UPDATE Dec. 9, 2020: Just one day after changing its method of reporting COVID-19 deaths, Iowa has surpassed 3,000 deaths during the pandemic. As of 10:30 a.m. Dec. 9, the state reported 3,021 Iowans have died of the virus, up 102 from the previous day, with 2,768 listing COVID-19 as the underlying cause and 253 as a contributing cause. Iowa also is nearing 250,000 positive cases, with 248,782 confirmed COVID-19 tests. Gov. Kim Reynolds extended her emergency proclamation through Dec. 16.
Iowa has changed its method of reporting COVID-19 deaths, resulting in a large increase, as the state retroactively applies the new methodology since the first Iowan died of coronavirus in March.
As of 10:30 a.m. Dec. 8, 2020, Iowa reported 2,919 deaths attributed to the virus, up 202 from the same time on Dec. 7, when 2,717 deaths were reported.
Related: COVID-19 deaths skyrocket in Iowa
Iowa also reported 141 nursing home outbreaks on Dec. 8, representing nearly one third of the state’s 432 long-term care facilities, with 1,127 deaths tied to those outbreaks.
Confirmed COVID-19 cases rose to 246,237, up 1,393 from Dec. 7, while 900 Iowans were hospitalized, with 191 in intensive care, 111 admitted in the past 24 hours and 111 on ventilators.
The Iowa Department of Public Health announced the change in methodology to better align with national and state reporting of coronavirus deaths.
“As we learn more about the virus and testing expands significantly, Iowa like many states has changed its methodology,” the department announced. “The Department elected to make this change in consultation with our federal partners at the Centers for Disease Control and Prevention (CDC), as well as a review of the variety of methodologies in other states. The new methodology will be consistent with the way the CDC reports deaths nationally, enhancing accuracy of reporting as counts will be tied directly to official death records.”
Under the methodology used since March, a death had to meet two requirements: a positive polymerase chain reaction (PCR) COVID-19 test recorded in IDPH’s Iowa Disease Surveillance System (IDSS) and reported to the department as deceased, through either case investigation or the death record.
That methodology did not include cases where a death was reported and could be matched with a positive antigen test result, nor did it include in the death count cases where COVID-19 is listed was a cause of death in the death record, but there was no positive PCR test result on file with the department.
Under the new methodology, based on the CDC’s National Center for Health Statistics (NCHS) cause-of-death coding, a case must be coded with the International Classification of Diseases, 10th Revision (ICD-10) code U07.1 as the underlying cause of death or a contributing factor to death. Coding is based on the registered death record completed by the health care provider.
This methodology does not require a positive PCR or antigen test result. Deaths will be counted as a COVID-19 death if NCHS codes the death record with code U07.1 as the underlying cause of or contributing factor to death. The new methodology ensures the number of COVID-19 deaths reported will match the official state vital statistics report, when eventually published, and will provide greater consistency between the number of deaths reported by federal, state and county government agencies.
The department noted that NCHS ICD-10 coding can take approximately seven days to complete and return to the state, which will increase the time between when a death is reported to the state and the date it will be published on the website.