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Medical Examiner plans to revisit pre-pandemic autopsies to look for COVID-19

Overdoses and Homicides on rise as Ohio re-opens
Posted at 4:00 PM, Jun 11, 2020

CLEVELAND — Ohio's first confirmed COVID-19 death was March 17. In the nearly three months since, Ohio has confirmed 2,490 deaths. Cuyahoga County has surpassed 300 deaths alone.

Now, the Cuyahoga County Medical Examiner said he wants to look at autopsies from before that first death to see what we can learn about the disease.

Note: This map is updated daily, and after 24 hours may not reflect the data at the time this story was first published.

“One of the things that we are going to undertake with the support of the Executive is to try to go back and look at some of the specimens that we collected going back to February and see if the disease was here earlier,” said Dr. Thomas Gilson, Cuyahoga County Medical Examiner.

“There wasn’t a lot of access to testing for anybody back at that time," Gilson said. "The state prioritized people who were living and symptomatic, so we couldn’t really test anybody in our agency.”

Re-testing older autopsies will likely prove more scientific answers as to when COVID-19 showed up in Cuyahoga County than conducting antibody tests on people who were diagnosed with flu or pneumonia before March.

Specimens from the time someone died will provide an accurate picture of what was going on right at their time of death.

"If we do have someone we can look at their symptoms and see if someone who died but wasn't really symptomatic from it," Gilson said. "That's a big question we really don't know. What is the extent of the disease and how does it manifest in people who don't get as sick as people who pass away."

What constitutes a COVID-19 Death?

The Medical Examiner's office typically does not conduct many COVID-19 autopsies.

Patients with COVID-19 are often hospitalized when they die. The death is deemed natural and certified by a physician at the hospital, instead of the medical examiner's office.

"I really think there has been chatter on both ends of the spectrum," Gilson said."The pressure is on to bump up the numbers or we are hiding COVID-19 deaths. I would have to say that is not my experience from what I am seeing."

Gilson said if people test positive for COVID-19 and have pneumonia or a lung condition, those are being counted as COVID-related deaths.

"I don't think anyone would argue with that," Gilson said. "But, if I had somebody who had flu-like symptoms and had a car crash on the way home, that's not a COVID death. I really don't think its that mysterious for the majority of cases."

RELATED: How COVID-19 deaths are reported, and why there's so much misinformation about the process

Other pandemic trends

Gilson said the county is not seeing a sustained increase in suicides, domestic violence deaths or motor vehicle crash deaths.

But he is concerned about a dramatic increase in drug overdoses. In May, at least 66 people died of drug overdoses, most often related to fentanyl, cocaine or carfentanyl, with heroin as a secondary drug. May's total will likely be the deadliest in Cuyahoga County's history.

RELATED: 66 overdose deaths in May brought Cuyahoga County to near-record levels

"We saw a really dramatic rise in opioid overdoses and it really was as bad a month as we've ever seen since the start of the opioid crisis," Gilson said. "It seemed to coincide with the lifting of the stay at home restrictions. It certainly bore out as bad as we could have imagined."

Gilson said he's not sure if people lost their tolerance for drugs, had limited access to rehabilitation or if the supply temporarily dried up. But, it is back and the trend is continuing into June.

Another disturbing trend: Gilson said homicides also jumped in May and that continues to be the case in the beginning of June as well.

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