There are many things about this “pandemic” that are unprecedented in medical history. One of the most startling is that at the height of the pandemic so few autopsies, especially total autopsies, were being done. A mysterious virus was rapidly spreading around the world, a selected group of people with weakened immune systems were getting seriously ill and many were dying and the one way we could rapidly gain the most knowledge about this virus—an autopsy, was being discouraged.
Guerriero noted that by the end of April 2020 approximately 150,000 people had died, yet there were only 16 autopsies performed and reported in the medical literature. Among these, only seven were complete autopsies, the remaining 9 being partial or by needle biopsy or incisional biopsy.
Only after 170,000 deaths by covid-19 and four months into the pandemic were the first series of autopsies actually done, that is, more than ten. And only after 280,000 deaths and another month, were the first large series of autopsies performed, some 80 in number. Sperhake, in a call for autopsies to be done without question, noted that the first full autopsy reported in the literature along with photomicrographs appeared in a medico-legal journal from China in February 2020. Sperhake expressed confusion as to why there was a reluctance to perform autopsies during the crisis, but he knew it was not coming from the pathologists. The medical literature was littered with appeals by pathologists for more autopsies to be performed. Sperhake further noted that the Robert Koch Institute (the German health monitoring system) at least initially advised against doing autopsies. He also knew that at the time 200 participating autopsy institutions in the United States had done at least 225 autopsies among 14 states.
Some have claimed that this dearth of autopsies was based on the government’s fear of infection among the pathologists, but a study of 225 autopsies on covid-19 cases demonstrated only one case of infection among the pathologist and this was concluded to have been an infection contracted elsewhere. Guerriero ends his article calling for more autopsies with this observation: “Shoulder to shoulder, clinical and forensic pathologists overcame the obstructions of autopsy studies in covid-19 victims and hereby generated valuable knowledge on the pathophysiology of the interaction between the SARS-CoV-2 and the human body, thus contributing to our understanding of the disease.”