Some COVID-19 deaths were dead on arrival, so did they die from the coronavirus?

Guam Memorial Hospital (PNC file photo)

It’s really been a curious thing. At least three COVID-related deaths thus far have been Dead on Arrivals who are then found to be COVID-positive through mandatory testing in GMH’s Emergency Room.

But if they’re dead on arrival, what’s to say COVID killed them?

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Dr. Hoa Nguyen, of the Governor’s Physicians Advisory Group, said: “You know, it’s very hard. COVID-19 will stress your body out so, if you have diabetes, hypertension, end-stage renal disease, and dialysis and you have those problems already, then COVID-19 will add to those co-morbidities and increase the risk of you passing away.”

“It’s important to know that COVID-19 might not be the reason why they pass away but it will play a role in identifying whether they’re positive or not, because they then have to go back to the family and all the contact tracing,” added Nguyen.

The Doctor says ultimately, the post-death testing is done to trace back how that person contracted the disease and who else could have it in their network.

“Those people are mostly the elderly, they’re not the ones who are traveling around so much but the family members might be the carriers. So, it’s important for Public Health to go back and do the tracing.”

Lillian Perez-Posadas, the administrator for GMH, says they don’t do autopsies on the COVID-positive bodies to avoid the potential spread of the infection.

“We’re increasing the possibility, the potential for spread of infection when the mortician or the coroner cuts up the body, you’re pretty much increasing the potential for exposure,” said Perez-Posadas, adding that ultimately it’s a matter of protecting the staff and other patients at GMH.

“The person expires at home, they call the ambulance, the body gets brought to the Emergency Room and the ER doctor takes a look at the body. It’s pulseless, breathless and who knows for how long. It’s probably already discolored. So the doctor will then pronounce the individual dead from cardiac arrest and that means your heart stops. So, your heart is not beating and that’s as much of an appropriate diagnosis as the doctor can give as the cause of death,” said Perez-Posadas.

But if they have COVID, weren’t there symptoms? Why didn’t they get tested sooner?

Both Nguyen and Perez-Posadas say people are likely reluctant to go to the hospital.

“More than likely, they have symptoms at home but it’s hard for old people to get around, sometimes they don’t drive, or they depend on their family to drive them to the hospital. And, sometimes, it’s a culture of being afraid to go to the hospital and by the time the serious symptoms present at home, it’s too late already,” Nguyen said.

Perez-Posadas added: “It’s human nature, we delay getting the medical treatment and I don’t know if that’s what happened with those individuals that they delayed getting medical treatment…either that or they probably just don’t have the insurance.”

Dr. Nguyen said we’re seeing the disease take a toll on older residents in these dead on arrival scenarios.

“It’s in the community…it’s spread everywhere. It’s no longer just a cluster. So, it’s important for people to pay attention to their symptoms and if they have any symptoms, they should stay home. We still see people who have cough, congestion and they still show up at work. And then when they eventually get seen at the clinic, they’re positive.”

“It’s in the 70s. The first one was a 70-year-old individual that the family said they heard a loud noise in room and then when they went to go check on him I don’t know how many minutes apart, they  found the individual unresponsive and breathless, so they brought the individual to the hospital. Same thing with this recent one, the 73-year-old female individual…the family found them dead and unresponsive,” added Perez-Posadas.

The three thus far who’ve been dead on arrival and tested positive posthumously are a 70-year-old man on August 20, a 96-year-old woman on Friday August 28 and most recently, a 73-year-old woman on Tuesday this week.

With regard to questionable test results from these DOA cases, Dr. Nguyen said despite there always being a statistical chance of false-positives, the GMH testing is reliable.

He said around 60% of the current COVID-cases on Island are in the 20-40 age group, adding, “I think all of the people with co-morbidities they got the message the first time so they stay at home but the 20-40 years-old, they’re not staying at home so that’s the message, be careful and don’t bring anything back to your family…”

In terms of the 36-year-old who also passed away Tuesday at GMH, Perez-Posadas said that person came in Monday for a kidney condition and was critically ill, so much so that resuscitative measures were needed. She tested positive as well when admitted, and not 24 hours later, around 8:30 Tuesday morning, she deteriorated and doctors were unable to save her.

Again, proving the risk is truly COVID-19 coupled with existing medical conditions and vulnerabilities.