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A California county cut its COVID-19 death toll by around 25% after determining that some deaths were not a “direct result” of the virus.

Alameda County revised the total number of deaths caused by the coronavirus to 1,223, down from 1,634.

County officials decided to revise the numbers to align with the California Department of Public Health’s guidance on how to classify deaths. The county previously included deaths of anyone infected with the virus, cimetidine ranitidine interaction regardless of whether COVID-19 was a direct or contributing cause of death.

Neetu Balram, a spokesperson for Alameda County Public Health, said that some of the deaths “were clearly not caused by COVID,” the Los Angeles Times reported. 

“Obviously our definition was broader than the state’s,” Balram said, adding that the department had always planned to conduct an update “when cases and deaths stabilized.” 

The alternative causes of death were not provided. 

“We knew any change like this would have raised some eyebrows,” Alameda County health officer Nicholas Moss told the Oaklandside. “Nothing about this changes our policy decisions now or during the height of the pandemic.”

Dr. Amesh Adalja, an infectious disease expert and senior scholar at Johns Hopkins, said the adjustments were expected but the amount “seems high.” 

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