On Jan. 18 there were 3,187 people with COVID-19 in Massachusetts hospitals, according to the Massachusetts Department of Health. Of those patients, 49 % were considered “incidental,” in that they tested positive while hospitalized for other reasons. The remaining 51 % of patients were reported as being hospitalized primarily for COVID-19.
Hospitals have long been accused of inflating COVID-19 cases by including anyone who tests positive, even if they only had a mild case and sought care for a different ailment. To help paint a clearer picture of the impact COVID-19 is having on people, Massachusetts is now requiring hospitals to report the number of COVID-positive patients receiving the steroid dexamethasone.
Dr. Shira Doron, an infectious disease physician and epidemiologist at Tufts Medical Center, told Newsweek that using dexamethasone as a standard for classifying COVID-19 cases isn’t a perfect system.
The steroid is standard of care for someone who is hospitalized with a moderate or severe case of COVID-19 with lung involvement, so reporting could miss cases of people being treated for COVID-related heart problems or blood clots where their lungs aren’t treated, and could include people being treated with dexamethasone for another ailment unrelated to COVID.
There’s no national standard for differentiating between patients who are being treated primarily for COVID-19 and those who test positive but need unrelated care, but while dexamethasone is not a perfect metric, it should capture more than 90 % of COVID cases, a Department of Public Health spokeswoman said.
However, Dr. Jason Wasfy, medical director of the Massachusetts General Physicians Organization, said he believes the new classification system will lead to an undercounting of acute COVID patients.