TRENTON, N.J. – Another 1,854 New Jerseyans will be counted as victims of the coronavirus following a state review of death certificates and prior outbreaks, bringing the actual total toll to 14,872 residents, officials said Thursday.
The 1,854 deaths were added after laborious work to tally probable COVID-19 related deaths in recent months. The number does not indicate a single-day surge that could slow or derail New Jersey's phased reopening.
“We report this out of nothing else than a solemn sense of duty," Gov. Phil Murphy said Thursday. "For many families we hope these determinations will provide a sense of closure and of finally knowing. For our state, I hope it steels our resolve to do all that we can to save every single life that we can save.”
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The state's prior count, updated daily, only included lab-confirmed cases and deaths. New Jersey now counts 13,018 lab-confirmed coronavirus deaths, with an additional 26 confirmed deaths added Thursday.
That total was lower than it should be, the governor said, because it did not include deaths where a COVID-19 test was not performed even though a person's symptoms and cause of death pointed to the virus. The new cluster of "probable deaths" include three groups of people, according to Dr. Edward Lifshitz, New Jersey's Communicable Disease Service medical director:Those who died and received a prior COVID-19 test, not one of the currently accepted testsPeople who died in known outbreaks, predominantly in long-term care facilities, and had symptoms, but were not testedPeople whose death certificates listed any of three terms related to the coronavirus, including COVID-19, SARS-CoV-2 or novel coronavirus. This group accounts for two-thirds of the probable deaths.
About a third of the probable deaths occurred in nursing homes and long-term care facilities, Lifshitz said. Those homes have been particularly hard hit by the virus, with 6,455 residents dead as of Thursday, according to reports from the facilities themselves.
The state's review did not identify any probable COVID-related deaths that occurred before the first confirmed death on March 10, Lifshitz said.
The state will continue its review and update the count of probable deaths weekly, Lifshitz said, noting that the number is not expected to increase greatly in coming weeks.
Other states have undertaken similar reviews, leading to dozens more deaths being counted as COVID-19 related. Delaware health officials announced on Tuesday they added 67 additional confirmed or probable COVID-19 related deaths to the state's total count after reviewing death certificates dated since April. There were 504 deaths and 10,847 positive cases in Delaware as of Tuesday.
North Carolina, Colorado and Michigan have also reviewed death certificates, according to media reports and news releases in those states.
States should review deaths to get a complete picture of how the virus spreads through communities, and should prioritize transparency — reporting deaths as probably related to COVID-19 and not confirmed — because there is some degree of interpretation involved, said Jeffrey Engel, former state epidemiologist in North Carolina and senior adviser to the COVID-19 response for the Council of State and Territorial Epidemiologists, which advises and advocates on behalf of state public health authorities.
Counting all COVID-19 related deaths, even those that are probably related to the virus, gives public health officials better information about how, and where, the virus impacts residents, which is especially important to study as states prepare for a second wave, Engel said.
And not knowing the full toll of the coronavirus could be detrimental as states reopen, he said.
“It leads to perhaps snap judgments on reopening," Engel said. "I think they need a complete picture of the impact of the disease in making these decisions.”
Complete counts better inform policymakers and elected officials, who chart the state's response and dedicate resources to it, said Dr. Henry Raymond, associate professor and epidemiologist at the Rutgers School of Public Health. It's common practice for public health officials to conduct reviews of prior deaths during epidemics, especially in the cases of new viruses like the coronavirus that initially aren't well understood, Raymond said.
Using probable and confirmed deaths, epidemiologists can see the path of the virus and if its victims share similar demographics that make them susceptible, Raymond said.
"If we can’t document that, we won’t know where best to put our resources for prevention and treatment," he said.
State Sen. Joseph Pennacchio, R-Morris, has been an outspoken critic of the Murphy administration's response to the virus. He said the state should have begun its review of death certificates much earlier.
"We need a lot more transparency," he said. "We have to be ready for this, we have to have the answer of what works and what doesn’t work, what we did and what we should have not done."
Follow Stacey Barchenger on Twitter: @sbarchenger