy]

I am just leaving this here. I have watched it twice, read through the comments on various news articles... What say you??

ETA: Video is 10 minutes.

@Slick1 thanks for sharing. It’s
terrifying. I believe that’s her friend’s experience at that specific hospital. I wish she would have named the hospital. Truly with no info but NYC there’s nothing anyone can do.

Name the hospital. And her friend came to help but instead because she’s afraid to speak out what can be done?

People need to say something when they see something. Isn’t that the motto?
If they don’t they’re part of the problem. IMO.

I was in healthcare and believe me when I saw things happening that were just not right I always spoke out. Why would I want to be a part of the problem and why wouldn’t I do something constructive like blow the whistle?
Damn right I’d blow the whistle. I wouldn’t let people die needlessly as she kept saying.

Horrible situation and I hope it’s not a widespread one.

 

[OboeGal]

I am just leaving this here. I have watched it twice, read through the comments on various news articles... What say you??

ETA: Video is 10 minutes.

I've been spending a GREAT DEAL of time - as in several hours a day - on Reddit on a couple of subreddits that are populated mainly by health care practitioners and researchers, reading research as well as the dialogue between practitioners, so I think I can perhaps offer a little insight for being a medical "civilian".

Based on what I've been reading for weeks......most of what she is saying has kernels of truth. She is describing what is occurring and decisions being made fairly accurately. What's misleading here is the ascribing of motive and reasoning and an attitude of blame of medical personnel. She is describing a large amount of gross neglicence and "not caring" and "people left to rot", and that is not an accurate picture of the motives, reasoning, or attitude of the large majority of these men and women in an untenable situation and risking their lives. They DO care; they are terrified; they are exhausted; they are beyond overwhelmed; they are having to make decisions without good information or good options, or often are having to treat based on guidelines being set by administrators that are NOT on the front lines. If they defy those guidelines or speak out about them, they are fired. And may lose licensing. They are in a brutal situation.

Yes, some people are not being resuscitated or only receive token resuscitation when they code, but there are reasons for that. These are very elderly, very frail patients that have no chance of surviving. These doctors and nurses know it because they are doing this all day, day in and day out. None of the patients like that were surviving even the most heroic efforts - not one - once they coded, and they were subjected to incredibly painful rib and sternum fractures and other severe discomfort in their final moments, while at the same time aerosolizing potentially large amounts of virus to infect all the personnel that are necessary to have in the room for the code procedures. Eventually, medical personnel had to make the decision to, in those most severe cases, not subject them to utterly pointless efforts that would cause severe pain and discomfort to patients with no benefit and make caregivers ill. It's a wrenching decision that is emotionally wrecking them, but it is utterly rational in the situation. Patients who are a little younger, a little stronger, might have a faint chance at surviving resuscitation, still are receiving full efforts. ETA: Even this utterly varies within the same hospital, depending upon who is the person in charge in any given room during any given code. It happens rarely that even the most hopeless patient without a DNR is not given full efforts, and those who are higher ranking and making these calls are constantly debating the ethics with each other and administrators, trying to make the best decision they can.

Up until very recently, it's true that hospitals were avoiding high-flow nasal cannulas and/or CPAP/BiPAP and going straight from normal-flow nasal cannulas to ventilators if patients decompensated for multiple reasons, but mainly due to concerns of aerosolizing viral particles being much higher for high-flow cannulas and CPAP/BiPAP. It was not known yet how damaging the ventilators can be to COVID-19 patients in a way that differs from the usual presentation of severe acute respiratory distress. Word is now spreading that most patients seem to do better on the high-flow oxygen support or at most very gentle settings on ventilators. Some hospitals have not gotten word of this yet, so have not changed protocol. Some hospitals are getting word and are changing protocol to reflect this new knowledge. Still others have gotten word, but refuse to change protocol because they are prioritizing using no aerosolizing procedures over patient outcomes, as they feel the risk to personnel is too great. Therefore, yes, patients and their loved ones need to know that low- and high-flow non-invasive oxygen and time to heal should be used if at all possible. Ventilation and ECMO are absolute last resorts. Ventilation may have actually caused some deaths due to barotrauma that would not have occurred on high-flow non-invasive support.

Yes, PPE is not getting changed from patient to patient in many places. That's not the fault of medical personnel. There isn't enough PPE - not even close. It's a shitshow. It's either keep on what they had on with the previous patient or not have any on at all.

Yes, medical personnel who speak out about disagreement with decisions about protocol, leave, compensation, disagreement with administration, or the whole PPE debacle are in some cases being fired.

Yes, there is a lot of chaos. In NYC, they've been overwhelmed. It's a novel, highly contagious virus. Chaos is a natural consequence. That is not the fault of these personnel. That is not murder.

The medications she's describing as not being given in that hospital may not be there, but that means nothing about what other hospitals even in NYC are giving. In some cases, different hospitals are giving different regimens because they are different arms of research trials of these medications, as that is sometimes the only way to be able to get them at all. No medication so far has been a silver bullet, and most that are being trialed are hard to get. As far as the more widely-available hydroxyquloriquine that she mentioned, several trials as well as the overwhelming majority of anecdotal experience of those on the front lines show no real benefit in moderate to severe disease, which makes sense based on the presumed mechanism of action. It might have some benefit very early in the course, and that will hopefully be trialed, but that is irrelevant for the patients to which she is referring. At the same time, it has very serious cardiac side effects, especially in the dose they are looking at, as does the azithromycin that it is often being paired with. Far too serious side effects to be administered without serious caution. All in all, critically ill patients are not being deprived of a "miracle medicine", as there isn't one yet. They are trying hard to find one.

Hopefully, that is helpful. What I really want folks to take away from this is that 99% of these medical personnel are doing their absolute best, with the best intentions, in a brutal situation. They are not committing "murder". While there are kernels of truth in what she is saying, she is misrepresenting the breadth of it - as if it's happening all the time - and the way she is presenting it and painting these dear and brave people is disgusting and reprehensible.

 

[GreenPapaya]

Yes I'm terrified of the virus and I'm even more terrified after reading this thread again. My dad is in a medically induced coma right now fighting for his life. He went to the ER for dehydration and fatigue due to covid 19 and is now having a heart attack?? Earlier he seems to be fine on just 100% oxygen but they needed to move him to a different hospital and doctors said he needed to be intubated to be moved. My mom and brother are also sick and my niece and my brother's girlfriend is living there and taking care of them but one has lupus and the other has a undiagnosed autoimmune disease (she was in the process of figuring out why she is sick before the pandemic). My sister in Florida is also sick and her bf has been hospitalized for the past 3 weeks. I'm in NYC trying to help coordinate care via facetime and zoom (my parents are in philly). I haven't been able to sleep. It all just feels like a horrible nightmare.

 

[MaisOuiMadame]

@dizzyakira I'm so sorry you are going through this. All I can offer you are ((hugs)) , prayers and the famous PS dust from across the pond.
Wishing you and your family strength and dunk recovery.

 

[TooPatient]

I am sorry for all he (and you) have gone through, TooPatient. Karl appears to be an amazing resource on breathing tips. Pricescope has so many functions besides being a place to learn about diamonds.

Gente hugs,
Deb

@Karl_K has been an amazing help through all of this! His information on this thread probably kept DH from getting bad enough to end up admitted to the hospital or worse. After he was sent home, I was so afraid I was going to wake up to him not breathing. Something so simple as sleeping propped up made a huge difference and I was too tired to remember that.

This really is a great place with kind, knowledgeable people. I have had more support through this group than from any of our local friends and family! (That includes a super sweet woman I met through PS who happens to be local and offered to sit in the hospital parking lot with me!)

 

[TooPatient]

Yes I'm terrified of the virus and I'm even more terrified after reading this thread again. My dad is in a medically induced coma right now fighting for his life. He went to the ER for dehydration and fatigue due to covid 19 and is now having a heart attack?? Earlier he seems to be fine on just 100% oxygen but they needed to move him to a different hospital and doctors said he needed to be intubated to be moved. My mom and brother are also sick and my niece and my brother's girlfriend is living there and taking care of them but one has lupus and the other has a undiagnosed autoimmune disease (she was in the process of figuring out why she is sick before the pandemic). My sister in Florida is also sick and her bf has been hospitalized for the past 3 weeks. I'm in NYC trying to help coordinate care via facetime and zoom (my parents are in philly). I haven't been able to sleep. It all just feels like a horrible nightmare.

I'm so sorry to hear of those in your family who are sick. Sending you hugs and prayers along with buckets of PS dust. I hope they all recover quickly and the rest of your family stays safe while they care for them.

 

[Niffler75]

@dizzyakira I am so sorry! My thoughts are with you and your family. Please take care. x ((hugs))

 

[TooPatient]

Interesting article! I have wondered if people were looking at these numbers. It seems so simple, but hasn't really been discussed anywhere that I have seen.

https://www.washingtonpost.com/inve...ovid-19-death-toll-undercounted/?arc404=true&

Copy/paste (forgive my unskilled attempt to paste, the article is intact but graphs had to be deleted as they didn't paste correctly):

U.S. deaths soared in early weeks of pandemic, far exceeding number attributed to covid-19


An analysis of federal data for the first time estimates excess deaths -- the number beyond what would normally be expected -- during that period.

By Emma Brown ,
Andrew Ba Tran ,
Beth Reinhard and
Monica Ulmanu
April 27


Excess deaths are deaths
above what is historically
expected for this period.

Sources: Overall death data comes from the National Center for Health Statistics, covid-19 death counts come from state health departments and are compiled by The Washington Post, and estimates for expected deaths come from Yale School of Public Health’s Modeling Unit.
In the early weeks of the coronavirus epidemic, the United States recorded an estimated 15,400 excess deaths, nearly two times as many as were publicly attributed to covid-19 at the time, according to an analysis of federal data conducted for The Washington Post by a research team led by the Yale School of Public Health.
The excess deaths — the number beyond what would normally be expected for that time of year — occurred during March and through April 4, a time when 8,128 coronavirus deaths were reported.
The excess deaths are not necessarily attributable directly to covid-19, the disease caused by the coronavirus. They could include people who died because of the epidemic but not from the disease, such as those who were afraid to seek medical treatment for unrelated illnesses, as well as some number of deaths that are part of the ordinary variation in the death rate. The count is also affected by increases or decreases in other categories of deaths, such as suicides, homicides and motor vehicle accidents.

But in any pandemic, higher-than-normal mortality is a starting point for scientists seeking to understand the full impact of the disease.
The Yale analysis for the first time estimates excess deaths, both nationally and in each state, in those five weeks. Relying on data that the National Center for Health Statistics (NCHS) released Friday, the analysis paints a picture of unusually high mortality that will come into sharper view as more data becomes available.
The analysis calculates excess deaths by using a model to estimate how many people probably would have died absent the pandemic, and then subtracting that number from the overall deaths reported by the NCHS.

The analysis suggests that the deaths announced in the weeks leading up to April 4, based on reports from state public health departments, failed to capture the full impact of the pandemic. Those incomplete numbers were widely cited at a time when many states were making critical decisions about closing businesses and taking other actions to stem the spread of the virus.
The analysis also suggests that the death toll from the pandemic is significantly higher than has been reported, said Daniel Weinberger, a Yale professor of epidemiology and the leader of the research team. As of Sunday, more than 54,000 people had been killed by the novel coronavirus, according to numbers reported by state health departments and compiled by The Post.
“It’s really important to get the right numbers to inform policymakers so they can understand how the epidemic is evolving and how severe it is in different places,” Weinberger said.

The national tally also shapes the public’s perception of how serious the disease is, and therefore how necessary it is to continue social distancing despite economic disruption. The figure has political implications for President Trump, who initially played down the threat of the virus and whose administration failed to ramp up covid-19 testing quickly, allowing the virus to spread undetected for weeks.
Some of Trump’s defenders have claimed that covid-19 death figures are inflated because they may include people who died with the disease but not of it.

[See link for graphs]

As deaths in the United States of covid-19 rise, some have started to question the official death count. But the death toll is most likely undercounted. (Elyse Samuels/The Washington Post)
“The death toll is being held up by everyone, really, as a pretty direct metric for assessing the competence of the federal response,” said Jeremy Konyndyk, a former USAID official who helped lead the U.S. response to the Ebola outbreak and other international disasters during the Obama administration.

The problem of undercounting coronavirus deaths is not unique to this pandemic or to the United States. In many countries, insufficient testing is a major obstacle to understanding the scale of the pandemic.
In the United States, public health experts say reporting lags, along with the fact that nearly every state initially counted only cases in which the coronavirus was confirmed through a test, contributed to an incomplete picture of deaths in those early weeks.
The NCHS recently started keeping its own tally of covid-19 deaths, separate from the tallies based on states’ reports to the Centers for Disease Control and Prevention.
The NCHS’s tally, based on death certificates, attempts to correct for reporting lags and includes cases that lacked a lab confirmation of the coronavirus. But even the NCHS covid-19 death total from those early weeks — 10,505 as of Sunday — is only two-thirds of the excess deaths in the Yale estimate.

No jurisdiction has been as aggressive as New York City, the U.S. epicenter of the epidemic, in revising its death counts from those early weeks. As of Saturday, the city had added 2,542 covid-19 deaths to those figures, driving the total from that period up to 5,085. The newly added deaths were almost equally split between cases that were confirmed through lab testing and cases that were deemed “probable” covid-19 deaths based only on symptoms and exposure.

New York City and Washington state have since updated their numbers for this period. New York state figures exclude New York City.
The revisions brought the covid-19 total for New York City closer to the Yale analysis’s estimate of 6,300 excess deaths during that period.
A handful of states have also begun reporting probable deaths in recent days, generally by adding them to current tallies rather than by publicly revising figures from past weeks. Most states have not added probable deaths. For example, New York state, unlike New York City, has not.

The Yale analysis estimates that, excluding New York City, approximately 1,700 more New York state residents than would be expected had died as of April 4 — far more than the 1,022 counted as covid-19 deaths.
Gov. Andrew M. Cuomo (D) acknowledged at a news conference last week that his state’s tally is “not an accurate total number of deaths, in my opinion.”
“That number is going to go up,” he said. “Those deaths are only hospitalization or nursing home deaths. That does not have what are called at-home deaths.”
The family of Long Island resident Adrian Sokoloff say they believe he is one of the uncounted. The retired owner of a pet products company, he had just celebrated his 99th birthday when he started showing symptoms of covid-19 on March 19, his daughter Karen Sokoloff said. His family said his pulmonologist diagnosed him with covid-19 because of spiking fevers and coughing — and because two of his caregivers had come down with chills and lost their sense of taste, a telltale sign of the virus.

Sokoloff’s children had decided not to take him to a hospital out of fear that he would die there alone. They couldn’t get him tested for covid-19 at home.
On March 29, he died at home in Sands Point, N.Y. His death certificate reads, “congestive heart failure,” according to his daughter.
She says her father’s death should be reflected in the covid-19 death toll and fears that an artificially low count is giving some states license to reopen their economies prematurely. “You have to have the data to make an intelligent decision, and if you’re not counting the number of people who died from this, then you’re not making an intelligent decision,” she said.

In New Jersey, another hard-hit state, 9,854 people died during the period covered by the analysis — approximately 2,200 more than would be expected, according to the Yale estimates. Of those, however, only 846 were counted as covid-19 deaths.
Marco Navarro, an EMT who works in three northern New Jersey cities, said that before the pandemic, he could go two to three weeks without seeing a cardiac arrest or a call that required his team to perform CPR. Now it happens two or three times a day.
No one knows why. Is the virus attacking the heart? Are blood clots causing cardiac issues? Are people terrified they will contract the virus in a hospital ignoring their symptoms and staying home until it’s too late, as many doctors have concluded?
“I don’t really have an answer,” said Navarro, who works in Union City and sometimes in Jersey City and North Bergen.
Interviews and 911 call data from other cities also suggest a spike in the numbers of people dying at home, a circumstance that makes them less likely to be tested for the coronavirus or included in the official death counts. For instance, the updates New York City has made to its covid-19 death tolls include hundreds of such at-home deaths.
As of mid-April, paramedics for the Chicago Fire Department were seeing about four times as many calls as usual in which the patient is beyond resuscitation and pronounced dead at the scene, spoke sman Larry Langford said. Normally there are about four such cases; now, some days, there are more than 20. In Detroit, as ProPublica has reported, 911 call data show that the number of calls coded “dead person observed” spiked in the first 10 days of April.
But in dozens of states, the Yale analysis shows that the reported number of overall deaths are either unchanged or even slightly down compared with historical patterns.
In some states, the epidemic started later and spread less quickly and so had killed few people as of early April. Relatively small numbers of covid-19 deaths may have been offset by decreases in fatal car accidents or other such traumatic events that are less likely when people are sequestered in their homes.
Lags in the reporting of overall deaths could also play a role, Weinberger said. Though the federal government’s provisional death count through April 4 is more complete than its count for more recent weeks, it remains incomplete, and the number of overall deaths is likely to continue to rise in coming months as states report additional deaths from those weeks. The number of overall deaths nationwide and in each state won’t be known with confidence until at least a year from now, Weinberger said.
In Washington, the first state to battle a large-scale outbreak, 310 people were originally reported to have died of the virus as of April 4. The state has since published data showing that, in fact, nearly 600 people had died of covid-19 as of that date. Because of the state’s relatively robust testing and contact-tracing infrastructure, experts say, the covid-19 death count there is likely more accurate than in other states.
The overall number of deaths in Washington during those weeks climbed by only about 100 over the number that would normally be expected, according to the Yale analysis. That could be in part because fewer people have been dying on the roads. Statewide, there have been 34 fatal collisions in March and April to date — about half the usual number for this time of year, according to data from 2018 and 2019.
There are signs that traffic fatalities are declining more broadly. Data collected by ESO, a company that provides software for about a third of EMS services nationwide, show a steep decline in calls for motor vehicle accidents as stay-at-home orders have taken hold.
Crime patterns are changing in some places, too. Miami did not report a single homicide for seven weeks and six days, from mid-February to mid-April, police said. The last time the city was free of homicides for that long was in 1957.
Gov. Ron DeSantis (R) has been pushing to lift restrictions in Florida as soon as possible to reopen the economy. According to the Yale estimate, the state had only a small number of excess deaths through early April, about 200, and that number is almost equal to the official covid-19 tally.
“We expect there is some level of undercounting,” said Natalie Dean, a professor of biostatistics at the University of Florida. “It’s clear we are missing deaths.”
In Louisiana, the Yale analysis seems to run counter to what might be expected based on news headlines.
The state is enduring one of the worst coronavirus outbreaks in the country after more than 1 million people gathered for Mardi Gras festivities in New Orleans in February. The analysis estimates, however, that although 408 people were reported to have died of covid-19 by April 4, Louisiana had slightly fewer deaths overall than normal during the preceding five weeks. According to the Yale team’s estimates, Louisiana has recently been among the slower states to report deaths.
Joe Kanter, an assistant state health officer for the Louisiana Department of Health, confirmed that as of the end of March, the state had not yet seen a surge in deaths overall compared with prior years. He said he believes that Louisiana’s covid-19 count is as close to accurate as possible, pointing out that last week, the state began reporting probable deaths in addition to those confirmed by lab tests.
But some officials in that state say the coronavirus death toll will end up higher than is currently known, according to emails obtained by Columbia University’s Brown Institute for Media Innovation that were shared with The Post.
In an April 4 email, New Orleans Health Director Jennifer Avegno noted a spike in paramedics’ reports of deaths on scene and of cardiac arrests requiring advanced life support, including CPR. The number of such reports in March was 24 percent higher than it had been in March 2019.
“Thus I would probably add about 15% or so to the known death toll,” she wrote to two city officials. “However — no city or state will be factoring this in or reporting it, so I don’t think we should either. We should just assume that the deaths are about 15% more than we can count, but not include them in official modeling, because we will never really know.”
In a phone interview on Thursday, Avegno said she is concerned about elected officials across the country reopening cities and states based on what she believes is an undercount of covid-19 cases and deaths.
“I worry that the numbers give them a false sense of security that they may be communicating to the public,” she said. “They may think the number of cases is more limited but they are not testing widely enough to know.”
Lenny Bernstein, Lenny Bronner, Jacqueline Dupree, Aaron Steckelberg and Reis Thebault contributed to this report.

Methodology
A research team led by the Yale School of Public Health used historical data on all deaths between 2015 and early 2020, published by the National Center for Health Statistics (NCHS), to model the number of deaths that would normally be expected each week from March 1 to April 4. The estimate takes into account seasonal variations, intensity of flu epidemics, as well as the expected increase in deaths due to overall population growth.
Details on the team’s statistical approach estimating seasonal baseline deaths can be found in an article posted online at the preprint server medRxiv. The method used for this analysis differs in that researchers did not attempt to correct for data reporting delays, as they did for their previous article. Instead, the analysis for The Post relied only on reported deaths, a more conservative approach to estimating excess deaths.
The number of overall deaths in the United States and for each state was obtained from provisional death data published weekly by the NCHS, part of the Centers for Disease Control and Prevention. Figures for Connecticut, North Carolina and the District were not up-to-date, and those jurisdictions are not included in this analysis.
Those data are collected from state health departments, which report deaths at different rates. It usually takes about three weeks for death data to stabilize, but even then, they are still not complete. As a result, it is expected that the numbers of total deaths as of April 4 will continue to increase as states continue reporting additional data to NCHS.
The number of excess deaths was calculated by subtracting the expected seasonal baseline from the number of all deaths. Because the seasonal baseline is an estimate, there is some uncertainty associated with the excess-death figure of 15,400. Based only on the deaths reported so far, there is a 90 percent chance that the actual number of excess deaths is greater than 12,000, and a 70 percent chance that it is greater than 14,000.(There is a 2.5 percent chance that the actual number of excess deaths is lower than 10,000, and an equal chance that it is higher than 20,000.)
The covid-19 death toll as of April 4 comes from figures reported by state public health departments and compiled by The Post.