LAST UPDATE | 3 Jul 2020
This article was originally published on 21 May but was republished on 3 July following the publication of a Hiqa report that noted a 13% increase in deaths in Ireland during the Covid-19 pandemic, but found that the number of Covid-related deaths may have been overestimated.
SOCIAL MEDIA POSTS questioning why some deaths are categorised as being due to Covid-19 are being widely shared in Ireland.
The posts, some of which originate here and some of which are from abroad, typically claim that the virus is being incorrectly listed as the cause of death for someone who has recently died.
Members of the public and people who identify themselves as healthcare workers have said they are aware of cases where people’s deaths were listed as being caused by Covid-19 despite them apparently not being tested for the virus or testing negative.
In some instances, people have claimed that the person in question died from another illness, such as cancer or heart failure, but their death was listed as being due to Covid-19.
A number of posts being shared on platforms such as Facebook and WhatsApp go so far as to claim that people’s deaths are being intentionally miscategorised to inflate the figures.
Some people have alleged that this is being done in an attempt to make the pandemic seem worse than it is, in part to push for travel and other restrictions to remain in place.
TheJournal.ie contacted the Department of Health and the HSE to clarify how deaths from Covid-19 – be they confirmed, probable or possible – are categorised here.
A spokesperson for the department said Ireland “has sought to follow international guidance and advice” from organisations such as the World Health Organization (WHO) and the European Centre for Disease Control (ECDC) in relation to counting deaths.
They noted that, from the outset of the coronavirus pandemic, Ireland has “reported all deaths in laboratory confirmed cases of Covid-19, in both hospital and community settings, unlike many other countries which have reported deaths in hospitalised cases only”.
The spokesperson told us that the reporting of Covid-19 deaths was extended in mid-April to include deaths in probable Covid-19 cases, as well as confirmed cases, in line with updated guidance issued by the WHO last month.
This guidance – which was issued on 16 April can be read in full here – states the following:
A death due to COVID-19 is defined for surveillance purposes as a death resulting from a clinically compatible illness, in a probable or confirmed COVID-19 case, unless there is a clear alternative cause of death that cannot be related to COVID disease (e.g. trauma).
“There should be no period of complete recovery from COVID-19 between illness and death. A death due to COVID-19 may not be attributed to another disease (e.g. cancer) and should be counted independently of pre-existing conditions that are suspected of triggering a severe course of COVID-19.”
Death certificates
The document adds that Covid-19 “should be recorded on the medical certificate of cause of death for ALL decedents (deceased people) where the disease caused, or is assumed to have caused, or contributed to death”.
The guidelines also note that if the person who died was suffering from other conditions, these should also be included on the death certificate.
For example, in cases where Covid-19 caused pneumonia and fatal respiratory distress, both pneumonia and respiratory distress should be included on the certificate, along with the virus, to highlight the “chain of events” that led to the person’s death.
The guidelines note there is “increasing evidence that people with existing chronic conditions or compromised immune systems due to disability are at higher risk of death due to COVID-19″.
The document adds that if the person who died had a non-communicable disease such as coronary artery disease, chronic obstructive pulmonary disease (COPD) or diabetes, this should also be reported on their death certificate.
The Department of Health said that, in following the WHO’s guidance, it has “sought to provide the fullest and most accurate picture possible of the impact of Covid-19″.
Probable or possible Covid-19 deaths
Of the 1,547 deaths related to Covid-19 reported in Ireland as of 18 May, the HSE’s Health Protection Surveillance Centre said 1,294 were confirmed to be due to the virus and 253 were listed as “probable cases”.
The Department of Health said it “understands that the monitoring of Covid-19 cases is a live process with information being collected continuously” and “has been advised that data validation exercises are regularly carried out by public health authorities in the HSE”.
The spokesperson added that the department wished to express its “sincere condolences to the families of those who have passed away as a result” of the virus.
When asked how Covid-19 deaths are recorded, a spokesperson for the HSE told TheJournal.ie: “In cases where an individual who has had a positive Covid-19 test before or after death, this will be notified to the national surveillance system and reported by HPSC as a death in a confirmed Covid-19 case.”
They added that where the treating doctor has “a strong clinical suspicion” the patient had Covid-19 “due to the circumstances” and “the nature of the illness” but where the person has tested negative for the virus, or not been tested at all, these deaths will be notified to the national surveillance system and reported by the HPSC as a death in a “probable/possible Covid-19 case”.
If it is later confirmed that the patient in question did not have the virus, their death is removed from the official figures.
When announcing the latest figures in its daily press release, the Department of Health sometimes includes the following line: “Validation of data at the HPSC has resulted in the denotification of x death(s).” This is generally a low number and indicates that a death previously listed as being caused or probably caused by Covid-19 was later found to be incorrectly categorised.
The HSE spokesperson said there are “different reasons as to why Covid-19 deaths would be denotified, for example, test results pending which are subsequently negative or validation of data which may identify duplicate entries”.
“The Computerised Infectious Disease Reporting (CIDR) surveillance system to which deaths are reported is a live dynamic system and is constantly being validated and updated,” they added.
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There is a lot of false news and scaremongering being spread in Ireland at the moment about coronavirus. Here are some practical ways for you to assess whether the messages that you’re seeing – especially on WhatsApp – are true or not.
STOP, THINK AND CHECK
Look at where it’s coming from. Is it someone you know? Do they have a source for the information (e.g. the HSE website) or are they just saying that the information comes from someone they know? A lot of the false news being spread right now is from people claiming that messages from ‘a friend’ of theirs. Have a look yourself – do a quick Google search and see if the information is being reported elsewhere.
Secondly, get the whole story, not just a headline. A lot of these messages have got vague information (“all the doctors at this hospital are panicking”) and don’t mention specific details. This is often – but not always a sign – that it may not be accurate.
Finally, see how you feel after reading it. A lot of these false messages are designed to make people feel panicked. They’re deliberately manipulating your feelings to make you more likely to share it. If you feel panicked after reading something, check it out and see if it really is true.
TheJournal.ie’s FactCheck is a signatory to the International Fact-Checking Network’s Code of Principles. You can read it here. For information on how FactCheck works, what the verdicts mean, and how you can take part, check out our Reader’s Guide here. You can read about the team of editors and reporters who work on the factchecks here
Have you gotten a message on WhatsApp or Facebook or Twitter about coronavirus that you’re not sure about and want us to check it out? Message or mail us and we’ll look into debunking it. WhatsApp: 085 221 4696 or Email: answers@thejournal.ie
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