Last week, California Gov. Gavin Newsom said he was requesting that coroners around the state reexamine deaths that back date back to December in an effort to hunt for previously undetected coronavirus cases.
Reports of California’s first death from the virus, in Santa Clara County on Feb. 6, turned out to be weeks earlier than officials previously had thought that people were succumbing to the illness. That prompted the governor’s request.
Whether local medical examiners actually will be able to test old cases, however, remains uncertain.
A day after the governor made his public request on April 22, the California Office of Emergency Services made calls to Southern California coroners, according to local officials.
Capt. Greg Myler runs the San Berardino County Sheriff’s coroner division, and got one of those calls. He said coroner’s employees researched what the Centers for Disease Control require to process samples for coronavirus tests — one of the requirements was submitting at least eight lung tissue specimens from a deceased person being tested.
“We only collect five,” Myler said.
Other requirements also could make testing old cases more complicated, Myler said. In its guidelines, the CDC said any sample stored in formalin — a mixture of water and formaldehyde commonly used in medical examiner offices to store old tissue samples — for more than two weeks could produce a false negative.
“These case that the governor’s office are talking about are far older than two weeks,” Myer said.
Newsom’s request reflects the confusing testing picture California officials were dealing with in the lead-up to statewide lockdown orders and widespread detection of where the virus was spreading.
In her announcement of the death, Santa Clara County Public Health Officer Sarah Cody said a medical examiner got the test results on the Feb. 6 death of the woman after sending her samples to the CDC. It’s not clear why the CDC took so long in sending them back.
Federal officials only approved emergency testing of potential coronavirus samples two days earlier. But the woman’s death prompted new concerns from public health officials that he virus was spreading in communities earlier than that.
Now, trying to go back and resurrect old samples that are viable for testing could be even more complicated — the conundrum for San Bernardino County in trying to get to the bottom of whether people were dying there of coronavirus weeks earlier than previously believed will likely apply to other counties.
Different coroner’s offices don’t follow the exact same procedures — some might store more tissue samples, others might use different storage solutions. But coroners contacted around Southern California were also still trying to figure out if testing old samples, and getting reliable results, was possible.
The Orange County Sheriff’s coroner division is asking for more guidance from state public health officials on how to proceed with testing.
“There’s not a lot of clarity on how difficult or easy this will be,” said Carrie Braun, a spokeswoman for the sheriff’s department.
No one in coroner’s offices in Los Angeles, Orange or San Bernardino counties were able to say exactly when they began testing for coronavirus among deceased people that they examined. The Riverside County Sheriff’s Department medical examiners did not respond to a request for comment.
Medical examiners in L.A. County were “already looking into the feasibility of testing individuals who died in previous months,” before the governor’s request, said Sarah Ardalani, a spokeswoman for the county coroner’s office.
“We are still working things out,” she said in an email.
A review of L.A. County coroner’s death records do not show a spike in deaths over the last few months, even as the county’s death toll from the virus rose past 1,000 this week. In December, the coroner investigated 554 deaths, followed by 578 in January and 573 in February. In March, the coroner investigated 569 deaths.
Coroner’s offices typically handle deaths that occur outside a health care facility, like crime victims and people who died at home.
Still, the governor was hopeful more counties would start investigating when their first deaths occurred.
In his April 22 address, Newsom called the timing of the first coronavirus deaths in the state “profoundly significant.”
“I imagine subsequent announcements that may be made by similar efforts all across the state of California,” he said.