COVID-19 deaths to be counted as such despite comorbidities, but there are exceptions: All you need to know

The Centre on Sunday submitted in the Supreme Court that all COVID-19 patients who succumbed to the disease will be listed as having 'died due to COVID-19 ', irrespective of the co-morbidities they had.

The Centre made the statement during a hearing of pleas accusing the state governments of wrongly certifying COVID-19 deaths in a bid to avoid paying an ex-gratia amount as stipulated by the Disaster Management Act.

In an affidavit, the Centre told the apex court, "All deaths with a diagnosis of COVID-19 , irrespective of co-morbidities, are to be classified as deaths due to COVID-19 . The only exception could be where there is an alternative cause of death, that can't be attributed to COVID-19 (for eg: Accidental trauma, poisoning, acute myocardial infarction, etc), where COVID-19 is an incidental finding."

"It is mandated that any death resulting from COVID-19 shall have to be so certified i.e. as COVID death, failing which, everyone responsible, including the certifying doctor, shall be responsible for penal consequences," the Centre said in its affidavit on Sunday.

The exceptions

In its affidavit, the Centre listed a few exceptions to the clause of certification of a COVID-19 death and labelled them as "clear alternative causes of death", The Hindu reported.

What are these exceptional situations?

Accidental trauma death: This refers to a death that is "unnatural", uncontrollable, or could have been avoided. Examples include a car accident, falling down a flight of stairs, choking, or drowning, etc. Insurance companies define the term 'accidental death' as "event that strictly occurs as a result of an accident" and that "can't be controlled".

"Accidents typically exclude things like acts of war and death caused by illegal activities. Death from an illness is also excluded. Any hazardous hobbies that the insured regularly engages in — race car driving, bungee jumping, or any other similar activity — are specifically excluded as well," Investopedia reported.

Poisoning: A 2019 study by the National Center for Biotechnology Information (NCBI) concluded that poisoning is one of the major causes of morbidity and mortality in India. It found that insecticides and pesticides compounds are commonly used for poisoning.

"In India, death due to poisoning is recorded as unnatural death along with registration in medicolegal case," the study said.

Acute myocardial infarction: An acute myocardial infarction is an official name for a heart attack, which is a fatal condition that occurs when "blood flow to the heart muscle is abruptly cut off, causing tissue damage", Healthline reported.

One of the major causes of a heart attack is a blockage in coronary arteries, which is caused due to excess plaque. Plaque is created by "fat, cholesterol, and cellular waste products".

"When these arteries become blocked or narrowed due to a buildup of plaque, the blood flow to your heart can decrease significantly or stop completely. This can cause a heart attack. Several factors may lead to a blockage in the coronary arteries," the report added.

The developments so far

On Monday, the Supreme Court instructed the Centre to simplify the process to issue and acquire COVID-19 death certificates.

The top court termed as "prima facie more complicated" the present process of issuing death certificates. It told the Centre to "simplify" the process to enable the dependents of COVID victims to get such certificates corrected even after their issuance, so that they can avail benefits of the welfare schemes.

"When humanity is absent and things like black marketing is happening, what can be said? But our priority is the common man," the bench said, asking the Solicitor General to do the needful to ensure that families of those who died of COVID get the proper death certificate and the provision for amending the reason for death should be available.

Noting that states do not give uniform compensation to families of the victims, it asked whether uniform guidelines on compensation can be framed under the Act "otherwise there will be heartburn. Somebody will get some money and others will get more"

In reply, Solicitor General Tushar Mehta, appearing for the Centre, said, "The Centre can consider having a uniform scheme under other provisions of the DMA."

In a hearing earlier, the Supreme Court told the Centre that the death certificates of those who died of COVID-19 often do not reveal COVID-19 as the cause of death. "The death certificates of persons who die from COVID-19 in hospitals show the reason as lung or heart problem or something else," the Bench had told the Centre.

With inputs from agencies