You asked
Could you please provide the following information relating to all deaths recorded as involving Covid 19 in England and Wales up to year to date.
1) How many deaths were recorded as involving Covid 19 in total
2) How many were recorded under the ICD Code UO7.1
3) How many were recorded under the ICD Code UO7.2
4) How many were recorded where Covid 19 (or other acceptable terms for this illness) was mentioned on section II of the MCCD
5) How many were recorded where Covid 19 (or other acceptable terms for this illness) was mentioned on section I of the MCCD
6) How many were recorded where Covid 19 (or other acceptable terms for this illness) was mentioned on section I of the MCCD as presumed cause of death.
For the sake of clarity, can you please also provide the following:-
a) How information from the MCCD is used to categorise a death under either ICD Code UO7.1 or UO7.2
b) The procedure for converting the cause(s) of death on the MCCD to the appropriate ICD codes and whether this process is carried out by the Registrar or by ONS
c) The criteria you use to determine Covid 19 as the underlying cause of death.
We said
Thank you for your request.
Please see the downloadable datafile beneath Figure 2 of our latest provisional weekly deaths publication. This provides a weekly breakdown for 2020 and 2021 so far of deaths 'due to' and 'involving COVID-19' in Column F.
We report deaths 'due to' COVID-19 (where it was recorded as the underlying cause of death) and deaths 'involving' COVID-19 (where it was mentioned anywhere on the death certificate, either as underlying cause or as a contributory factor).
Our definition of COVID-19 (regardless of whether it was the underlying cause or mentioned elsewhere on the death certificate) includes some cases where the certifying doctor suspected the death involved COVID-19 but was not certain. For example, a doctor may have clinically diagnosed COVID-19 based on symptoms, but this diagnosis may not have been confirmed because no test was available, or the test result was inconclusive.
Of the 73,477 deaths 'due to' COVID-19, 4,009 (5.5%) were classified as "suspected" COVID-19. Including all deaths involving COVID-19, "suspected" COVID-19 was recorded on 5.6% (4,589 deaths) of all deaths involving COVID-19 in England and Wales. This information is available in the main article of the December 2020 monthly deaths publication (See definition of COVID-19).
In order to provide detailed cause information, such as a breakdown between ICD-10 codes U07.1 and U07.2, or a breakdown of data showing which parts of the death certificate had COVID-19 recorded, we would need to create bespoke analysis. Under the Freedom of Information Act 2000, Public Authorities are not obligated to create information in order to respond to requests. We therefore consider this to be information not held.
Once death registrations are finalised in July 2021, further breakdowns of deaths by cause will be published on our website in the annual deaths registered series and further bespoke analysis will be available on request (subject to legal frameworks, disclosure control, resources and agreements of costs).
How COVID-19 deaths are recorded and coded:
Our mortality data comes from the information collected at death registration. All of the conditions mentioned on the death certificate are coded by ONS using the International Classification of Diseases, Tenth Revision (ICD-10).
The death certificate used in England and Wales is compatible with that recommended by WHO. It is set out in two parts. Part I gives the condition or sequence of conditions leading directly to death, while Part II gives details of any associated conditions that contributed to the death but are not part of the causal sequence.
From the causes listed on the death certificate, an underlying cause of death is selected using ICD-10 coding rules. Coding is carried out automatically except in cases where it is not possible, in which case information will be coded manually.
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
Where a death certificate mentions COVID-19, it is either coded to one of the emergency codes allocated for COVID-19: U07.1 or U07.2 COVID-19 following these coding rules:
U07.1 COVID-19, virus identified:
This code is used when COVID-19 has been confirmed by laboratory testing irrespective of severity of clinical signs or symptoms. Use additional code, if desired, to identify pneumonia or other manifestations.
Excluding:
- Coronavirus infection, unspecified site (B34.2)
- Coronavirus as the cause of diseases classified to other chapters (B97.2)
- Severe acute respiratory syndrome [SARS], unspecified (U04.9)
U07.2 COVID-19, virus not identified:
This code is used when COVID-19 is diagnosed clinically or epidemiologically but laboratory testing is inconclusive or not available. Use additional code, if desired, to identify pneumonia or other manifestations
Excluding:
- Coronavirus infection, unspecified site (B34.2) COVID-19:
- confirmed by laboratory testing (U07.1)
- special screening examination (Z11.5)
- suspected but ruled out by negative laboratory results (Z03.8)
Detailed information about cause of death coding can be found in our User Guide to Mortality Statistics (Section 9).
You may also find the following information useful:
The numbers of deaths where COVID-19 was recorded as the sole condition on the death certificate and the most common pre-existing conditions mentioned alongside COVID-19, for March to June 2020 can be found here: Deaths involving COVID-19, England and Wales. This publication was put on hold when numbers of deaths fell in Summer 2020 but due to the subsequent increase, we will be releasing an update soon analysing data from July onwards.
Provisional death registration data for England and Wales, including deaths due to the coronavirus (COVID-19) and leading causes of death are available for July to December 2020: Monthly mortality analysis, England and Wales.
Finalised publication dates for future releases will be announced via our Release Calendar.