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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

If an employer identifies that higher PPE spec is required for BAME employees undertaking a particular task, is it necessary to increase the spec for all employees working in that area?

It is. If you assess a risk and identify a control measure then fail to deploy it, then you are breaching your legal duties under HASWA and potentially committing a criminal offence. So if you decide for example that N95 respirators have to be used by everyone, you have a duty to provide them.

So the short answer is yes.

Can I collect health data in relation to Covid-19?

Yes. With respect to employees you have an obligation to protect their health so you can gather information to do that. You might gather information from your employees on who has the virus, who has had it and recovered and also who has tested negative. You might also want to know if individuals have been in contact with someone who has it or if they are in a vulnerable group. It is reasonable to want to know where individuals have travelled. In the future it may also be reasonable to know if they are planning to travel to a virus hot spot, as the impact of the virus around the world is likely to continue for some time even after the outbreak has been contained in the UK.

It is reasonable to gather some information about visitors to your site, be they customers or suppliers, as this information will also help protect your staff. However, you should keep what you gather to a minimum. For visitors, it’s unlikely that you need to know anything more than they have Covid-19, are displaying symptoms or have recently been in contact with someone who has the virus.

What is the guidance in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards during the Covid-19 pandemic?

The Department of Health & Social Care has published guidance for hospitals, care homes and supervisory bodies on the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) during the coronavirus pandemic.

In many scenarios created or affected by the pandemic, decision makers in hospitals and care homes will need to decide:

  • if new arrangements constitute a ‘deprivation of liberty’ (most will not), and
  • if the new measures do amount to a deprivation of liberty, whether a new DoLS authorisation will be required (in most cases it will not be).

If a new authorisation is required, decision makers should follow their usual DoLS processes, including those for urgent authorisations.

A summary of the key points to be taken from the guidance is outlined below:

Use of the MCA and DoLS due to Covid-19

  • During the pandemic, the principles of the MCA and the safeguards provided by DoLS still apply.
  • It may be necessary to change the usual care and treatment arrangements, for example to provide treatment for people with Covid-19, to move them to a new hospital or care home to better utilise resources or to protect them from becoming infected.
  • All decision makers are responsible for implementing the emergency Government health advice  and any decision made under the MCA must be made in relation to a particular individual, it cannot be made in relation to groups of people.

Best interest decisions

  • In many cases, a best interests decision will be sufficient to provide the necessary care and treatment for a person who lacks the capacity to consent to the care and/or treatment arrangements during this emergency period.
  • If an individual has made a valid and applicable advance decision to refuse the treatment in question, then the relevant treatment, even for Covid-19, cannot be provided.

Delivering life-saving treatment

  • Where life-saving treatment is being provided in care homes or hospitals, including for the treatment of Covid-19, then the person will not be deprived of liberty as long as the treatment is the same as would normally be given to any person without a mental disorder.
  • The DoLS will therefore not apply to the vast majority of patients who need life-saving treatment who lack the mental capacity to consent to that treatment, including treatment to prevent the deterioration of a person with Covid-19.

The full guidance can be found here.

What fees will I pay for a loan under CBILS?

Borrowers will not have to pay a guarantee fee. Lenders will pay a fee to access the scheme. The Government will make a Business Interruption Payment to cover the first 12 months of interest payments and any lender-levied fees, allowing smaller businesses to benefit from no upfront cost.

British Business Bank has indicated that following earlier discussions with the banking industry, some lenders indicated that they would not charge arrangement fees or early repayment charges to SMEs borrowing under the scheme. Each business should check the terms of the loans being made to ensure this is the case and what the interest rate and prepayment fees will be following the period in which the Government makes payment of these amounts.  

Is there going to be any support after October 2020 for employers to try and protect jobs?

The Chancellor announced:

  • A new “job retention bonus” for employers to access for furloughed employees subject to certain conditions being met – see below for more information.
  • A “Kickstart scheme” which will directly pay employers to create jobs for any 16-24 year old at risk of long-term unemployment.
  • Incentives for employers to take on apprentices.

As a result of the CJRS being extended, the Job Retention Bonus will no longer be paid in February 2021.