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Guidance for certifying COVID-19 deaths


Mar 30, 2020

The following information was provided by the BC Vital Statistics Agency to ensure deaths due to COVID-19 are properly certified.

With the World Health Organization declaring COVID-19 a pandemic and subsequent increasing mortality from the virus worldwide, there is increased importance on certifying these deaths correctly.

1. Recording COVID-19 on the medical certificate as cause of death

COVID-19 should be recorded on the medical certificate of cause of death for ALL decedents where the disease caused, or is assumed to have caused, or contributed to death.

2. Terminology

The use of official terminology, as recommended by the World Health Organization, i.e. COVID-19, should be used for all certification of this cause of death.

As there are many types of coronaviruses it is recommended not to use "coronavirus" in place of COVID-19. This will help to reduce uncertainty for coding and monitoring these deaths which may lead to underreporting.

3. Chain of events

Due to the public health importance of COVID-19, when it is thought to have caused or contributed to death it should be recorded in Part I of the medical certificate of cause of death.

Specification of the causal sequence leading to death in Part I of the certificate is also important.  For example, in cases when COVID-19 causes pneumonia and fatal respiratory distress, both pneumonia and respiratory distress should be included along with COVID-19 in Part I.  Certifiers should include as much detail as possible based on their knowledge of the case, medical records, laboratory testing, etc. 

Example

Immediate cause: Acute respiratory distress syndrome
Conditions leading to the cause: Pneumonia, COVID-19

4. Co-morbidities

There is increasing evidence that people with existing chronic conditions or compromised immune systems due to disability are at greater risk of death due to COVID-19. Chronic conditions may be non-communicable diseases such as coronary artery disease, COPD, and diabetes or disabilities. If the decedent had existing chronic conditions, such as those listed above, these should be listed in Part II of the medical certificate of cause of death.

Example:

Other significant conditions contributing to death but not related to the disease or conditions causing it:

A. Coronary artery disease
B. Type 2 diabetes
C. COPD​