FOI/2021/2812
You asked
I have heard on the radio on 30 July the following: "There have been 128,000 deaths from the Covid-19". The programme then went on to state the following "If you died as a result of getting hit by the proverbial bus, then the death certificate will include Covid-19."
We said
Thank you for your enquiry.
If someone dies in circumstances involving an accident, violence or suspicious circumstances, the case is referred to a coroner for investigation. A post-mortem examination is carried out and usually an inquest is held. The Coroner's Court hears all the evidence and follows legal rules of evidence when deciding the causes of death. It is extremely unlikely that a coroner would find that someone was involved in a traffic accident, or was the victim of violence, because of having COVID-19 or a positive COVID-19 test -- so they would not mention COVID-19 on the death certificate. This applies to any death caused by an accident, violence, poisoning, or other external causes.
Even if in an unusual case a death certificate mentioned both COVID-19 and a traffic accident (or other external causes), the World Health Organisation (WHO) rules for coding deaths mean that the traffic accident would be identified as the underlying cause of death in our data.
You can read in detail about the coding of causes of death and identifying the underlying cause in the ONS User guide to mortality statistics and the WHO International Classification of Diseases (ICD-10) instruction manual.
The doctor or coroner certifying a death can record more than one health condition or event on the form. The medical certificate of cause of death has two parts, Part 1 contains the sequence of health conditions or events leading directly to death, while Part 2 can contain other health conditions that contributed to the death but were not part of the direct sequence. For statistical purposes one of the health conditions on the certificate is chosen as the 'underlying cause of death'. The underlying cause of death is defined as the health condition or event that started the train of events leading to death and is worked out according to rules from the World Health Organisation (WHO).
When we say that a death 'involved' COVID-19, we mean that COVID-19 was mentioned anywhere on the death certificate, possibly along with other health conditions, not necessarily as the underlying cause of death. When we say that a death was 'due to' COVID-19, we mean that COVID-19 was the underlying cause of death, because it was either the only health condition mentioned on the death certificate, or it was the one that started the train of events leading to death.
Using table 1 in Deaths due to COVID-19, registered in England and Wales 2020 there were 73,766 registered deaths where COVID-19 was the underlying cause in 2020.
Using Deaths registered weekly in England and Wales 2021, there were 52,576 registered deaths where COVID-19 was the underlying cause as of 13 August (latest available data). This publication is updated every Tuesday.
We also hold the following analysis showing deaths from COVID-19 with no pre-existing conditions by broad age-bands in England and Wales: Pre-existing conditions of people who died due to COVID-19, England and Wales - Office for National Statistics. Please navigate to Table 2 of this publication to view this information for 2020 and quarter 1 and quarter 2 of 2021.
For further information, please contact Health.Data@ons.gov.uk