Please could you supply me with the following information under the FOI act regarding how covid statistics are compiled:
1. If a person who has no covid symptoms suffers a heart attack and is admitted to hospital then tests positive but is asymptomatic and then dies because of the heart attack would that person then be included in the number of covid deaths that is reported in the media, would it be counted as a death from covid?
2. If a person is admitted to hospital for a routine procedure requiring a stay in hospital and then tests positive for covid whilst in hospital, would that person be counted as being in hospital due to covid?
Thank you for your enquiry.
1. If a person who has no COVID-19 symptoms suffers a heart attack and is admitted to hospital then tests positive but is asymptomatic and then dies because of the heart attack would that person then be included in the number of COVID-19 deaths that is reported in the media, would it be counted as a death from COVID-19?
ONS mortality data is based on the information listed on a death certificate. 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.
If someone dies in circumstances involving an accident, violence or suspicious circumstances, the case is referred to a coroner for investigation. A post-mortem examination is carried out and usually an inquest is held. The Coroner's Court hears all the evidence and follows legal rules of evidence when deciding the causes of death. It is extremely unlikely that a coroner would find that someone was involved in a traffic accident, or was the victim of violence, because of having COVID-19 or a positive COVID-19 test -- so they would not mention COVID-19 on the death certificate. This applies to any death caused by an accident, violence, poisoning, or other external causes.
Even if in an unusual case a death certificate mentioned both COVID-19 and a traffic accident (or other external causes), the World Health Organisation (WHO) rules for coding deaths mean that the traffic accident would be identified as the underlying cause of death in our data.
So in relation to your question, COVID-19 would only be recorded if the doctor in question judged that it was the direct cause of death, or if they felt COVID-19 was a contributory cause which resulted in the heart attack and subsequent death.
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.
2. If a person is admitted to hospital for a routine procedure requiring a stay in hospital and then tests positive for covid whilst in hospital, would that person be counted as being in hospital due to COVID-19?
Unfortunately, we do not hold hospital infection statistics. This data is held by NHS Digital, so they may be better placed to answer your query. They can be contacted via email at firstname.lastname@example.org, and by telephone at 0300 303 5678.