FOI Reference: FOI/2022/3660
You asked
I have read two FOI questions and answers and one explains deaths 'involving' and 'due to' and another explains deaths 'solely' of COVID-19
Please can you confirm the difference between dying 'due to' and 'solely' of COVID-19?
The figures for solely are remarkably lower that due to and wondered if you can clarify why?
We said
Thank you for your enquiry.
Deaths due to and involving COVID
We publish 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, whether as the underlying cause or contributory factor). These figures are available in our latest weekly deaths publication. You can access the datasets here.
Deaths due to COVID-19 where no pre-existing condition was recorded
Numbers of deaths due to COVID-19 by main pre-existing condition, and where no pre-existing condition was recorded on the death certificate for Q1 (Jan to Mar) 2020 to Q4 (Oct to Dec) 2022 are available in our Pre-existing conditions dataset, which is published as part of our Monthly mortality analysis release. The next update will include data for Q1 (Jan to Mar) 2022 and will be published in our monthly mortality analysis on 27 April 2022.
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. Deaths due to COVID-19 usually have COVID-19 mentioned in Part 1 and may have consequences of COVID, such as pneumonia, mentioned in lines above. The presence of conditions listed as consequences of COVID-19 are not underlying conditions and are not counted in our method to describe pre-existing conditions mentioned in deaths due to COVID-19.
We define pre-existing conditions as those mentioned in Part 2 of the medical certificate of cause of death. If COVID-19 is mentioned in Part 1 on lines above other conditions also mentioned in Part 1, the last condition mentioned in Part 1 is also considered a pre-existing condition. We don't know exactly how many people who died from COVID-19 had no pre-existing health conditions, only how many did not have a pre-existing condition mentioned on the death certificate. A contributor to the cause of death is expected to have increased the likelihood of death, but this doesn't mean that the death would have been avoided in its absence.
Deaths where COVID-19 was the sole cause mentioned on the death certificate
You can find numbers of deaths where COVID-19 was the sole cause mentioned on the death certificate, by sex and five year age band, for deaths registered in England and Wales between February 2020 and December 2021 here.
It is important to note, that the definition of 'COVID-19 as the sole cause is different to 'COVID-19 with no pre-existing condition recorded on the death certificate', as explained above. Therefore, the number of deaths where COVID-19 was the sole cause mentioned anywhere on the death certificate, is less than the number of deaths where COVID-19 was recorded with no pre-existing conditions.
We consider the methodology used to produce the figures published in the pre-existing conditions dataset to be more robust because part 1 mentions are more likely a consequence of COVID-19 infection.
We recently published a blog post that explains more about coronavirus deaths where no other health conditions were noted on the death certificate, this will clarify your question about the figures for solely being lower than due to.
If you wish to discuss this further, please contact health.data@on.gov.uk.