Few COVID-19 tests performed after death

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In the effort to curtail the spread of the coronavirus, government leaders are working to increase the number of people being tested for COVID-19. In rare cases, that includes testing people who have recently died.

In the midst of the pandemic, many people have had difficulty getting tested, though the federal Centers for Disease Control and Prevention are loosening .

"Until the testing ability ramps up, the resources and testing should be reserved for those critically ill patients that the quick test and diagnosis may significantly impact their direct care," said MariaTeresa Tersigni-Tarrant, chief death investigator for St. Louis. "For decedents, we can always collect the samples immediately but hold them for testing until ability increases."

Few tests are being performed on the dead, but in some cases, testing for the is time-sensitive even after death. There may be a risk, for example, that other people have been exposed.

St. Louis city's medical examiner has requested just one COVID-19 test done quickly, because first responders came in close contact with the body.

"The ramifications of that are, we're taking and paramedics off the streets," Chief Medical Examiner Michael Graham said. The test came back negative, he said, so those first responders were able to return to work.

St. Louis County Chief Medical Examiner Mary Case said she's tested four bodies for COVID-19 in the past two weeks.

"We've done the test when people need to be checked out," Case said. "If they've died in a nursing home, and they had respiratory symptoms but they died before the test could be done ... because they were in a nursing home, people get very anxious. I will do that kind of test."

Case is also the chief medical examiner for the Regional Medical Examiner's Office, which includes St. Charles, Jefferson and Franklin counties. Case said she has not had to perform any post-mortem COVID-19 cases in those jurisdictions.

Coroners in Madison and St. Clair counties also reported performing no COVID-19 tests. The Madison County office has a checklist of questions about symptoms that death investigators ask families of the deceased to see whether testing needs to be done.

It's unclear how many post-mortem tests may have been performed statewide. Missouri officials said no post-mortem swabs were sent to the state lab. Samples can be tested at commercial labs without needing state approval.

Just as is done with living patients, testing is done on bodies by taking a nasal swab. Graham said that samples from the lungs of a deceased person also may be used to test for COVID-19.

"We were already doing a similar test" for viruses, Case said. "It's done pretty much the same way with exactly the same kit we already had."

Medical examiners in some jurisdictions are now taking greater precautions to protect themselves from exposure to COVID-19, including wearing more personal protective equipment. Case said their investigators aren't going out to car crash scenes or overdose scenes unless first responders tell them there's something unusual about the case, to minimize contact with others.

"Because of the big risk out there of community spread, we're bending over backward to see how we can prevent that," Case said. "We're having to create new protocols every day for what we're doing."


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