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The CDC says over 600 health care workers have died from the coronavirus. This doctor has counted hundreds more.

CDC warns of "worst fall" ever if COVID-19 guidelines ignored
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Dr. Claire Rezba, an anesthesiologist at a hospital in Richmond, Virginia, began tracking health care worker deaths in late March. She has since counted at least 1,000 lives lost while working in health care during the pandemic; the CDC, meanwhile, has counted 625. 

In April, when the CDC issued its first report on COVID-19 infections among U.S. health care personnel, the tally of deaths was 27. By then, Rezba said she had already identified 150 to 200.  

"At that point, I got really upset that our numbers were so different," she told CBS News. "(Then it) evolved into a sense of purpose that these sacrifices shouldn't go unnoticed."

Armed only with Google, Rezba started her count by searching for reported deaths in New York and New England, where the pandemic first took hold in the United States. Entering in search terms such as "nurse dies," and combing through local news, obituaries and GoFundMe pages, she was able to spot patterns that eventually made national headlines. 

"As time has gone on it's really migrated," she said. "In Texas, they're just hemorrhaging deaths at the moment." Rezba also noted Florida and Arizona as health care fatality hotspots and said finding deaths in California has been particularly challenging. 

"I'm still finding some folks that died in April and May," she said. 

The CDC compiles its tally from laboratory-confirmed COVID-19 cases voluntarily reported by all 50 states, four U.S. territories and affiliated islands, and the District of Columbia.

"Public health departments report COVID-19 cases to CDC using a standardized case report form that collects information on patient demographics," including "whether the patient is a U.S. health care worker," the agency said. 

According to Rezba, however, the case report form does not account for all health care occupations, creating an undercount. 

"Maybe they don't consider a food service worker in a hospital a health care worker, but hospitals can't run if we can't feed people," she said. 

The CDC's April report on "characteristics of health care personnel with COVID-19" defined HCP as "paid and unpaid persons serving in health care settings who have the potential for direct or indirect exposure to patients or infectious materials." 

In her count, Rezba considers anyone who works in a hospital, medical office, nursing home, or long term care facility, as well as professionals like pharmacists, to be HCP. She also includes any COVID deaths of EMTs, which she said are not listed on the standardized form. 

While the form is limiting, the CDC's glossary of terms HCP definition is exhaustive, and does include "emergency medical service personnel." The definition goes on to cite "contractual staff not employed by the health care facility" who are "not directly involved in patient care but potentially exposed to infectious agents." As examples, the CDC lists: "clerical, dietary, environmental services, laundry, security, maintenance, engineering and facilities management, administrative, billing, and volunteer personnel."

The CDC's definition, however, does not consider dental, autopsy, or laboratory personnel as HCP, "as recommendations to address occupational infection prevention and control (IPC) services for these personnel are posted elsewhere."

In addition to the form's limiting parameters of what constitutes health care personnel, Rezba stressed that the people filling out the form — many of them HCP themselves — are working under immense pressure, and may not be equipped to note every patient's exposure to the health care field. 

Rezba said she began her count as a way to deal with anxiety about the pandemic. As a doctor, with small children at home and family members in the health care field, the threat of coronavirus was all-encompassing.

"Was I going to get it? Was I going to give it to my kids?" she said of her initial concerns. 

Soon she started sharing the count on social media, using her Twitter to memorialize individual health care workers as the pandemic raged on. The account, US HCWs Lost to Covid19, now has over 3,000 followers. Rezba invites anyone with someone they'd like memorialized to contact her there.

"If you don't know who's dying," she said, "you can't stop them from dying."

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