FOI Ref: FOI/2022/3545
You asked
Please provide information on all COVID-19 deaths since March 2020 relating to COVID-19 only.
We said
Thank you for your enquiry.
Doctors are required by law to certify the cause of death 'to the best of their knowledge and belief'. That means they use their medical expertise to decide the cause based on symptoms, physical examination, hospital records, laboratory tests, and all the other information available. If death is certified by a coroner, the Coroner's Court follows legal rules of evidence when deciding the causes of death. No-one has the power to tell a doctor or coroner to reach a particular decision about the cause of death. There are long-standing guidelines and processes which have to be followed, and some changes have been made to these to allow for the circumstances of the pandemic -- but there is no change to the legal and professional obligation to record the cause of death accurately.
You can read the government guidelines for doctors on completing a medical certificate of cause of death (MCCD).
When a person dies, in most cases a doctor writes a medical certificate of cause of death (MCCD) which is then recorded in the death registration (at a local authority registration office). The details are printed out as the official 'death certificate' for the next of kin. The same information is sent electronically from the registration office to ONS for us to produce statistics about causes of death. For some deaths, such as when the death was due to an accident or violence, there is a coroner's inquest to establish the facts and the coroner then decides the cause of death and sends their findings to the local registrar.
You can read in detail about the process of counting deaths and producing mortality statistics in the ONS User guide to mortality statistics.
Our data as described here are different from the figures on COVID-19 deaths published on the government's COVID-19 dashboard which shows 'deaths within 28 days of a positive test'. You can read a blog by Professor John Newton of Public Health England about the complexities of counting COVID-19 deaths and the different methods used.
Our mortality data comes from the information collected at death registration. All the conditions mentioned on the death certificate are coded using the International Classification of Diseases, Tenth Revision (ICD-10). From all of these causes an underlying cause of death is selected using ICD-10 coding rules.
The underlying cause of death is defined by WHO as:
a) the disease or injury that initiated the train of events directly leading to death, or\ b) the circumstances of the accident or violence that produced the fatal injury
The ICD-10 cause codes for COVID-19 are U07.1 and U07.2.
For 2020 data, we hold finalised analysis of COVID-19 deaths in the following publication: Deaths due to COVID-19, registered in England and Wales: 2020
We also publish COVID-19 deaths in our Deaths Registered Weekly in England and Wales and Monthly Mortality Analysis publications. This data includes deaths by place of occurrence including hospitals.
2021 data is still provisional and therefore subject to change. This is to allow the inclusion of late registration deaths which have typically been referred to a coroner for further investigation. Finalised 2021 mortality data will be published in July 2022 as part of our Deaths Registered in England and Wales series.
Headline UK data on COVID-19 deaths is available as part of our Weekly Deaths publication. If you require for further information on Scottish or Northern Irish COVID-19 deaths, National Records Scotland (NRS) and Northern Ireland Statistics and Research Agency (NISRA) are responsible for statistics pertaining to Scotland and Northern Ireland. They can be contacted at foi@nrscotland.gov.uk and info@nisra.gov.uk respectively.
Further information on the description of changes to death certificate and registration under the Coronavirus 2020 Act and the impact it has had on the quality of death registration data is available in our Quality of mortality data during the coronavirus pandemic, England and Wales publication.