Autopsy rates plunged to an all-time low during the first year of the COVID-19 pandemic as deaths from the virus surged without being examined more closely, according to federal data released Wednesday.
An analysis of death certificates from all 50 states and the District of Columbia found that the autopsy rate fell from 8% in 2019 to 7.4% in 2020, the lowest mark since the first year of data in 1972, the Centers for Disease Control and Prevention reported.
From 2019 to 2020, the raw numbers fell from 229,011 autopsies out of 2,854,838 deaths to 249,337 out of 3,383,729 deaths.
In 2020 COVID deaths were “infrequently autopsied,” the CDC reported. For example, while 98.7% of homicide deaths and 49.3% of suicide deaths led to autopsies, less than 1% of all coronavirus deaths merited examination on an autopsy table.
“The COVID-19 pandemic introduced a large number of deaths with a low autopsy rate, which may account for the significant decline in the autopsy rate between 2019 and 2020,” CDC statistician Donna Hoyert told The Washington Times.
The decrease in 2020 came after a slight increase in the autopsy rate from 2018 to 2019. The report found that the autopsy rate decreased between 1972 and 2020, with the most consistent pattern of decline coming before 1994.
According to Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security, autopsies were “not deemed necessary” as COVID deaths increased from zero in 2019 to more than 300,000 nationwide in 2020.
“There were hundreds of thousands of excess deaths in the U.S. during the first year of the pandemic, many of which were caused by COVID,” said Dr. Adalja, an infectious disease specialist. “Autopsies are often done when the cause of death is elusive and for COVID-related deaths — the third most common cause of death in 2020 — an autopsy would not necessarily have provided any new information.”
But Dr. Carlos del Rio, president of the Infectious Diseases Society of America, said doctors should have done more to examine the corpses of COVID patients for information about the virus.
“Should we had done more? Yes. Autopsies are an important component of learning about diseases and the pathogenesis,” Dr. del Rio, interim dean of the Emory School of Medicine, told The Times.
Fear of infection likely kept many physicians from ordering autopsies, he added in an email.
“There was reluctance from pathologists to do the autopsies because of the ‘unknown’ and fear of getting infected. Some people said that their autopsy rooms were not equipped to do them, but that is not necessarily true,” the doctor said.
In 1972, 79% of all autopsies were performed for deaths due to diseases and 19% for deaths due to external causes, according to the CDC. Those numbers flipped in 2020 to 37% of autopsies performed for deaths from diseases and 60% due to death from external causes.
The CDC report found that the U.S. autopsy rate in 2020 peaked at 62.6% of deaths among people aged 15-24, then decreased in each older age group after that.
“Deaths occurring in settings such as hospital inpatient, hospice facility, and nursing home or longterm care were least likely to be autopsied compared with other locations,” the report noted.
For more information, visit The Washington Times COVID-19 resource page.
• Sean Salai can be reached at ssalai@washingtontimes.com.