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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.

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What happens if a patient is admitted to critical care during the pandemic?
  • On admission to critical care, the risks, benefits and likely outcomes of the different treatment options should be discussed with patients, families and carers so they can make informed decisions about their treatment wherever possible.
  • A member of the critical care team should be involved in these discussions whenever the patient or team needs advice about critical care to make decisions about treatment.
Which products and services are affected?

Initially, the relaxation applied to supermarkets and food suppliers. This was subsequently widened to apply to other businesses, permitting them to collaborate where necessary to respond to the crisis in the interests of consumers.

What is the penalty for failing to comply with the collective consultation obligations?

Failure to comply with the collective inform and consult obligations could impact on the fairness of any dismissals – see next question. In addition, a Tribunal can award a protective award of up to 90 days gross pay for each affected employee. The purpose is intended punish the employer for not complying with the obligations, not to compensate the employee for their individual financial loss.

What actions and measures should be avoided?

The CMA is particularly concerned about certain activities, its guidance highlights:

  • Exchange of commercially sensitive information where this is not necessary in response to the crisis
  • Collaboration which unfairly excludes third parties
  • Abuse of a dominant position (including a dominant position held as a result of the crisis) – particularly to charge excessive prices
  • Seeking to maintain prices or prevent reductions in prices
  • Cooperation going beyond what is necessary to respond to the crisis in the interests of consumers