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
The definition of a relevant establishment is a question of fact for an Employment Tribunal. Guidance from case law says that ‘establishment’ should be interpreted very broadly (so as to avoid employers escaping the need to collectively consult), and may consist of:
- A distinct entity
- With a certain degree of permanence and stability
- Which is assigned to perform one or more tasks
- Which has a workforce, technical means and a certain organisational structure to allow it to do so
However, there is no need for it to have the following:
- Legal, economic, financial, administrative or technological autonomy
- A management which can independently effect collective redundancies
- Geographical separation from the other units and facilities of the undertaking
MHFAs are not qualified mental health medical professionals and they should not be diagnosing or giving medical advice, however, their training will equip them to provide initial support to those experiencing symptoms of mental ill health, and to signpost to further professional help when needed. The MHFA training makes the boundaries of the MHFA role very clear and there should be clearly defined role specifications, procedures and support pathways in place to ensure that individuals are referred on appropriately. There should be peer support in place for MHFAs and a system in place to ensure no individual or individuals are overloaded.
To respond to the crisis businesses might need to exchange information to a greater extent than they would usually. They might need to discuss capacity and to coordinate supply chains (both upstream and downstream). They might need to purchase or sell jointly to ensure vital supplies are maintained. In general agreements or collaboration which:
- Avoid a shortage, or ensure security, of supply
- Ensure a fair distribution of scarce products
- Continue essential services
- Provide new services such as food delivery to vulnerable consumers
The reality of these unprecedented times is that enforcement of health and safety legislation by the HSE (particularly through the criminal courts) in relation to Covid-19 is an extremely unlikely outcome.
In practice this means that any risk assessment will need to be reviewed constantly and adjusted as our understanding of the nature and level of the risk grows.
Some service-providers are instigating special Oversight Groups to keep this issue under review but engagement and consultation with those affected is critical and making sure they feel confident to raise concerns and refuse to work if they believe they are not safe.