The COVID-19 death-toll within the New York State prison system–including staff, people in prison and people on parole, stands at 10, but at least one county medical examiner is reviewing another prison death, City Limits has learned, although it is unclear whether that fatality is related the pandemic.

While the state Department of Corrections and Community Supervision (DOCCS) has divulged how many confirmed COVID-19 deaths have occurred among staff and inmates—as well as among parolees it supervises—it has declined to say how many other deaths have occurred during the crisis period.

Deaths in the prison system are investigated by county medical examiners. DOCCS declined to reveal how many deaths have been referred to the “MEs” since the crisis began, directing City Limits to file a freedom of information law request, which is now pending, or to contact the county examiners.

City Limits contacted the medical examiners or coroners in all 26 New York counties were DOCCS has facilities.

Seven said they had no prison deaths among their caseload. Two—Erie and Onondaga—refused to answer.

Monroe County, which provides medical examination services to several surrounding counties (including a few who have prisons) refused to tell City Limits if it was reviewing any prison deaths. Onondaga County’s medical examiner, who serves Cayuga and Oswego counties (which together host five prisons), said only that it had “recently investigated and certified deaths of inmates.”

Dutchess County’s ME office said they were examining one death, from the Fishkill Correctional Facility in Beacon.

The others have yet to respond.

The hodgepodge approach to tracking possible COVID deaths—with some counties having multiple, elected, lay corners and others using centralized medical examiner offices, and some sharing information and others refusing—makes achieving transparency difficult

Death is not uncommon in New York’s prison system, which with 43,000 inmates would be the state’s 15^th largest city (bigger than Rome, Poughkeepsie or Ithaca) if it stood alone. The most recent DOCCS report on “unusual incidents” covers 2016, when there were 148 deaths—none of them homicides—in the system. It’s possible the fatality in Fishkill is not COVID-related, but that prison did lead the DOCCS system in positive tests.

Advocates are concerned that while New York City’s jails have shed population during the crisis—yesterday City Hall announced that it was detaining fewer than 4,000 people for the first time since 1946—state prisons have not released a single person for COVID-19.

Rates of infection within DOCCS are lower than in the city or the state as a whole, but there have been very few tests: As of Tuesday, only 425 of the department’s 43,000 inmates have been tested.

Advocates think it odd that 794 DOCCS staff members have tested positive for the coronavirus while only 211 of the inmates those staff members supervise have—although history does point to prisons being able to navigate pandemics with remarkable success, perhaps because of their ability to close off to the outside world.

The fuzziness of determining whether deaths are due to COVID-19 or to other causes will introduce an element of imprecision to all death tolls, including the prison system’s.

“I just don’t trust DOCCS reporting numbers about itself,” says Steven Zeidman, a CUNY Law School professor. “Are there people who have died, or will die, from ‘natural causes’ that were actually impacted by the virus? Sure.”