COVID contributed to overdose death, medical examiner saysFree Access

Infection puts opiate abusers at greater risk



A 37-year-old man who died from an overdose of fentanyl has been added to the ranks of Ventura County’s COVID-19-related deaths.

The reason, said the county’s chief medical examiner, Dr. Christopher Young, is that the respiratory illness caused by the novel coronavirus was deemed a contributing factor, meaning the man, whose name and city of residence are not being released, did not die from drug use alone.

“Fentanyl intoxication is the main cause of death, and the contributing cause was a COVID-19 infection,” Young said in an interview with the Acorn. “They were working together to cause this person’s death.”

Young, whose office is responsible for determining the cause of death of individuals found at home, said his team’s investigations now involve trying to figure out whether the deceased had any COVID symptoms (fever, coughing, shortness of breath, etc.) before death or if they could have been exposed to someone with the virus. If the answer to either question is yes, the victim is swabbed and the sample is sent to the county lab for testing.

“In this particular case . . . we did do the testing and it came back positive (for COVID-19),” Young said.

“Ultimately we’re deciding whether to run tests just like a doctor in a hospital or a clinic would. Even if somebody dies of something that is obviously not COVID-19, it’s important to catch those positive cases to limit spread into the community and to limit exposure to other people they’ve been in contact with, first responders and, frankly, our own staff,” Young said.

Increased danger for drug users

Use of opioids, especially powerful ones like fentanyl—which can be 50 times more potent than heroin—is particularly dangerous for people with COVID-19, he said.

“Somebody who’s walking around with that condition, and they take something that’s a respiratory depressant, you can see that’s a recipe for disaster,” he said.

Young said it’s not unusual for his office to list contributing factors in overdose deaths. For example, those who die from methamphetamine often have an existing heart condition, which is noted in the record.

As of Wednesday, Ventura County Public Health had attributed 17 deaths to COVID-19. Of those, 13 were over the age of 70 (the oldest was 99), nine were male, eight were female, and all had an underlying medical condition. The 37-year-old would be the youngest COVID death in the county by at least 15 years.

Young said VCPH was following Centers for Disease Control and Prevention guidelines when it decided to include the man in its ongoing COVID count despite the primary cause of death being fentanyl overdose.

“The way the state and federal statistics are being compiled, cases where it’s contributing to the cause of death are also counted as COVID deaths,” he said. “That’s how the epidemiologists are handling it.”

Asked if he’s concerned that this instance will stoke accusations that the country is overcounting deaths, the medical examiner said he fears the opposite is happening.

“My concern is places are undercounting because they’re not testing (people found dead at home),” he said.

“Honestly this (pandemic) has affected our office in an interesting way because . . . cases where we’d normally decline jurisdiction and allow the community doctor to sign (the death certificate), as soon as we start getting a few answers to questions about COVID-19 and hearing about potential symptoms, we’re swabbing and making sure.”