Not sure if this is true in all states but in my state, if someone has a heart attack while driving and and crash their car, the crash is not considered a fatal car crash if they are determined to have died from the heart attack and not the crash. That is, unless someone else dies in the accident. So this part about is the cause of death COVID-19 or whatever had the person in hospice in the first place, while being news, is not particularly surprising now that I think about it. I didn't realize that there was no CDC definition yet. So as far as you know your region is using the CSTE standard but I wonder how widespread the adoption of that standard is, or if there are other, competing standards, and if so, what the differences might be. That whole thing with the tests and EUA labs... wow. This is going to be a mess for awhile, isn't it?I never put this in Chat, but one of the concepts of death I want people to consider -- Someone has a heart attack while driving. They crash their car. They die. Did they die from the heart attack or the car crash? Is this person's cause of death heart disease, or accident? How do we keep statistics as accurate as possible? There's no right or wrong answer, it's simply a though-experiment to ponder.
It's great your state defines that kind of stuff. I'm not sure which ones do and which ones don't. I think John Oliver's look into coroners and medial examiners is interesting. I haven't watched it in quite a while so I don't remember exactly how relevant it will be, but I remember being appalled at the lack of training some of these people need. Actually, CDC adopted CSTE's definition between me posting that in Chat and now!. I don't know exactly which day, but they did accept it. In regards to other standards I couldn't begin to guess. But now that CDC has adopted hopefully that helps things out a bit. Now, of course that's new and who knows how long it will take for that to be adopted nationwide. As much as we like to think it'll happen overnight, that's a wildly optimistic viewpoint. That assumes every level is auditing the next level below, to the local head of disease investigation auditing their workers', and I can verify they're too busy to be doing that. Maybe the state is watching, but they won't be watching if labs and kits are EUA approved, that's my and my colleagues jobs. And the idea we have time for that is wild. We have to find time, but that means other things get pushed off. It's vital because that's the difference between an asymptomatic person being counted as Confirmed vs Not a Case. When I have a facility that tested everyone and have a pile of 40 tests all of which are from an unapproved lab and 3/4 of cases are asymptomatic, that's a ton of time whether or not I have to manually input those patients and labs and call them a case or if I just get to shred the report. All of my colleagues are running into the same issues. We had a meeting on Friday at like 2:30 to review test kit and lab guidance and the determination was pretty much we're expected to do the legwork to find out if people are EUA approved or not, which includes calling labs and asking if they're approved and not on the FDA's site yet, if their kits are approved, or if they're all unapproved. And the lowly receptionists who answer the phones certainly don't know. So they bounce us up to a voicemail we may or may not hear back from. Now I get to play the game of "How many times do I have to call the lab?" Oh, and Friday right after that meeting, I found a lab result in the system which said the lab and test kit are not EUA approved, but the assay medium in the test kit is. I bounced that up to my our head of disease investigation and am waiting on a response. I really hope I'm not expected to call a lab and find out they use a test kit then call the kit company and find out what specific part of the kit is approved then keep going to him and asking what is and isn't allowed. When I left Friday I still didn't have an answer. Yeah, it's gonna be a mess for a good long while.