Death certificates and causes

There have been over 180,000 UK deaths involving Covid-19.

What does a death certificate show? As well as personal details and factual information, there are two parts about causes:

• Part I: This is the main causal sequence of disease or conditions that led to the death.
• Part II: Other conditions that were not part of the main chain which were likely to hasten the death.

In the first part, clinicians write the direct cause of death at the start (1a). Doctors work backwards, giving what induced the direct cause on the next line (1b). The last line is the start of the chain, known as the underlying cause. The second part contains independent contributory causes.

(Image: GOV.UK)

A limitation of death certificate counts is: this is a doctor’s best opinion. Doctors are fallible: their opinions can err from reality.

There are also different recording practices between doctors across time and space. Software used to encode these certificates for statistical purposes can give different results.

(Image: Office for National Statistics)

There are different statistics which use death certificates as a data source:

• Deaths involving Covid-19: All deaths which mention Covid-19 anywhere on the certificate. In the UK, there are over 180,000 such deaths so far. For England and Wales, that figure is above 165,000.
• Deaths due to Covid-19: All deaths where Covid-19 was the underlying cause (the last line in Part I). In England and Wales, that total is more than 145,000 deaths.

(Image: Office for National Statistics)

There have been two lower figures circulating on social media. Propagators label these figures as the ‘true’ number of Covid-19 deaths.

Deaths in England and Wales due to Covid-19 with no pre-existing conditions: 17,000.