Deaths due to co-morbidities also classified as Covid deaths: Centre tells SC

All Covid-19 deaths, irrespective of co-morbidities, are to be classified as deaths due to the virus, according to guidelines issued on October 9, 2020, the Centre has told the Supreme Court.

The only exception, however, could be where there is a clear alternative cause of death, that cannot be attributed to Covid-19, for example, accidental trauma, poisoning, acute myocardial infarction, etc, where Covid-19 is an incidental finding, the Ministry of Home Affairs said in an affidavit.

The Centre said any breach of the guidelines, prepared by the Indian Council of Medical Research (ICMR), would be a criminal offence as stipulated under Section 188 of the IPC.

“The guidelines clearly state that positive deaths, implicate deaths related to Covid-19. Further, these guidelines are in sync with the WHO Mortality Coding," it added.

"It is mandated that any death resulting from Covid-19 has to be so certified that is, as Covid death, failing which everyone responsible, including the certifying doctor, will be responsible for penal consequences," it added.

The Ministry of Health and Family Welfare had released guidelines on October 9, 2020, on the distinction between ‘death audit’ and ‘death certification’.

The Centre said the primary goal of certification of cause of death (death certificate) is to identify and correctly classify all deaths due to a medical condition (e.g. Covid-19) and to eliminate any discrepancy in coding so as to obtain true estimates of the burden of Covid-19 deaths.

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On the other hand, ‘death audit’ is an administrative exercise to identify gaps that contribute to the deaths of patients. The aim is to improve the quality of healthcare services by suitable corrective measures to prevent/minimize future deaths.

However, States/UTs may continue using their own specific death audit proforma, provided it broadly captured the parameters as the indicative proforma, the affidavit said.

The MHA said, in May 2021, the Office of the Registrar General of India (ORGI) has also issued guidelines regarding registration and recording of the cause of death, wherein it was advised that the death of the person should be registered within the stipulated time of 21 days.

The government's response came to the top court's suggestion made on May 24 that there must be a uniform policy and also some guidelines for issuance of death certificates for those affected with Covid-19 during the hearing of PILs by advocates Gaurav Kumar Bansal and Reepak Kansal.