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Data discrepancy: Oklahoma officials provided out-of-date look at coronavirus deaths

A nurse administers treatment to a COVID-19 patient in the SSM Health St. Anthony Hospital COVID-19 intensive care unit in December.  [Chris Landsberger/The Oklahoman]
A nurse administers treatment to a COVID-19 patient in the SSM Health St. Anthony Hospital COVID-19 intensive care unit in December. [Chris Landsberger/The Oklahoman]

The Oklahoma State Department of Health for months presented the public with a COVID-19 death toll that had fallen far out of date.

Noting that its count was no longer timely, the agency announced last week that it would begin to present the death toll that is used by the Centers for Disease Control’s National Center for Health Statistics, which shows roughly 2,500 more Oklahomans have died from COVID-19 than the state had reported.

Until then, the state reported a death toll that lagged far behind the CDC’s provisional death count.

While that count is based on death certificates — and is considered the “most complete and accurate picture of lives lost to COVID-19,” according to the CDC — Oklahoma’s health department was only adding a death to its toll after a detailed investigation.

The state’s process relies on health care providers to enter information into a database, and when hospitals were overwhelmed with patients, the state started to get more incomplete reports. In turn, the health department had to do more legwork in its investigations to verify coronavirus deaths, and its staff struggled to keep up.

State epidemiologist Dr. Jared Taylor said the health department had been aware of discrepancies in the death tolls since November.

“I think the next obvious question is, well, why now?” Taylor said. “Arguably, we were a little late in getting that done. I’ll own that.”

He said it became apparent that the state’s numbers weren’t going to align with the toll based on death certificates “in the near future,” and that prompted the change.

Taylor said there hadn’t been earlier discussions about making the change and that it wasn’t purposefully delayed.

“We certainly had not been waiting to do it,” he said. “There wasn’t anything that was a reason for delay. We just had not made that call until just recently.”

Asked if he believed the state had been providing an accurate depiction of COVID-19’s impact on Oklahoma before the change in death reporting, Taylor said he did, though he acknowledged the change could’ve come sooner.

“I would like to say and believe that, yes, we were representing it correctly, although again, I will own, myself, the responsibility of saying I think I could have been more quick in noting the significance of that difference.”

When health officials announced the change, Taylor had said it was an appropriate time to present the CDC’s provisional death toll “so that there's no perception that we're minimizing these deaths.”

“We recognize that each one of these deaths is a tragedy and is a great cost to the family and friends of that individual, to the state of Oklahoma, and to the world,” he said at the time.

Although the COVID-19 death toll reported by neighboring states has differed slightly from the deaths reported by the CDC, nowhere was that difference more glaring than in Oklahoma.

Texas, which has seen six times more COVID-19 deaths than Oklahoma, reported roughly 1,700 fewer deaths than those reported by the CDC. In Kansas and Arkansas, the discrepancy between state data and deaths reported by the CDC was just a couple hundred deaths.

Guided by data

From the beginning of the pandemic, Gov. Kevin Stitt said his decisions would be guided by Oklahoma’s COVID-19 data and that his administration would be transparent with Oklahomans about the spread of the virus.

“We will continue to make decisions based on the data in our state,” Stitt said in a May news conference.

But what if that data didn’t present the most accurate information about the virus’ toll?

Throughout the pandemic, the number of people hospitalized due to COVID-19 has driven Stitt’s decisions more so than any other metric. A lagging indicator, COVID-19 deaths aren’t the best figure for real-time decision making, said Stitt spokesman Charlie Hannema.

But the governor has, at times, touted Oklahoma’s low COVID-19 death rate. In a September news conference, Stitt said many Oklahomans who contracted the virus were asymptomatic or experienced mild symptoms.

“All lives are precious, and even one death is regrettable,” Stitt said. “But it’s important to note that we have the 14th lowest death rate per capita. That means 60% more Oklahomans are recovering than the national average.”

However, in light of the Department of Health’s announcement, the death toll Stitt touted was likely low.

In a statement, Stitt said he supports the agency’s decision to switch to reporting the death toll used by the CDC.

“As we continue to fight COVID, our team is constantly looking for ways to improve and be even more transparent with Oklahomans,” he said. “I support our health department’s decision to switch methodologies for tracking COVID deaths in Oklahoma to report information that is currently the most accurate and timely.”

In weekly reports from the Department of Health, calculations for Oklahoma’s per capita death rate use the state’s investigated total of deaths. Using that math, Oklahoma ranked 37th out of all states and Washington, D.C.

That doesn’t align with how Oklahoma has ranked for COVID-19 cases and hospitalizations per capita, said Dr. George Monks, president of the Oklahoma State Medical Association.

For months, he said, the state would rank in the top 10 for COVID-19 cases and hospitalizations per capita, while ranking much lower for deaths by population.

“We know Oklahoma in general has a number of comorbid conditions — we’re a fairly unhealthy state,” Monks said. “So you would expect our deaths per population to be very similar to what our cases and hospitalizations per population are, and perhaps a bit higher. But that wasn't the case. And the reason why it wasn't the case is because we've been so slow.”

Monks said the state should have relied on death certificate data from the start.

“Oklahomans expect timely and accurate information,” he said. “When you're 2,500 off the CDC number, it's not accurate. And when you're reporting deaths that occurred several months ago, that's not timely.”

When will Oklahoma’s count catch up?

The state health department will keep investigating and confirming COVID-19 deaths, and eventually, health officials expect Oklahoma’s investigated count and the provisional death count from the CDC to align.

That’s important, Monks said, because while the CDC toll is timely and accurate, the state’s process provides more detailed data about COVID-19 victims, including information about where a person lived.

Taylor, the epidemiologist, said the state will attempt to automate the process of confirming deaths. That will require the department connecting two systems: acute disease services, which investigates infectious diseases, and vital records, which is a repository of legal documents including death certificates.

“Once we do get those two systems connected, what we're going to do is, we're going to try to automate some of this process and probably not going to end up putting human eyes on all 2,000 or 2,400 of these differences,” Taylor said.

That should be able to address a large portion of the discrepancy between the two numbers. What that might look like to the public is a large number of COVID-19 deaths being officially confirmed by the state in a given week, Taylor said. He said he hopes that could happen within the next month.

Death investigations will continue to be made. Taylor said the department is lately seeing health providers send more complete information, making the investigation process faster for the state.

Related Photos


<figure><img src="//" alt="Photo - Taylor " title=" Taylor "><figcaption> Taylor </figcaption></figure><figure><img src="//" alt="Photo - A nurse administers treatment to a COVID-19 patient in the SSM Health St. Anthony Hospital COVID-19 intensive care unit in December. [Chris Landsberger/The Oklahoman] " title=" A nurse administers treatment to a COVID-19 patient in the SSM Health St. Anthony Hospital COVID-19 intensive care unit in December. [Chris Landsberger/The Oklahoman] "><figcaption> A nurse administers treatment to a COVID-19 patient in the SSM Health St. Anthony Hospital COVID-19 intensive care unit in December. [Chris Landsberger/The Oklahoman] </figcaption></figure>
Carmen Forman

Carmen Forman covers the state Capitol and governor's office for The Oklahoman. A Norman native and graduate of the University of Oklahoma, she previously covered state politics in Virginia and Arizona before returning to Oklahoma. Read more ›

Dana Branham

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