In January 2020, the SARS-CoV-2 virus took the world by surprise, leading to many deaths and much disruption to our lives. Now, more than a year on, we need to take stock of our response and ask if all emergency actions taken were necessary, whether they are still necessary and if any mistakes were made.
Normally in England and Wales if a death is caused by a Notifiable Disease like Covid-19, an inquest must be held. However, with the introduction of the Coronavirus Act 2020 last March, this requirement was suspended in cases where Covid-19 was suspected as a cause of death. This remains the case for the duration of the “Emergency Period” defined in the act.
The act also radically changed the established procedures for registering deaths. Previously, an attending doctor would complete and submit a death certificate to the local medical examiner who would scrutinise it and discuss the death with a family representative. Once it was confirmed they had no concerns, the examiner and the representative would sign the death certificate and the death would be officially registered. This was also changed under the Coronavirus Act, allowing any doctor to complete and sign the death certificate even if they have never seen the deceased.
The removal of these independent oversight measures has increased the likelihood of mistakes being made. Over the last year, there have been many cases where families have been surprised to find Covid-19 listed as cause of death for a loved one. Anecdotal evidence indicates that this has sometimes been successfully overturned but in the vast majority of cases, the certificates haven’t been challenged.
Querying Covid-19 as a cause of death has been further complicated due to the current definition of an official Covid death. Any person who dies within 28 days of testing positive for Covid-19 – or having the disease mentioned anywhere on their death certificate even if not as primary cause – is counted as an official Covid death.
This is misleading because it leads to instances where, for example, a person died of Cancer but because their doctor thinks they may also have had some symptoms of Covid he or she lists it on the person’s death certificate (even though it did not contribute significantly to their death). This is then counted as a Covid death. In addition, only a small number of post mortems have been carried out for Covid deaths, further confusing the issue.
As a result, more families are coming forward with stories of suspected misattributed causes of death. Recent stories in the British press have highlighted numerous cases and there is increasing speculation that the official number of Covid deaths may be incorrect. This growing concern has led to calls for an official enquiry into the misattribution of Covid as a cause of death.
The Role of the Covid-19 Assembly
All actions to mitigate the harm caused by Covid-19 were taken due to the perceived death rate of the disease. However, with so much confusion around these deaths, in scientific terms the death rate is effectively unknown and as such, it is impossible to judge the proportionality of these measures.
The Covid-19 Assembly was formed because of its members’ concern that scientific methods are being abandoned in the approach to tackling Covid-19. It is dedicated to evidence-based research in this area in order to establish correct facts and figures.
Our position is that every official Covid death must be properly investigated as it would be if an inquest was still required. As such, in the absence of official programmes to do so, our first major project in the Covid-19 arena will be to catalogue and audit these deaths. Appropriate evidence will be presented to the relevant coroners pending the time when inquests for Covid-19 deaths are reinstated. We will also be making our findings available to any future enquiry into the handling of the Covid-19 pandemic.
The Covid Deaths Audit will be overseen by pathologist Dr. Clare Craig and will involve a team of experienced researchers, health professionals, statisticians, data analysts and legal experts.
Initially focusing on individual local/unitary authority areas, our aim is to create a list of every official Covid death in each area, collating data from official sources, families, hospitals, hospices, care homes, funeral homes and other relevant sources. We do not intend to cherrypick contentious/high-profile cases only, but to investigate every death where possible.
As our funding and resources increase, out intention is to increase the number of areas we cover at a time. Findings for areas will be reported as we progress and our our final findings will also be published at the end of the investigation.