You asked
Do lateral flow positive tests count towards COVID-19 death figures? In other words - when deaths within 28 days of a positive test are reported, which tests are eligible?
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Thank you for your request.
When a person passes on, 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.
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). COVID-19 is the underlying cause of death in around 92% of deaths where it was mentioned on the death certificate.
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.
ONS and PHE COVID-19 deaths data are produced in different ways and have different purposes:
- the daily COVID deaths counts reported on the government's COVID-19 dashboard (produced by PHE) shows deaths within 28 days of a first positive laboratory-confirmed test.
- ONS weekly death registrations data for England and Wales, relate to the week that ended 11 days prior and are based on the cause of death reported on the death certificate, thereby not restricted to only deaths that showed a positive test.
More information can be found in a blog by Professor John Newton of Public Health England about the complexities of counting COVID-19 deaths and the different methods used.