COVID-19 is reportable by law, under Rule R386-702 Communicable Disease Rule, to the Utah Department of Health and Human Services. 

When someone is tested for COVID-19, the lab processing the sample submits the test results to the Utah Department of Health and Human Services via a database called EpiTrax. Data sharing agreements are in place to allow the Utah Department of Health and Human Services Office of Vital Records and Statistics to share a list of Utah deaths with COVID-19 or any derivative listed on the death certificate to EpiTrax. EpiTrax also shares information about deceased individuals who test positive for COVID-19 with the Office of the Medical Examiner. 

The following flow chart shows how a death record is processed in Utah.

Cause of death is a narrative field on the death certificate. A certifier lists, in sequence, any health conditions a decedent had (a health history) and the cause of death. They may also list any suspect COVID-19 symptoms which would then be reviewed and investigated further by the Office of Vital Records or the Office of the Medical Examiner. The information is reviewed by vital records offices at the local level and if needed, further investigation into the cause of death can be done. After a local investigation is complete, the local vital records office registers the death and the information is sent to the Office of Vital Records and Statistics. The Utah Department of Health and Human Services sends the information to the CDC where ICD10 codes are applied. Any codes listed as R00-R99 are sent back to the Utah Department of Health and Human Services for further investigation and clarity. This is the same process used for any death in Utah.

Do all deaths go through the Office of the Medical Examiner? 

Only about 15-18% of ALL deaths in Utah go to the Office of the Medical Examiner. Decedents who go to the Office of the Medical Examiner are tested for COVID-19 when there is a suspicion that the person had undiagnosed COVID or another respiratory infection that may have led to their death. If a person died from a car crash for example, COVID-19 testing would not be done and they would NOT be counted in the COVID-19 deaths (it would be listed as a motor vehicle crash on the death certificate). They would, however, be counted in our positive COVID-19 case counts. 

What if the body doesn’t go to the Office of the Medical Examiner?

If an individual tests positive for COVID-19 and then dies, EpiTrax and vital records link the patient as a COVID-19 death, even if the death certificate doesn’t list COVID-19. 

It is likely the number of COVID-19 cases (not deaths) in Utah is higher than what the case counts show. However, given the robust reporting systems and checks-and-balances with EpiTrax, vital records, and a centralized medical examiner system, the Utah Department of Health and Human Services believes the number of deaths due to COVID-19 not captured in our data is very small.