By Charlotte Webster-
The number of coronavirus related deaths in England and Wales has reached its highest since May, ONS statistics reveal.
The UK’s total Covid death toll has exceeded 75,000, according to a tally of all fatalities that mention Covid-19 on the death certificates. The number of deaths in the UK soared by 603 with another 13,430 cases recorded, making the overall death toll rocket high.
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However, the role played by underlying issues in these figures is far from clear even with the knowledge that COVID-19 can trigger the death of those with other underlying issues, or the fact that those with underlying issues are more vulnerable to contracting COVID-19.
With the death toll close to tripling yesterday when it rose by 205 with 12,330 more cases recorded, there are important questions to be asked. The Isles of Scilly is the only local authority area in the country not to have had a coronavirus related fatality. The possible reasons why this area has escaped COVID-19 related deaths is the subject of research.
Under guidelines by the World Health Organisation (WHO), a death due to COVID-19 is defined for surveillance purposes as a death resulting from a clinically compatible illness, in a probable or confirmed COVID-19 case, except where there is a clear alternative
cause of death that cannot be related to COVID disease (e.g. trauma).
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The guidelines also state that ”there should be no period of complete recovery from COVID-19 between illness and death. Also, 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 latter requirement suggests that even where there are serious underlying issues that may have triggered a severe course of the virus, it is important to establish that the death was caused by COVID-19, and not the other underlying issues.
Statistics relating the percentage of patients who have died with COVID-19 to those who had underlying issues are available, but not a lot of examination has been given to the requirement by WHO that all deaths due to the virus must be independent of pre-existing conditions.
Establishing the independence of COVID-19 death from other issues is not so straightforward because the reality of underlying issues in a patient does not necessarily mean COVID-19 did not cause the person’s death.
It also doesn’t mean COVID-19 caused their death. Much depends on how likely it is that the patient would have lived a lot longer if they never caught the virus, and there is not yet any clear directions as to how to establish facts like this.
Up until now, the general understanding has been that the presence of COVID-19 as a contributory factor in the death of a patient makes it a cause of death. The British government this year revised the criteria for determining COVID-19 as a cause of death by only registering deaths under the virus which occurred 28 days after the first positive test of COVID-19.
Revision
This revision was brought along when it was discovered that COVID-19 death certificates had been exaggerated in many cases, with even those who may have died of a crash long after testing positive for the virus, having COVID-19 on their death certificate
The importance of this revision is that it makes it clear that determining COVID-19 as the main cause of death is key to the registration process of the death certificate, and providing an accurate picture of the devastation of the disease.
The only potential missing factor is whether there may be any connections between pre-existing issues and the reasons patients who died within 28 days of their first testing were tested at the time. All this is the subject of broad research.
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