FOI REF: FOI/2023/5100
You asked
Please disclose where the recordings of Coronavirus (COVID-19) on death certificates for England are received from, whether there is some electronic system for example that receives the reports from doctors in England at the ONS, and disclose any change to the reporting/recording system, or any change in data in it from what is recorded compared to what the ONS receives relating to England, that occurred from December 2021.
Is the same system for Wales?
Why would doctors in Wales have continued to record COVID-19 at higher levels than the 28 days after positive test when England doctors have recorded consistently at lower than the 28-day levels since December 2021?
We said
Thank you for your request.
The registration of life events (births, deaths, marriages and civil partnerships) is a service carried out by the Local Registration Service in partnership with the General Register Office (GRO). We receive registrations from GRO using the Registration Online System (RON). The same system is used for deaths registered in England and Wales.
Mortality statistics are based on information recorded when deaths are certified and registered. Most deaths are certified by a medical practitioner, using the Medical Certificate of Cause of Death (MCCD), which can be found in Annex A . This certificate is taken to a registrar by an informant - usually a near relative of the deceased.
The MCCD 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.
The selection of the underlying cause of death is based on International Classification of Diseases, Tenth Revision (ICD-10) coding rules and is made from the condition or conditions reported by the certifier, as recorded on the certificate. The underlying cause of death is defined by World Health Organisation (WHO) as the disease or injury that initiated the train of events directly leading to death or the circumstances of the accident or violence that produced the fatal injury.
The ICD-10 cause codes used for COVID-19 are:
U07.1 COVID-19, virus identified
U07.2 COVID-19, virus not identified
U09.9 post-COVID condition, unspecified
U10.9 Multisystem inflammatory syndrome associated with COVID-19, unspecified
I have included a selection of our analysis of COVID-19 deaths below. Please note, we use the term "due to" to denote underlying cause and "involving" to denote underlying cause or contributory mention.
Deaths due to COVID-19, registered in England and Wales which holds data for deaths registered in 2020 and 2021. 2022 data will be published in July 2023, this is to allow the inclusion of late registrations which are deaths referred for Coroner investigation.
Deaths registered weekly in England and Wales, provisional and Monthly mortality analysis, England and Wales will provide provisional data for 2022 and 2023.
If you would like to discuss this further, please contact Health Analysis and Pandemic Insight (HAPI) Customer Service team at Health.Data@ons.gov.uk
UK Health Security Agency data
You may be aware of data that has used the 28-day positive test methodology in the past. This was not ONS data and was produced by Public Health England now known as UK Health Security Agency (UKHSA).
ONS COVID-19 data are different from the figures which were published on the government's COVID-19 dashboard, which showed 'deaths within 28 days of a positive test'.
You can read a blog by Professor John Newton of formerly Public Health England about the complexities of counting COVID-19 deaths and the different methods used.
UKHSA therefore may be better placed to assist with your queries around the use of 28-day methodology. They can be contacted at enquiries@ukhsa.gov.uk.