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Death certificates to include Covid-19 as cause of death, says WHO

The U.S., India and Brazil remain the top three most affected countries with Covid-19. FILE PHOTO (AP Photo/Vincent Thian)

The U.S., India and Brazil remain the top three most affected countries with Covid-19. FILE PHOTO (AP Photo/Vincent Thian)

Published Apr 29, 2020


DURBAN - When the World Health Organization (WHO) updated its coding system for death certificates to include Covid-19, many concluded that the data count of people who died from Covid-19 will be skewed.

WHO updated the coding system on April 16 to ensure that “all deaths due to Covid-19” are identified. Under the new coding system, death due to Covid-19 may not be attributed to another disease (for example cancer) and should be counted independently of pre-existing conditions that are suspected of triggering a severe course of Covid-19.

“Covid-19 should be recorded on the medical certificate as the cause of death in all cases where the disease caused, or is assumed to have caused, or contributed to death. Pre-existing chronic conditions or comorbidities must also be listed, because of increasing evidence that people with existing chronic conditions or compromised immune systems are at higher risk of death due to Covid-19,” stated the agency.

South Africa uses the standard international causes of death classification systems based on WHO rules and it's International Classification of Diseases (ICD-10) codes. According to this system, the “immediate cause” is the final disease, injury or complication directly causing the death.

The “underlying cause” of death is the disease or injury that started the sequence of events leading directly to death while “contributing causes” are other significant conditions contributing to death.

Forensic pathologist Dr Ed Donoghue argued that: "No matter how these deaths are currently being attributed after this pandemic terminates, an excellent approximation of the true fatality rate of Covid-19 deaths can be made by the calculation of the excess mortality for the period. This calculation was very helpful during the 1995 Chicago heatwave. Almost certainly, because of the scarcity of testing and other reasons we will find that the number of Covid-19 deaths has been grossly underestimated.”

According to epidemiologist James Eugene Enstrom, it’s possible that the lethality of Covid-19 is no greater than that of the seasonal flu.

“The pandemic and Covid-19 deaths must be put in proper perspective given the unprecedented societal and economic disruption of the current national lockdown. A Stanford University survey

suggests that at most 0.1% of infected persons will die from Covid-19 comparable to the seasonal flu death rate.”

Meanwhile, forensic pathologist Dr Judy Melinek believes that the death toll of Covid-19 is not going to be accurate until epidemiologists and statisticians have time to crunch the numbers.

“We are slogging through a slow, brutal, worldwide mass-fatality event. Whatever the final tally, it will be a terrible one,” she said.

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