Gene Proctor remembers one of the first times he told the family of a recently deceased Georgian that he couldn’t test their loved one for COVID-19.
It was early April, and a 58-year-old woman had passed away at home after years of battling multiple illnesses. The family wanted to know if the coronavirus had ultimately caused her death, but Proctor, the Floyd County Coroner, didn’t have a test.
“At first they were upset because I couldn’t test her and I said, ‘Look, the few tests that we do have, have to go to the people that are still alive,” Proctor told The Daily Beast. “I told the daughter, in fact, ‘You take care of your mother most of the time, so it would be more important to know that you had it then if she did.’”
Since then, testing has increased substantially in the state, according to Dr. Jose Vazquez, chief of infectious disease at the Medical College of Georgia - Augusta University. Meanwhile, Georgia Gov. Brian Kemp has invited a slew of non-essential businesses, from hair salons to restaurants, to reopen in recent days.
But even as that scheme proceeded this week, coroners across the state told The Daily Beast the actual number of deaths caused by the coronavirus was higher than the official count published each day by the Department of Public Health. That number stood at just more than 1,000 on Tuesday afternoon.
That the United States has previously undercounted coronavirus deaths, and coroners have often lacked tests to pick up the virus, has been well established.
But interviews this week painted a picture of a state still lacking the tests needed to get an accurate picture of the body count even as pandemic models pointed to the potential for a massive surge in deaths thanks to such an aggressive reopening calendar.
“I think it’s a real possibility that we could be seeing under-reporting by anywhere from 10 to 20 percent, and that’s a lot of deaths,” said Tony Brazier, coroner in Polk County, an hour outside Atlanta.
“What I and countless other coroners and health-care providers across the state are worried about is, in 14 or 15 days, are we gonna see a second wave of this stuff?” Brazier added. “That’s the $64,000 question right now.”
The governor’s office did not respond to requests for comment from The Daily Beast for this story. A spokeswoman for the State Department of Health said that, while there aren’t currently plans to provide coroners with coronavirus tests, “with more test kits available now than previously, that may change.”
Brazier believes the coronavirus has been present in Georgia for some time, citing doctors in his county who he said began seeing patients come in with headaches, high fevers, and dry coughs months ago. Many of those patients, Brazier added, tested negative for the common flu and strep throat. Some of them died, but their deaths came long before most people in the United States were taking the threat seriously, he said.
At least a portion of those deaths should now be considered uncounted coronavirus deaths, according to Brazier. But far worse, argued Fannin County Coroner Becky Callihan, is that many deaths caused by the virus continue—even now—to go uncounted in the state’s official tally.
“I don’t think [the state’s] reporting is accurate because there are people that are not being tested that are dying, and we’re putting down that they had pneumonia or they had a heart attack, but they also had the symptoms of COVID,” Callihan told The Daily Beast on Tuesday.
Coroners in some states have had access to tests for some time, although not as many as they would like, CNN reported in early April. For her part, Callihan said coroners statewide don’t have access to tests they need to offer a picture of the death toll.
“Without testing, how’s the state going to get an accurate number of deaths?” she asked.
One way to reach a more robust count of deaths likely caused by the coronavirus is to look to the total number of deaths across the state so far this year compared to years past, argued Terrell County Coroner James Hamby.
“Normally we have 38-50 deaths a year in Terrell County. I’m on number 52, and it’s only April,” Hamby said. “I’ve done a year’s worth of work in less than four months, and not all of them were tested, because in January and February we weren’t even looking for COVID.”
Data from the Centers for Disease Control and Prevention (CDC) show a slight uptick in statewide flu and pneumonia-related deaths in the first four months of 2020, some of which could have actually been coronavirus-related, coroners in Georgia said. That’s because people who die in their own homes and are discovered by family—as opposed to those with nurses, in hospice care, nursing homes and hospitals—are not tested, they said. (In New York City in early April, more than 3,000 people were added to the city’s coronavirus deaths by attempting to account for those who died in their own homes.)
“If we could have a test on hand that would be wonderful, but being realistic I don’t think the state is going to pay for that,” said Twiggs County Coroner Harold Reece Jr. In Dawson County, Coroner Ted Bearden said “there isn’t a coroner in this state” that wouldn’t regularly test for the coronavirus if given the chance. “But I could not tell you today where I could get a test kit from,” Bearden added.
CDC data shows that deaths across the country were higher than normal in the first months of 2020, when federal, state and local governments had yet to implement procedures to slow the coronavirus’ spread. Researchers at Yale recently estimated that as many as twice as many people died from the coronavirus between Jan. 1 and the week of April 4 than state health department data showed. Instead of roughly 8,000 Americans dying from the coronavirus in that time period, the researchers said the number could be as high as upwards of 15,000.
“What if we’re off by 50 percent?” Brazier said. “What if, in the state of Georgia, instead of 1,050 deaths we’re really at 2,100?”
The concerns from Georgia’s coroners came as other states moved to implement their own reopening plans. But Peach State coroners said having a full accounting of deaths caused by the virus not only helps the public understand its dangers, but informs state and local leaders on whether reopening is safe in the first place.
“They went from total lockdown to pretty much,’ Do what you want to do,’” said Houston County Coroner Danny Galpin. “It should have been slower than that here.”