Coronavirus Pandemic Highlights Importance Of Accurate Death Certificates
PITTSBURGH (KDKA) -- To get an accurate count of deaths due to coronavirus, we need accurate death certificates.
"Death certification is a very important process to tracking diseases and vital statistics in general," says AHN pathologist Dr. Joseph DelTondo. "During a pandemic, it brings it up to the forefront."
The certificate may list the cause of death, but it should also list why.
It's not enough to simply say cardiac arrest or respiratory failure. Coronavirus should be included if appropriate.
"If someone dies of respiratory failure, for example, and they tested positive for coronavirus, that should be listed on the death certificate. And it will be logged and tracked in vital statistics," says Dr. DelTondo.
But sometimes, testing isn't done, and doctors use clinical judgment. For instance, someone with Alzheimer's disease in a nursing home with other known coronavirus cases — who develop low oxygen levels and dies in a matter of hours — this could be designated a probable case.
"So you could say respiratory failure or pneumonia due to probable coronavirus infection or COVID-19 infection. And you could put their comorbidities, such as dementia or heart disease, etc., in part two of the death certificate," Dr. DelTondo said.
But death certificates are not a means for tracking every case, only those in which the virus contributed to the death.
"There are instances where people may die with coronavirus and not from coronavirus. An example would be if someone is in a car accident and dies an accidental death or traumatic death, and they just happen to test positive after death for coronavirus. That probably really shouldn't make it on the death certificate. It didn't contribute but it still may need to be recorded somewhere," Dr. DelTondo says.
Treating physicians fill out these documents, but often they've had little instruction on how to do it. When Dr. DelTondo was in training, "We might have done one or two death certificates. That's it."
He tells his students and residents that they need to put down not only the cause of death but the cause of the cause of death, too.
Having the most complete and accurate death certificates is important because the information can shape public health responses at the local and national levels.
