Across the country, coroners are going through a process of re-evaluation, reconsidering deaths that occurred before testing was widely available. Coroners and medical examiners generally investigate deaths that are considered unusual,
Joani Shields, the coroner in Monroe County, Ind., said she wondered about a man diagnosed with pneumonia who died in early March.
A coronavirus test was requested at the time, but the local health department denied it, Ms. Shields said, on the ground that the supply of tests was too limited.
“I wish we could have tested him,” she said.
In Shelby County, Ala., Lina Evans, the coroner, said she was now suspicious of a surge in deaths in her county earlier this year, many of which involved severe pneumonia: “We had a lot of hospice deaths this year, and now it makes me go back and think, wow, did they have Covid? Did that accelerate their death?”
Ms. Evans, who is also a nurse, is frustrated that she will never know.
“When we go back to those deaths that occurred earlier this year, people who were negative for flu, now we’re having the ‘aha!’ moment,” she said. “They should have been tested for the coronavirus. As far as underreporting, I would say, definitely.”
Disparate reporting, more waiting
Even now, as testing is more widely available, there is a patchwork of standards about information being reported by state and local health officials on deaths in the United States.
Around the world, keeping an accurate death toll has been a challenge for governments. Availability of testing and other resources have affected the official counts in some places, and significant questions have emerged about official government tallies in places such as China and Iran.