Top health official: 4-year-old’s death “consistent" for COVID,” no final decision yet

Galveston County top health official: 4-year-old’s death “consistent with her dying from COVID,” but no final decision yet

* Changes in COVID-19 death determination policy being considered

Galveston County’s top health official says while it may be “weeks” before final test results will confirm the cause of death of 4-year-old Kali Cook, a Bacliff girl who died in her home on Sept. 7 after developing a fever the night before.

Initially, the Galveston County Medical Examiner’s Office ruled the death from COVID-19 based on the fact that a post-mortem test showed Cook positive for COVID-19 and because others in the household - including Cook’s mother - tested positive for COVID-19.

The Galveston County Health District too announced Cook’s death as a result of COVID-19, making her the youngest COVID-19 fatality - and first child - in the county since the pandemic was first found in the county in the Spring of 2020.

It was news that was alarming and made headlines across the globe.

The next day however, after questions arose how the COVID-19 determination was confirmed, the health district and medical examiner backtracked when it was discovered the medical examiner Dr. Erin Barnhart had not performed an autopsy to confirm if there were any unknown underlying conditions or other chemical factors that may have contributed to the death.

This despite the death of a child with no previous recorded major health issues and whose death occurs within a home are subject to more investigation.

In fact the Galveston County Sheriff’s Office, as is protocol, is still investigating the child’s death. Sheriff Henry Trochesset has maintained from the start that there are no indications of foul play.

But he also was unaware the medical examiner didn’t perform an autopsy, which he said was “a bit odd.”

Galveston County Medical Examiner’s Office Chief Forensics Investigator DJ Florence said X-rays and a general physical exam showed no signs of abuse or outward signs of other conditions or injuries.

He tested the girl for COVID-19, because others in the house were positive for the virus and none of the adults were vaccinated, he said.

It was only after that test was there any indication Cook was positive for COVID-19 he said.

But he acknowledged there were no toxicology tests done nor an autopsy to confirm no other factors contributed to the girl’s death.

That’s when, under pressure from the Local Health Authority, the girl’s body was returned from a local funeral home and an autopsy was conducted at a special examination room at UTMB Health.

The medical examiner’s office does not have an infectious disease examination room for autopsies, Florence confirmed. So such autopsies have to be conducted at UTMB Health.

It’s unclear if the lack of such a facility at the medical examiner’s office contributed to the lack of an autopsy.

But Keiser confirmed it was one of the reasons the medical examiner cited to him as to what an autopsy wasn’t conducted.

Dr. Philip Keiser the Local Health Authority for Galveston County and the interim CEO of the Galveston County Health District said from what data he and the medical examiner have reviewed thus far points to a COVID-19 death.

That would be a rare case of someone younger than 17 dying as a result of COVID-19. Even more rare for a child under 4 to die, according to Centers for Disease Control data.

According to the CDC’s data, a total of 560 children nationwide younger than 17 have a COVID-19 attributed death since March 2020.

Of those 179 have been 4-years-old or younger. That is .026% of all recorded COVID-19 deaths in the country

It’s also rare that someone dies while not under the direct care of a physician or medical facility, data shows.

According to Galveston County Health District’s data, as of Friday (9/24/2021) 2 Galveston County children younger than 10-years-old are hospitalized with COVID-19.

However, there are 953 active cases of COVID-19 amongst Galveston County residents who are 10 or younger. That age bracket is the largest of all positive cases of COVID-19, accounting for 20% of the county’s active cases.

The question remains, were there other factors that contributed to the girl’s death?

“From what we know, a 4-year-old should not die from COVID and not as quickly as this little girl did,” Keiser said. “Was something missed, did this girl have an underlying condition that no one previously knew about? That’s an important question to be answered.”

One that almost went unanswered given how the COVID-19 death was declared only because of a test and knowledge that others in the same household had COVID-19.

That should not have happened, Keiser said.

As a result, Keiser said more there will be more thorough reviews of deaths of suspected COVID-19 deaths that happened while someone isn’t under direct physician’s care or within a medical facility.