A Macon County, Missouri, coroner has admitted to omitting COVID-19 as the cause of death for certain people whose deaths involved other factors, according to a new report.

Coroner Brian Hayes omitted COVID-19 as the cause of death on at least six death certificates for deceased residents of his rural county who suffered from other conditions, he told The Kansas City Star in an interview published Thursday, giving examples of an elderly patient with pneumonia or "you know, grandma had one lung and smoked all her life."

"A lot of families were upset. They didn’t want COVID on the death certificates," Hayes told the outlet. "I won’t lie for them, it’s gotta be true, but I do what pleases the family."

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As a result of him allowing families to omit COVID as the cause of death, the number of official coronavirus deaths in Macon County changed from 30 or more to 19, the Star reported, citing state and local estimates.

"There are always numerous factors that are considered when making decisions on these fronts," Missouri Department of Health Lisa Cox said in a statement to Fox News regarding Hayes' actions. "Missouri has worked to balance the need for updating information, protocols, and definitions across a spectrum of COVID-related impacts while also working to mitigate confusion and further skepticism of public health messaging and information."

A Silver Dollar City employee takes the temperature of guests before they are allowed to enter the park just west of Branson, Mo.. (Nathan Papes/The Springfield News-Leader via AP, File) 

A Silver Dollar City employee takes the temperature of guests before they are allowed to enter the park just west of Branson, Mo.. (Nathan Papes/The Springfield News-Leader via AP, File) 

Between July 28 and Aug. 3, Macon County reported 63 new cases of COVID-19, 16 of which involved vaccinated people.

The state of Missouri does not count "probable" COVID-19 deaths, or deaths of people who do not have positive COVID-19 PCR tests, according to the Star.

Missouri and other states such as New York have counted fewer COVID-19 deaths in comparison to local health departments because they do not count probable virus-related deaths.

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Cox added that "there has been substantial misinformation aimed at both understating and overstating the impacts of COVID nationally."

"As such, Missouri has chosen to remain consistent in our determination process, verify it against a national standards process by CDC’s [National Center for Health Statistics], and report consistently," Cox said.

The Centers for Disease Control and Prevention (CDC) reported that 92% of those who died while COVID-19 positive have the virus listed as the main cause of death. COVID-19 deaths "can include laboratory confirmed cases, as well as cases without laboratory confirmation," the CDC's website states.

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Macon County Health Department administrator Mike Chambers told the Star that while he disagrees with Haye's actions, he "sees both sides" of the story, which he said has become an increasingly politicized one over the last year.

"There are viruses out there that are so similar to COVID, like the flu, and unless you do a test to confirm, you just don’t know," Chambers told the Star. "If you can link it to a known case, maybe, but we’ve had people that were exposed but their tests turned up negative."

Conditions including pregnancy, substance use, asthma, blood disorders, cancer, hypertension, heart disease and obesity can put adults at higher risk of developing a severe reaction to COVID-19, according to the CDC.