You asked
In regards to the weekly excess death statistics, can you please confirm when a death is recorded when Covid-19 is mentioned on the death certificate but is not the primary underlying cause of death do these cases appear twice. For example a person who has a respiratory disease and tested positive for Covid-19 within the 28 day period to qualify as a Covid-19 death. The person dies of the respiratory disease, this is the underlying cause of death and Covid-19 appears on the death certificate.
Does this get recorded as
1) a respiratory illness death
2) a death with Covid-19 mentioned on the death certificate.
3) the case is recorded in both.
Are deaths when Covid-19 is mentioned on the death certificate numbers additional figures or are they recorded elsewhere on the same report?
We said
Thank you for your enquiry.
Latest provisional weekly deaths are available in the provisional weekly deaths publication. This publication provides:
Deaths where the underlying cause was respiratory disease (ICD-10 J00-J99)
Deaths where coronavirus (COVID-19) was mentioned on the death certificate (ICD-10 U07.1 and U07.2)
Information on the number of deaths where coronavirus (COVID-19) was the underlying cause is available. We plan to include these figures in the weekly deaths publication in the near future.
When we use the term "mentioned" or "involved" COVID-19 we are referring to deaths where COVID-19 was recorded anywhere on the death certificate, whether as the underlying cause of death or as a contributory factor.
Although COVID-19 is a respiratory disease, it is currently coded to emergency ICD codes U.701 and U.702, so if COVID-19 was recorded as the underlying cause of death then it would be included in the COVID-19 mentions category but not the respiratory disease underlying cause category. However, if COVID was mentioned as a contributory factor and another type of respiratory disease was recorded as the underlying cause of death, then the death would be counted in both the respiratory and COVID categories.
In the example you have provided, the underlying cause of death would be recorded as respiratory disease and COVID would probably be recorded as a contributory factor. Whether or not COVID is recorded as a contributory factor depends on the decision made by the doctor who certifies the death. If COVID was recorded as a contributory factor, then the death would be counted in both categories.
The mortality data published by the Office for National Statistics (ONS) comes from the information collected at death registration. All of 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
Information on how the medical certificate of cause of death (MCCD) is completed is available.