Covid 19 -

[russellw]

Originally Posted by Romulus

If it weren't for a car crash or Covid, a patient with a terminal co-morbidity is likely to cross the rainbow bridge sooner rather than later. CV-19 is forcing those with co-morbidities to cross that bridge sooner.

The bit in italics is correct and that is why it should properly be recorded as the cause of death and it frankly doesn't matter if it's one day less than they would otherwise have had or years.

Some countries (notably the UK) have decided to ignore the international guidelines and as a result the number of reported deaths dropped by about 3k a a couple of days ago after they reclassified some deaths to other causes.

That is manipulation of the data. If everyone sings from the same hymn sheet then we end up with directly comparable statistics but if some countries start doing their own thing in order to make the data more palatable then we lose consistency in the data models.

The WHO also issues a separate set of guidelines for classification of COVID19 to ensure consistency in the data. In short, these guidelines state: (the emphasis is mine)

A death due to COVID-19 is defined as a death resulting from a clinically compatible illness, in a probable or confirmed COVID-19 case, unless there is a clear alternative cause of death that cannot be related to COVID disease (e.g. trauma). There should be no period of complete recovery from COVID-19 between illness and death.

A death due to COVID-19 may not be attributed to another disease (e.g. cancer) and should be counted independently of pre-existing conditions that are suspected of triggering a severe course of COVID-19.

The current form for recording a death that is used for global reporting of all morbidities has multiple lines to record the 'cause' with the main cause on the last line and 2 sections.

Line 1: Report disease or condition directly leading to death

This is used to identify the specific diagnosis that caused the death - e.g pneumonia or ARDS.

Lines 2 onwards: Report chain of events in due to order (if applicable)

So in a COVID19 case we might have the following:

Line 1: ARDS
Line 2: (due to) Pneumonia
Line 3: (due to) COVID19

The second section is used for recording co-morbidities:

2. Other significant conditions contributing to death (time intervals can be included in brackets after the condition)