In 2020, I used social media for my Coroner’s posts on COVID-19. These are some of the Facebook posts I wrote documenting the first surge of the pandemic in early 2020.
The posts are unedited and shown with original images. The quality of writing and graphics could be better, but that wasn’t the priority at the time. We were all doing the best we could with the time and resources we had. I’ve added a few clarifying footnotes.
Foreshadowing the COVID-19 Pandemic
January 3, 2020, 7:35 PM. The first statistics for 2019 in the Coroner’s Office: we investigated a total of 1114 deaths, with a big surge in December. As always, the majority are natural deaths, but without a central facility and no County morgue or autopsy facility, managing more than 150 cases in one month was a huge challenge.
We hope the new Commissioners understand this and will support moving ahead with plans for a safe and decent central facility for Chester County families.
Author’s Note: With hindsight, this is fascinating. At the time, the December jump in cases was overwhelming, but unexplained. In retrospect, is it possible COVID-19 was already here? “New Commissioners” refers to the three newly-elected County Commissioners of Chester County, PA, the folks who control the Coroner’s budget. “Central facility” refers to the fact that Chester County had no morgue when the pandemic broke. It still doesn’t, except for a refrigeration unit in a maintenance garage.
COVID-19 Preparations
February 26, 2020, 9:53 PM. We checked in with the CDC and the State Department of Health’s Virology Lab today to find out how and where we would send tests for this new virus. The State Dept. of Health doesn’t have the new testing kits yet, so we’d have to send samples (two kinds) to the CDC. However, we were told to expect that tests from decedents would understandably be lower priority than tests in living patients.
March 15, 2020, 1:52 PM. We are not aware of any deaths due to COVID-19 in Chester County at this time. By Pennsylvania law, the Coroner’s Office is responsible for investigation of “Deaths known or suspected due to contagious disease and constituting a public hazard.” So, we do have policies and procedures in place should such a death occur, as we do for other types of deaths impacting public health.
March 25, 2020, 10:31 PM. We are recommending that everyone who may be faced with the death of someone at home or in hospice care plan in advance with regard to a funeral home decision. …It is critical that we limit transport of decedents into a hospital morgue (our only option currently). Not only may the hospital need those few morgue spaces, but avoiding hospital exposure is a wise precaution given our staff’s frequent contact with the public and law enforcement.
Coroner’s Posts on COVID-19 in early April, 2020
March 30, 2020, 2:58 PM. Chester County’s first confirmed COVID-19 death happened yesterday; details are in (this article) The decedent’s name is not being released at this time.
April 1, 2020, 7:26 PM. This article highlights the difficulties with determining cause of death in this coronavirus pandemic.
Challenges in determining cause and manner of death, though, are not new to coroners and medical examiners. Some causes (motor vehicle collision with obvious trauma) are straightforward. Many others require synthesizing all the information available from the death scene, from medical records, from interviews, from autopsies and laboratory tests, and as it says in the CDC instructions, coming up with “your best medical opinion.”
April 5, 2020, 5:52 PM. So far in the past week, seven deaths attributed to COVID-19 have been reported to the Chester County Coroner’s Office, most in the past two days. These are deaths occurring within the County (regardless of residence) with a clinical picture consistent with COVID-19 and a positive COVID-19 test.
Our office now has a few kits available to test decedents. We know this is worth doing, because two positive tests this week came from nasopharyngeal samples taken by our hard-working Autopsy Technician on decedents in a morgue or funeral home. These people never sought medical care but died at home.
April 7, 2020, 5:51 PM. Pennsylvania Coroners are having trouble getting tests, and it looks like we aren’t the only ones. Deaths that occur out of hospital also need to be tested – the decedents have been out in the community, or with family, and EMS, police, and funeral homes are responding to these home deaths and want to know: Was it COVID-19?
Coroner’s Posts on COVID-19 in mid-April, 2020
April 10, 2020, 6:34 PM. Starting today, the Chester County Coroner’s Office will be posting weekly information on Chester County COVID-19 deaths reported to our office, including some basic demographic summary statistics. This first report covers the time period from 3/28/2020 (first death) to this morning (04/10/2020): Number of COVID-19 test-positive deaths: 21.
April 11, 2020, 2:33 PM. Coroners count all deaths occurring within the County (that’s our legal jurisdiction), whereas the County Health Department counts all Chester County residents who die of COVID-19 (regardless of where they pass away). They do not count those who die in the County but came from elsewhere (like Montgomery or Lancaster County); we do.
Two systems, with different definitions. Hope this helps explain any discrepancies and dispels confusion, which is certainly the last thing we need right now!
April 17, 2020, 9:18 PM. Our office, like other county coroner offices in Pennsylvania, receives reports of all COVID-19 deaths from facilities in our county as required by state law. We know everyone is doing the best they can fighting an invisible and deadly enemy.
We are so sad that our elderly and their overwhelmed care providers, whether in long term care facilities, hospitals, or homes, are bearing the brunt of this pandemic in Chester County and elsewhere.
Author’s Note: Long term care facilities refers to the April 17 News breaks of a high number of COVID-19 deaths at Chester County’s Southeastern Veterans Center.
Coroner’s Posts on COVID-19 in late April, 2020
April 18, 2020, 4:25 PM. The Chester County Coroner’s Office weekly report Friday was in the form of a press release (which includes full demographic data). We reported a total of 52 confirmed (test-positive) COVID-19 deaths as of 5 pm on Thursday, April 16.
April 24, 2020, 4:52 PM. Once again, to be clear, the Chester County Coroner’s Office, like every other Coroner in the Commonwealth, is responsible for jurisdictional deaths (defined in state law) that occur in the county. Seems simple enough and no one ever questioned this before since the law was passed in 1953 and renewed in 2018.
As of today, 04/24/2020 at 16:45, 117 test-confirmed COVID-19 deaths and 15 “presumed” COVID-19 deaths (the reporting facility did not test) have been reported to this office. Three additional cases have test results pending. We also know that due to the confusion described in this article, some facilities are not reporting as they should be.
April 27, 2020, 8:03 PM. This chart tracks the cumulative number of COVID-19 related deaths (confirmed, presumed, and total) reported to the Coroner’s Office (note: as of April 26, 2020). The actual number is likely somewhat higher (than the 150 shown), as long-term care facilities have received mixed messages on the reporting requirement for contagious diseases.
Even though COVID-19 death reporting is incomplete, it is not as incomplete as COVID-19 testing. When even sick people in congregate care communities are dying without being tested, and only a tiny fraction of the rest of the community is being tested, how will we really know if the number of new infections is going down?
April 28, 2020, Approximately 70% of those dying of COVID-19 in Chester County are from long term care facilities, mainly nursing homes.
This CNN article shows the same is true across the United States.
COVID-19 deaths in Chester County, PA dip in May 2020
May 6, 2020, 4:47 PM. The Chester County Coroner’s Office noted a decrease in the number of newly reported COVID-19 last week and is hoping this is the beginning of a trend and not just a temporary dip.
Author’s Note: In 2022 I downloaded a copy of all my Facebook posts. I have no idea if they still exist on the platform anymore. The only change I made in the posts was a new link in the March 30, 2020 post. The original Chester County press release was no longer available.