All coronavirus deaths to be certified, irrespective of comorbidities: Centre to SC

A Covid-19 patient waits to be admitted at LNJP hospital for treatment, in New Delhi, Monday, June 14, 2021. Photo: PTI

New Delhi: The Centre has told the Supreme Court that all deaths with a diagnosis of COVID-19, irrespective of co-morbidities, are to be classified as deaths due to COVID-19.

The MHA in its affidavit said: "All deaths with a diagnosis of COVID-19, irrespective of comorbidities, are to be classified as deaths due to COVID-19. The only exception could be where there is a clear alternative cause of death, that cannot be attributed to COVID-19 (e.g. accidental trauma, poisoning, acute myocardial infarction, etc), where COVID-19 is an incidental finding."

Violation of guidelines a criminal offence

The MHA submitted for recording of Covid-19 deaths, that there is a statutory mechanism in place either by way of an Act of Parliament or guidelines having the force of mandate and the law. Any breach of the guidelines mentioned hereunder would be a criminal offence as stipulated under section 188 of the IPC. The affidavit said broad guidelines for recording of COVID-19 related deaths in India were prepared by the Indian Council of Medical Research (ICMR). "The guidelines clearly state positive deaths, implicate deaths related to COVID-19. Further these guidelines are in sync with the WHO Mortality Coding", said the affidavit.

Death Audit vs Death Certification

The affidavit said the ministry of health had released guidelines on 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 burden of COVID-19 deaths.

On the other hand, 'death audit' is an administrative exercise to identify gaps that contribute to deaths of patients. The aim is to improve quality of healthcare services by suitable corrective measures to prevent/minimize future deaths. "It is however submitted that, States/UTs may continue using their State specific death audit proforma, provided it broadly captures the parameters as the indicative proforma", added the affidavit.

21 day limit for certification

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

On May 24, the top court had suggested there must be a uniform policy and also some guidelines for issuance of death certificates for those affected with Covid-19. A bench comprising Justices Ashok Bhushan and M.R. Shah had said many a time reasons given in a death certificate can be heart attack or lung failure, but these could be triggered by Covid-19. The bench asked Centre's counsel, "So, how are death certificates being issued?"

The Centre filed affidavit in response to the petitions filed by advocates Reepak Kansal and Gaurav Kumar Bansal citing Section 12(iii) of the Disaster Management Act (DMA) providing for ex gratia monetary compensation for the families of those who died during a notified disaster.

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