Cuyahoga County To Test For Coronavirus From Pre-Lockdown Deaths

Cuyahoga County's medical examiner hopes this week to begin the process of testing samples for the coronavirus from before Ohio's lockdown.

This kind of post-mortem testing was also done in Northern California, where Santa Clara County health officials found confirmed cases dating from early February, earlier than other confirmed cases at the time.

ideastream’s All Things Considered host Tony Ganzer asked Dr. Thomas Gilson for the details on this type of testing and what it could reveal about the pandemic timeline.

Is such a review going to happen in Northeast Ohio and if so, how will it work?

Actually, your question is really timely. When the pandemic initially kind of was sweeping through everywhere there was very little post-mortem testing going on, and most of the people who died who would’ve come to our office, we would not have tested because the limited availability really compelled the priority of testing to people who were symptomatic, alive, and would need to have that information for treatment and things like that.

One of the things though that I think has come up since then is this idea: how prevalent is the disease in the population? What we’re hoping to initiate actually this week is to go back to blood that was collected from people who passed away in our office and see if we can test before the closure, the stay-at-home order, and some of the specimens collected after that, and see if there’s any baseline positivity for COVID in the community for people say, who were not symptomatic, which may be very helpful in terms of getting a sense of the trajectory of COVID throughout the community. So I don’t know what we’ll see, but we want to go back and take a look.”

So just to recap, doing these tests potentially we could have a better of idea of what the timeline is for having COVID-19 cases in Northeast Ohio?

I think that’s part of the information we’ll get, and on top of it, how prevalent is the disease? And I think using that kind of fault line of the stay-at-home order, did things change or did they stay the same after we had a stay-at-home order in place? I don’t know, I’m kind of interested to see what the results are. But I think the surveillance piece would be very interesting, and the timeline could be interesting, too.

And you’re hoping to get the process going as early as this week?

We’ve been working on it for actually a few weeks, at least getting all the ducks in a row to do the testing and hopefully have those things nailed down this week, and start submitting specimens to MetroHealth.

Can you talk a little more about how this is possible?

The basic part of an autopsy that we would do would include taking specimens for different kinds of testing, mostly toxicology. Also, my professional organization — the National Association of Medical Examiners — said probably about five years ago you should consider saving specimens in the event that somebody might need genetic testing as a look-back, and we’re following that guidance. The question kind of comes, can we use these specimens potentially in a situation like COVID to go back and look at the prevalence of the disease in the population, or when it showed up before we were even aware of it, if it was here. I think it’s part of the mission of our office to kind of understand the health of our community, and these were things we otherwise would have collected anyway.

When you talk about being able to do the tests now, is this part of the ramp-up that we’ve seen statewide of just increased testing capacity, that now your office has more accessibility to the tests?

It’s a by-product of it. Initially, the state access through the Department of Health [labs] was very, very limited, and our county’s ability to get things tested was also limited. And my shout-out to the county board of health to help us at least test some of the folks who were coming through our office, especially people who would be say, in a communal setting, so that’d be in a group home or something like that.

This is very interesting, I’ll be interested to see how this develops, as I’m sure you are.

You and I both. You know, I’ve talked to our executive [Cuyahoga County Executive Armond Budish] and I know he’s interested in the potential. We’ll have better information to maybe make decisions about reopening and things like that.