Vermont Health Department guidance tells doctors to list COVID-19 as cause of death even without lab confirmation

Health Department guidelines for filling out death certificates in Vermont instruct doctors to cite COVID-19 as the cause of death even if patients didn’t test positive for the virus. Patients who died with other serious underlying health conditions also are to be classified as having died of the coronavirus.

As the COVID-19 pandemic continues to see hopeful signs of slowing in the United States, many state health departments have given instructions for how to list the cause of death for patients who died with flu-like or respiratory symptoms.

The Vermont Department of Health guidelines for death certification, sent to health care providers and facilities on March 10, show a preference for listing COVID-19, even when patients hadn’t tested positive for the virus, or had other underlying diseases.

The guidance offers multiple scenarios for doctors.

For example, if a patient is presenting with flu-like or respiratory symptoms but has no lab test confirming coronavirus and subsequently dies, the guidance tells doctors to list the cause of death as “Coronavirus Disease 2019 (COVID-19), presumed.”

state of Vermont

CAUSE OF DEATH: Language in both federal and state guidelines for attributing deaths to the coronavirus allows that some deaths may be attributed to the virus even if it may not be present or the primary cause of death.

If a patient has chronic underlying conditions such as diabetes, cardiovascular disease or emphysema, and presents with flu-like or respiratory symptoms but doesn’t test positive for coronavirus and dies, the doctor is to list COVID-19 as the presumed cause of death. The doctor may list the underlying diseases as “contributory conditions.”

If a patient has chronic underlying conditions and presents with flu-like and respiratory symptoms and does test positive for coronavirus, the doctor is to list the cause of death as “Coronavirus Disease 2019 (COVID-19), laboratory confirmed.” The underlying diseases are to be listed as contributory conditions.

Doctors are not instructed to presume influenza or other illnesses are the cause of death.

The guidelines have the potential to artificially inflate the true number of COVID-19 deaths, stoking panic and providing justification for governors who have collapsed their economies and forced residents to follow “stay home, stay safe” orders.

As reported in Politico, New York City on Tuesday saw an alarming spike in coronavirus deaths —  from 6,589 to 10,367 — after health officials included 3,778 “presumed” COVID-19 deaths among patients who hadn’t tested positive for the virus. As a result, more than 36% percent of the city’s COVID-19 death toll is comprised of decedents not known to have had the virus.

Ben Truman, the public health communication officer for the Vermont Department of Health, told True North in an email Monday that the 28 Vermont deaths attributed to the coronavirus as of April 13 were “all COVID-19 confirmed cases.”

The preference for getting coronavirus listed on death certificates can be seen at the federal level as well, beginning with the Centers for Disease Control and Prevention. CDC guidelines contain similar language for how deaths may be attributed to the virus.

“COVID-19 should be reported on the death certificate for all decedents where the disease caused or is assumed to have caused or contributed to death,” the guidelines state.

Other potential causes of death may be labeled as secondary: “If the decedent had other chronic conditions such as COPD or asthma that may have also contributed, these conditions can be reported in Part II.”

Another challenge involves trying to determine if a person who tested positive for coronavirus actually died from it. Many patients who die with COVID-19 also have other grave illnesses that may have been the true cause of death. Notably, the Vermont Health Department’s regular COVID-19 updates have the artfully worded phrase, “death occurring in persons known to have COVID-19. Death certificate may be pending.”

Doctors, politicians, and media personalities are beginning to take note of the unusual preference being given to COVID-19 in state death tolls. A Minnesota physician and state senator, Dr. Scott Jensen, recently told Fox News host Laura Ingraham that CDC guidelines are misleading the public.

“The idea that we are going to allow people to massage and sort of game the numbers is a real issue because we are going to undermine the [public] trust,” he said. “And right now, as we see politicians doing things that aren’t necessarily motivated on fact and science, their trust in politicians is already wearing thin.”

Dr. Annie Bukacek, a board-certified internal medicine physician in Montana with over 30 years experience, echoed that sentiment.

“The real number of COVID-19 deaths are not what most people are told and what they then think. How many people actually died from COVID-19 is anyone’s guess,” she said. “… Based on inaccurate, incomplete data, people are being terrorized by fear-mongers into relinquishing freedoms.”

Alex Berenson, a former New York Times reporter, criticized the death certificate guidelines on Twitter.

“As you sit home watching #COVID death counts spiral, please know the official @CDCgov guidance for coding COVID-related deaths is as follows: any death where the disease ’caused or is *assumed* to have caused or *contributed to* death.’ Confirmed lab tests are not required.”

Across the nation, governments are under pressure to reopen the economy as hospitalization and death rates continue to occur well below initial predictions, and as more than 16 million Americans have filed for unemployment over the past month due to “stay home” orders.

As of of April 15, the United States has 605,390 coronavirus cases and 24,582 related deaths, according to the Centers for Disease Control and Prevention.

By comparison, between 24,000 and 63,000 Americans have died of seasonal flu since Oct. 1, according to the CDC.

Michael Bielawski is a reporter for True North. Send him news tips at and follow him on Twitter @TrueNorthMikeB. Bruce Parker contributed to this report.

Image courtesy of state of Vermont

36 thoughts on “Vermont Health Department guidance tells doctors to list COVID-19 as cause of death even without lab confirmation

  1. This is why I don’t bother with the masks, because Vermont is Faking the Covid numbers, just like the rest of the Country, not buying it for a second anymore,

  2. Seems like a lot of Health Departments have become tools of the democrat/nazi party.

  3. Hang onto your seats, here’s another one. This is from Scientific Mag received today. You may have to sign up to view the article, it’s free. Another pandemic, jumping from horses to humans? There was the Swine Flu. And this Covid-19 is questionable how it got to humans. Thailand.

    Thailand scrambles to contain major outbreak of horse-killing virus

    Posted in: Asia/Pacific Plants & Animals doi:10.1126/science.abc2942
    By Christa Lesté-Lasserre Apr. 16, 2020 , is a journalist in Paris.

  4. Reflecting on all the scenarios that have been generated by those under the Dome, regarding the control of people and un-Constitutional orders and control I believe this provides the VT Agri-republicans a good platform to argue positions and differences for the next election. Those in Montpelier have violated their offices and oaths.

    Similarly, the Governor of NJ issued similar orders and omitted in his own words he didn’t observe the Bill of Rights. Just knee jerk reactions.

      • Typical, take the easy way out. Wonder how they justify labeling a pedestrian killed by a hit and run a Covid-19 fatality. That requires some real creative thinking.

  5. If I get shot in the lung and die, this would probably be counted as a respiratory disease caused by covid. I am beginning to mistrust the medical establishment as much as the MSM.

  6. Will a person killed in an auto accident be listed as a Covis-19 fatality? If the attending physician follows state guide lines, it would be reasonable for he or she would have to ASSUMED so. Bazaar!!!!

  7. It’s a power pushed money game. Deaths have been forced to over report. The CDC has so directed and dictated to the states, hence the title of this article. Refer to this:

    NYC Officials Just Artificially Increased Their COVID Death Total by 57%

    It’s a money game, mega bucks to be made. Bill Gates invested $100 million in medical companies for the vaccine. In order for school kids world wide to report back to schools, they will need to be vaccinated. Figure the cost per administrated dose. huge pay back. Gates was kicked of of India concerning vaccines there. He with his money is not helpful to society in this regard. Others with much less has done far more.

    The CDC tells the obeying Gov officials to jump, they say “how high”, no questions. It results in Martial Law and control of people. And it all happened in 30 days. The controllers know now how to control with such episodes. 1984, the Constitutions are over ridden. A little research can enforce these facts.

  8. At 81 with pulmonary fibrosis I make an excellent target for Covid-19, but covid-dependent death isn’t going to happen. I am stocked up and isolated.

    Demographics identify our various population groups as very resistant to, reasonably resistant to, moderately resistant to, or susceptible in different degrees to the corona virus. These sections of the general population could restore much of the work force and allow the opening of large/small businesses and normal social interaction, yet I hear of no numbers, of no plans to reopen our society based on the aforementioned concepts. The medically susceptible are now informed, and most who are retired or old do not contribute to the labor force anyway. And if I decide to expose my life with PF that is my choice, unwise as it might be. That the VHD encourages dishonesty in recording covid-related deaths, is egregious, but a lock down based on those false numbers would be an outrage justifying complete and uncompromising social defiance. What I would like to see first is the application of common sense wherein the covid-resistant population engages normal social interaction.

  9. Behold how this was a top down directive which also includes mouthpieces for WHO – CDC bureaucrat Tony Fauci and Bill Gates foundation board member and consummate bureaucrat Deb Birx – masquerading as commonsense experts and advisors to POTUS…also credited as attempting shut down our country entirely as 2.2 million would die…huh…We’re all gonna die much…all of the players in this game have proven selves to as fearmongering frauds. Unbelievable.

    Conspiracy FACT: Why Do the WHO and CDC Require ZERO Virus Testing for “COVID DEATHS”?
    April 15, 2020 renegade 4 Comments

  10. Gene, at the bottom of the comment page, hits the nail on the head. The ’cause of death’ classifications are intended to maximize State income from various Federal grants, reimbursements and loans. The greater the disaster, the greater the qualified disaster relief.

    If, on the other hand, the increase in Covid-19 death classifications resulting from this statitical bias extends Vermonts ‘Stay Home’ executive order, the long term costs to Vermont’s economy may very well exceed the shorter term benefits from those Federal grants, reimbursements and loans.

    As with everything, it’s a question of balance. And, in the final analysis, we should all be careful in our judgment of the data because that data is the result of governmental fiddling, not reality.

  11. We have to ask ourselves some simple questions, such as: why, when Tokyo is the most populous metropolitan area in the world with 38 million, there are only 178 deaths from Covid in the entire country of Japan, while in NYC, population 8.4 million, in a country that supposedly has the greatest health care system in the world, there are 10,899 Covid deaths? Manila, population of 1.7 million, has the highest population density in the world yet in the whole of the Philippines, there are only 362 deaths.

    Japan never locked down; they have emergency measures but these were only applied lately and are nothing like the western lock downs. Why so few deaths? Why has South Korea, with a population of 51 million, only had 229 deaths? South Korea recommended, but did not force, a self quarantine (except for infected cases; those were mandatory) and it didn’t shut down businesses.

    Covid deaths are taken from the mainstream source:

    This simply doesn’t add up. We can do a song and dance about this but the plain truth is that these numbers make no sense at all. What’s going on? We can argue that the western world is incompetent but this smacks of excuses: especially in America, we’re the best, right? So …?

    Why don’t we have an accurate case fatality rate (CFR)? Many epidemiologists have argued that the true number of cases is far higher than the official number since so many cases are uncounted (and therefore the CFR would be much, much lower than we’re told) but why haven’t we attempted to get an accurate, scientific case fatality rate? All it would take is testing every resident of several “typical” areas. We have some good ideas of the “real” case fatality rate but as yet no one has done a scientific survey, even though this information is extremely important. If accurate CFRs have been done we aren’t hearing about it in the mainstream, and these scare figures of 2-3-4% are pure fiction since they rely only on confirmed cases that suffer from “selection bias” (many people who are asymptomatic or have mild symptoms– and these numbers are significant– don’t get tested.) We’re ignoring this because, I’m afraid, we know the answer: the CFR is likely very close to 0.1%, which would put it squarely in line with a bad flu. We’re locking down for that?

    Where are our leaders?

    So many questions, so much unwillingness to find answers.

  12. Lets get simple!! This is our govt instructing doctors to LIE on a death certificate and become complicit in a fraudulent theft of federal dollars. Does this remind anyone of Leahy and Quiros and a Refugee scam?

    • I don’t really understand why this is a “lie” or even controversial at all. If you have diabetes or another underlying condition that makes you more likely to die of Covid, but you would likely not have died if you didn’t get Covid, then Covid is the cause of death and diabetes is a contributing factor. This is precisely accurate. And providing doctors guidelines for such cases is absolutely normal and necessary or each doctor is making it up themselves and there is no consistency in reporting.
      If there is no test done, the cause of death is “presumed”. Testing would be preferred, but without it you don’t just throw your hands and say who knows.
      The question of social distancing to flatten the curve (lower the number of cases presenting to hospitals) isn’t a left versus right issue. Lower case numbers would imply that it does seem to be working and would validate stay-at-home orders, it doesn’t invalidate them.

      • “…but you would likely not have died if you didn’t get Covid,…”

        Conjecture is conjecture. No one, for example, ever dies from starvation. They simply become so weak they die of festering hangnail, dehydration, or some other pre-existing condition. The point is, if the patient in question didn’t have diabetes, Covid-19 likely wouldn’t have killed them in the first place. So, what’s your point?

      • Pot meet kettle and a hearty facepalm. If one does not want to see the truth – they won’t – while glossing it and explaining it away by opting for the selfdeception of “my truth” which results in the blindness of MSM and all connected by their affliction of TrumpHating Delusional Syndrome which is the true disease pandemic here.

        Story clearly details everyone with a sniffle or a cough is presumed Covid-19…so if they also die its Covid-19…and while these ‘trusted’ health care officials and workers do the bidding of tentacled US-economy destroying Chinese Communist agent WHO and the globalist stooge-released Wuhan Flu plan-demic connecting the dots is quite simple – no pencil needed.
        May I suggest you read the story as facts matter and disprove your position:
        – from story emphasis added
        Health Department guidelines for filling out death certificates in Vermont instruct doctors to cite COVID-19 as the cause of death
        ***even if patients didn’t test positive for the virus.***

        For example, if a patient is presenting with flu-like or respiratory ***symptoms but has no lab test confirming coronavirus*** and subsequently dies, the guidance tells doctors to list the cause of death as “Coronavirus Disease 2019 (COVID-19), presumed.”

        If a patient has chronic underlying conditions such as diabetes, cardiovascular disease or emphysema, and presents with flu-like or respiratory symptoms ***but doesn’t test positive for coronavirus and dies***, the doctor is to list COVID-19 as the presumed cause of death. The doctor may list the underlying diseases as “contributory conditions.”

        This represents massive top down fraud from WHO>CDC> scientific, disease, health and medical community and collapse of the credibility of those affectionately referred to as the Medical Industrial Complex – complete and utter disgrace.

      • “But there’s another, potentially even more serious problem: the way that deaths are recorded. If someone dies of a respiratory infection in the UK, the specific cause of the infection is not usually recorded, unless the illness is a rare ‘notifiable disease’. So the vast majority of respiratory deaths in the UK are recorded as bronchopneumonia, pneumonia, old age or a similar designation. We don’t really test for flu, or other seasonal infections. If the patient has, say, cancer, motor neurone disease or another serious disease, this will be recorded as the cause of death, even if the final illness was a respiratory infection. This means UK certifications normally under-record deaths due to respiratory infections.

        “Now look at what has happened since the emergence of Covid-19. The list of notifiable diseases has been updated. This list — as well as containing smallpox (which has been extinct for many years) and conditions such as anthrax, brucellosis, plague and rabies (which most UK doctors will never see in their entire careers) — has now been amended to include Covid-19. But not flu. That means every positive test for Covid-19 must be notified, in a way that it just would not be for flu or most other infections.”

        Dr. John Lee, The Spectator, March 28, 2020

  13. It’s a pretty sad state of affairs in Verment when a department in Montpelier orders doctors to ASSUME cause of death. What if they were instructed to “assume” anything when diagnosing a sick person’s illness? This bazaar at best. Further these assumptions will distort the actual picture and impact on the decision, if and when it comes, to lift the stay at home guide lines.

  14. These are the same Lefties who claim to be the “reality based community” who only go by the facts and science, which, as usual, is the complete opposite of the truth. Leftist politics is their religion and whatever impedes their will to power is ignored or attacked.

  15. If ever there was a reason to get out and vote it is now. If we are being lied to now about the cause of a persons death what else are we being lied to about.

    • If ever there was a reason to come out, each and every one of us, and disobey these tyrants, it is this and the other lies government is propagating on the state of Vermont.

  16. Vermont Health Department guidance tells doctors to list ” COVID-19 ” as cause
    of death even without lab confirmation……… politics, nothing more !!

    It seems to me states are looking for all the federal funding they can get and using
    this Wuhan Virus is the apparatus………

    All the States Lack of Preparedness for a pandemic is appalling.

    Vermont has a real epidemic on its hands, it’s Liberal Democrats in our statehouse,
    save the state vote these fools out.

  17. Why would they do this?? This is not medicine. This is politics. The end result will be that no one believes anything they say from here on in because we will think we are being lied to for the purposes of control. It is like the boy who cried “wolf” too often. Medicine is being politicized and that is dangerous to people’s faith and trust in it.

    • You bet it’s politics! And it is happening across the country. Subversion leading to totalitarian government under the guise of “the best interests of the people.”

  18. What a sin. Countless people have been hurt deeply because of this shutdown of society. Hopefully the American people have not been so frightened that every cold and flu season will now be cause for alarm.

  19. Great, great article!!!

    Also, apparently those who have respiratory disease often get pneumonia, which takes many, many people out. This should also be looked into with regard to fudging the numbers, we may find our pneumonia cases have dropped significantly. Sadly I’ve been informed many die because they get to the hospital too late and the simple anti-biotics can’t save their lives only because they went to the doctors/hospital too late.

    It is so nice to see an actual reporters work, not something that is regurgitated from up above. Well done, well done.

  20. That’s has to be one of the dumbest things I’ve seen out of the State health department.
    Is it to make the numbers look much worse than they really are? What’s the thought process behind this??

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