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CDC Tells Hospitals To List COVID as Cause of Death Even if You’re Just Assuming or It Only Contributed

By C. Douglas Golden | 4 April 2020

THE WESTERN JOURNAL — The problem with making informed decisions about coronavirus is that we don’t have a whole lot of data on it at the moment.

The data that we do have, meanwhile, could end up being terminally skewed, particularly the data that’s been coming out of China.

The Centers for Disease Control and Prevention’s guidance on determining COVID-19 as a cause of death isn’t going to help those numbers.

Issued March 24, the guidance tells hospitals to list COVID-19 as a cause of death regardless of whether or not there’s actual testing to confirm that’s the case.

Instead, even if the coronavirus was just a contributing factor or if it’s “assumed to have caused or contributed to death,” it can be listed as the primary cause. […]

1 Comment on CDC Tells Hospitals To List COVID as Cause of Death Even if You’re Just Assuming or It Only Contributed

  1. Mark Gobell | April 4, 2020 at 5:56 am | Reply
    https://judithcurry.com/2020/03/30/cov-discussion-thread-ii/#comment-913255

    Florian | April 4, 2020 at 5:22 am |

    In Germany we don’t differ. As long as you are testpositive you will go to the statistics for dead Covid patients.

    *

    In the UK we adopt the more inclusive WHO mandated approach to reporting our supposed “cv mortality” …

    For any deceased patient :

    https://judithcurry.com/2020/03/30/cov-discussion-thread-ii/#comment-912705

    WHO code U07.1 if they tested positive

    and

    WHO code U07.2 if they had not been tested AND were “suspected” or “probable” cv cases …

    That way we we get to count anyone and everyone as cv dead, regardless of whether they were or not …

    Thus upholding our strong tradition of non-discrimination …

    Also, SARS-COV-2 the alleged novel virus and Covid-19 the alleged novel disease, have also been added to the list of notifiable diseases, making reporting of even suspected case mandatory …

    Gov.uk : Notifiable diseases and causative organisms: how to report
    https://www.gov.uk/guidance/notifiable-diseases-and-causative-organisms-how-to-report

    “Accuracy of diagnosis is secondary, and since 1968 clinical suspicion of a notifiable infection is all that’s required.”

    MG

    ***

    MG google groups post from 30 March :

    Two new Classification codes U07.1 and U07.2 were introduced by the WHO to allow coding for Covid-19 related deaths as follows :

    WHO.org : Emergency use ICD codes for COVID-19 disease outbreak
    https://www.who.int/classifications/icd/covid19/en/

    The COVID-19 disease outbreak has been declared a public health emergency of international concern.

    An emergency ICD-10 code of ‘U07.1 COVID-19, virus identified’ is assigned to a disease diagnosis of COVID-19 confirmed by laboratory testing.
    An emergency ICD-10 code of ‘U07.2 COVID-19, virus not identified’ is assigned to a clinical or epidemiological diagnosis of COVID-19 where laboratory confirmation is inconclusive or not available.
    Both U07.1 and U07.2 may be used for mortality coding as cause of death
    In ICD-11, the code for the confirmed diagnosis of COVID-19 is RA01.0 and the code for the clinical diagnosis (suspected or probable) of COVID-19 is RA01.1.

    More information on coding COVID-19 in ICD-10 ( PDF, 194kb )
    https://www.who.int/classifications/icd/COVID-19-coding-icd10.pdf?ua=1

    The PDF reveals :

    COVID-19 coding in ICD-1025 March 2020

    This document provides information about the new codes for COVID-19 and includes clinical coding examples in the context of COVID-19.

    It includes a reference to the WHO case definitions for surveillance.

    1 New ICD-10 codes for COVID-19

    • U07.1 COVID-19, virus identified

    • U07.2 COVID-19, virus not identified

    o Clinically-epidemiologically diagnosed COVID-19
    o Probable COVID-19
    o Suspected COVID-19

    *

    The next pages in the PDF further define the use of the new Covid-19 mortality codes U07.1 and U07.2 :

    See : 2 Clinical Coding of COVID-19 with ICD-10

    and : 3 Mortality Coding of COVID-19 with ICD-10

    and : 4 WHO COVID-19 Case definitions for Global Surveillance

    *

    Summary

    U07.1 should be used to classify a death as Covid-19 only when the virus has been identified from a test

    U07.2 should be used to classify a death as Covid-19 for “suspected” or “probable” cases :

    “Suspected” or “Probable” Covid-19 cases are defined thus :

    Suspected cases

    A) a patient with acute respiratory illness (that is, fever and at least one sign or symptom of respiratory disease, for example, cough or shortness of breath)

    AND with no other etiology that fully explains the clinical presentation
    AND a history of travel to or residence in a country, area or territory that has reported local transmission of COVID-19 disease during the 14 days prior to symptom onset

    OR

    B) a patient with any acute respiratory illness AND who has been a contact of a confirmed or probable case of COVID-19 disease during the 14 days prior to the onset of symptoms

    OR

    C) a patient with severe acute respiratory infection (that is, fever and at least one sign or symptom of respiratory disease, for example, cough or shortness breath) AND who requires hospitalization AND who has no other etiology that fully explains the clinical presentation.

    Probable case

    A probable case is a suspected case for whom the report from laboratory testing for the COVID-19 virus is inconclusive.

    ***

    The U.S. CDC / NVSS implementation of the WHO’s two new Covid-19 mortality codes ( PDF)
    https://www.cdc.gov/nchs/data/nvss/coronavirus/Alert-2-New-ICD-code-introduced-for-COVID-19-deaths.pdf

    The above PDF details the Centers for Disease Control and Prevention ( CDC ) ( and NVSS ) implementation of the two new Covid-19 mortality codes U07.1 and U07.2 issued by the WHO.

    See also : WHO PDF : More information on coding COVID-19 in ICD-10 pdf, 194kb
    https://www.who.int/classifications/icd/COVID-19-coding-icd10.pdf

    I thought that the WHO rules for coding deaths as “Probable” or “Suspected” Covid-19 cases where either a test was unavailable or inconclusive, was bad enough, but the CDC have gone one step further in their implementation of the WHO codes and their rules :

    According to the WHO’s new mortality codes for Covid-19, deaths with positive test should be coded U07.1

    “Suspected” or “Probable” Covid-19 deaths without a test, are coded U07.2

    Hence the pandemic of reporting “Covid-19 deaths” …

    *

    The CDC / NVSS have gone beyond the WHO specification by stating ;

    “The WHO has provided a second code, U07.2, for clinical or epidemiological diagnosis of COVID-19 where a laboratory confirmation is inconclusive or not available. Because laboratory test results are not typically reported on death certificates in the U.S., NCHS is not planning to implement U07.2 for mortality statistics. ”

    and :

    “Will COVID-19 be the underlying cause?

    The underlying cause depends upon what and where conditions are reported on the death certificate. However, the rules for coding and selection of the underlying cause of death are expected to result in COVID-19 being the underlying cause more often than not.”

    *

    So, in the US there will be no mortality coding using the WHO’s U07.2 code for deaths where Covid-19 is “Suspected” or “Probable” and either untested or test are inconclusive.

    All U.S. Covid-19 mortality will be coded as U07.1, which according to the WHO specification should only be used for “Tested Positive” “Confirmed Cases” where “COVID-19 documented as cause of death.”

    Hence the pandemic of reporting “Covid-19 deaths” …

    MG

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