New York will start testing for COVID-19 of the dead: why is it needed

New York plans to increase the number of tests for patients with symptoms COVID-19 and for those who were not tested before dying. This will help better control the spread of the coronavirus and better prepare for the flu season. The details are shared by the newspaper The New York Times.

Cough, fever, chills are symptoms seen in both COVID-19 patients and those with the flu. This means that regular testing for both viruses will be critical in the fight against coronavirus - even possibly after some patients have already died.

To this end, New York plans to begin testing patients posthumously for both coronavirus and influenza, the official said.

According to the new rules, respiratory-related death that was not confirmed prior to death must be followed by testing for both viruses within 48 hours. “These rules will provide us with the most accurate death data available as we continue to monitor COVID-19 as we prepare for the flu season,” said state health commissioner Dr. Howard Zucker last week.

Deceased hospital patients and residents of nursing homes, as well as bodies in the care of funeral directors or medical examiners, will be among those who will be tested posthumously. If experts at a local facility are unable to conduct testing on their own, they can ask the state to test for them at its public health laboratory.

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The results of these tests will help health officials track the prevalence of both types of infections. And if a coronavirus is detected in the dead, their relatives will be able to notify of the need to self-isolate. “People need to know which people around them were sick,” said Dr. Valerie Fitzhugh, a pathologist at Rutgers School of Medicine in New Jersey. "If someone cannot be tested while alive, why not test him shortly after death?"

“The early introduction of such a rule will also encourage counties to increase their willingness to test ahead of fall and winter, when seasonal viruses such as influenza and respiratory syncytial virus (RSV) tend to thrive,” said Dr. Mary Fawkes. Fowkes, a pathologist at Mount Sinai Hospital in New York. In many parts of the country, COVID-19 is progressing every day, and new cases will become increasingly difficult to track, as diseases like these make it difficult to see the full picture. “I think it's important to prepare for this,” Fawkes said.

In the early days of the pandemic, New York, like the rest of the country, fought to curb the virus. Many diseases remained untested, including several thousand people whose deaths were later reclassified as alleged but unconfirmed cases of COVID-19.

"A lot has changed since the spring," said Gareth Rhodes, special adviser to the New York State Department of Financial Services and a member of Governor Andrew Cuomo's virus team. - New Yorkers began testing for coronavirus in March. Today, about 100 COVID-19 tests are performed per day, of which about 1% or less are positive. While hundreds of people are still hospitalized across the state, daily deaths from the virus have been in single digits on average since late August. ”

The new rules also stipulate that living patients with flu symptoms must be tested for both pathogens. This makes it less likely that a COVID-19 case will be missed. “We are monitoring deaths very closely,” said Mr Rhodes. So far, he added, New York City's coronavirus testing regimes in healthcare settings are pretty consistent. “You can't be in a hospital in New York right now and not get tested,” he added.

These rules do not apply to all deaths, only to those suspected of having respiratory infections. This means that testing the dead for coronavirus is unlikely to reveal a large number of new cases, which means that the picture will not change much.

Since the announcement made last Sunday, the Wadsworth state lab has yet to receive a request for post-autopsy testing.

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However, the rules can come in handy if, for example, death occurred on the way to the hospital or shortly after arrival, or if an emergency caused the laboratory to be temporarily closed, making tests impossible immediately. Others may die at home or elsewhere outside a hospital or nursing home without access to tests. "It's designed to track all cases," said Dr. Rosemary She, a pathologist at Southern California's Keck School of Medicine.

A number of pathologists noted that while testing for coronavirus for sick patients is almost universally used in healthcare facilities in other states, combination testing, which includes testing for influenza, including post-mortem testing, is not as common and may require consideration.

More laboratories are likely to need investment to acquire tests that can detect several types of pathogens at the same time. One of the tests conducted at Wadsworth, for example, is the so-called breathing panel made by BioFire. It simultaneously searches for genetic material from more than 20 types of bacteria and viruses, including the coronavirus and several types of influenza viruses.

Some experts have postulated that measures such as distancing and wearing masks could soften the blow of the upcoming flu season, as has apparently happened in the southern hemisphere. But "it's in our best interest to prepare for the worst," said Valerie Fitzhugh, "and hope for the best."