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Should Covid-19 be recorded as a cause of death?

The Chief Coroner supports the position, communicated by NHS England and the Chief Medical Officer that Covid-19 is an acceptable direct or underlying cause of death for the purposes of completing the Medical Certificate of Cause of Death (MCCD) and is considered a naturally occurring disease. This cause of death alone is not a reason to refer a death to a coroner under CJA 2009.

If the cause of death is believed to be due to confirmed Covid-19 infection, there is unlikely to be any need for a post mortem to be conducted and the MCCD should be issued, and guidance is given on how this is delivered to the Registrar in the event of the next of kin/informant being in self-isolation. 

In a hospital setting the MCCD process should be straightforward because of diagnosis and treatment in life. This may be more complex in a community setting. The Coronavirus Act 2020 however expanded the window for last medical review from 14 to 28 days. Outside of this, the death will need to be reported to the coroner.

Although Covid-19 is a naturally occurring disease, there may be additional factors around the death which mean it should be reported to the coroner; for example, the cause of death is unclear, or where there are other relevant factors. Guidance is given to coroners on how to manage such reported deaths, particularly where post mortem examinations may not be readily availability.

Related FAQs

Should we stop employees working from home?

No, government advice remains that if employees can work from home, they should continue to do so in order to minimise social contact across the country in order to keep infection rates down.

If an employee works with vulnerable people who are at high risk of catching coronavirus, can the employer require them to limit their activities outside of work?

It is unlikely that an employer can place such a requirement on staff without infringing the employee’s privacy. If the employee is acting in accordance with the rules, limiting their activity would likely be considered unreasonable.

What is the risk if I insist that my employees have the vaccine?

If you do not have a justifiable reason for insisting that your employees have the vaccine (see FAQ above) your employee could resign and bring a claim of constructive unfair dismissal if they have more than 2 years’ continuous employment. This would be on the basis that you have breached trust and confidence.

If the vaccine includes pig gelatine (as many do), and the employee refuses on religious or because they are vegan, you may face a claim for discrimination under the Equality Act 2010.

What are the rules?

State aid rules are contained in the Treaty on the Functioning of the European Union (previously referred to as the Treaty of Rome). The State aid rules prohibit the use of state resources, or any public support with an economic value, which given selectively has the capacity to distort trade by favouring certain undertakings, or the production of certain goods, and which has the potential to affect trade between Member States. Where aid is present it must not be granted unless it has been specifically approved in advance by the European Commission or benefits from a general exemption to the rules.

In general, the rules apply to all State actions which might assist businesses including:

  • Grants
  • “Soft” loans
  • Selling to business at an undervalue
  • Buying from business at an overvalue
What are the NICE protocols around a patient’s ongoing treatment whilst in critical care during the pandemic?
  • Start critical care treatment with a clear plan of how the treatment will address the diagnosis and lead to agreed outcomes.
  • Review critical care treatment regularly and when the patient’s clinical condition changes.
  • Stop critical care treatment when it is no longer considered able to achieve the desired outcomes. Record the decision and the discussion with family, carers and the patient (if possible).