Centre Issues Guidelines For COVID Death Certificates Following Supreme Court's Directions
The Government of India has told the Supreme Court that it has framed guidelines to simplify the process of the issuance of COVID-19 death certificates in compliance with the directions in the judgment passed on June 30.A compliance affidavit filed before the Supreme Court on September 11 stated that the Union Ministry of Health and Family Welfare and the Indian Council for Medical Research...
The Government of India has told the Supreme Court that it has framed guidelines to simplify the process of the issuance of COVID-19 death certificates in compliance with the directions in the judgment passed on June 30.
A compliance affidavit filed before the Supreme Court on September 11 stated that the Union Ministry of Health and Family Welfare and the Indian Council for Medical Research have jointly issued guidelines on September 3 for issuance of an "official document" on COVID-19 deaths.
It was also submitted in the affidavit that the Office of the Registrar General of India ("ORGI") has issued a circular on 3rd September, 2021 to provide a Medical Certificate of Cause of Death to the next of kin of deceased.
The key highlights from the guidelines are given below :
What are COVID-19 cases?
COVID-19 case, for the purposes of the guidelines, are those which are diagnosed through RT-PCR test, molecular test, rapid-antigen test or clinically determined through investigations at a hospital or in-patient facility by a treating physician, while admitted at the hospital or in-patient facility.
What will not be considered as COVID deaths?
Deaths occurring due to poisoning, suicide, homicide and deaths due to accident, among others, will not be considered as COVID-19 deaths even if COVID- 19 is an accompanying condition.
COVID-19 deaths
COVID-19 cases which are not resolved and have died either in hospital settings or at home, and where a Medical Certificate of Cause of Death (MCCD) in Form 4 and 4 A has been issued to the registering authority as required under Section 10 of the Registration of Birth and Death (RBD) Act, 1969, will be treated as a COVID-19 death,� according to the guidelines. The Registrar General of India will issue necessary guidelines to chief registrars of all states and union territories in this regard.
According to an ICMR study, 95 per cent of deaths take place within 25 days of a person testing COVID-19 positive, it was mentioned in the guidelines.
"To make the scope broader and more inclusive, deaths occurring within 30 days from the date of testing or from the date of being clinically determined as a COVID-19 case, will be treated as 'deaths due to COVID-19, even if the death takes place outside the hospital/ in-patient facility," the guidelines stated.
However, a COVID-19 patient, while admitted at a hospital or in-patient facility, and who continued as the same admission beyond 30 days, and died subsequently, shall be treated as a COVID-19 death, according to the guidelines.
Procedure for redressal of grievances regarding death certificates
The guidelines also prescribe a procedure for grievance redressal, as mandated by the Court judgmetn .
The guidelines state that in cases where the MCCD is not available or the next of kin of the deceased is not satisfied with the cause of death given in the MCCD and which are not covered by the aforesaid scenarios, states and union territories shall notify a committee at the district level.
The committee would consist of an additional district collector, the chief medical officer of health (CMOH), an additional CMOH/ principal or head of department of medicine of a medical college (if one exists in the district) and a subject expert, for issuing of the "Official Document for COVID-19 Death", the guidelines said.
The procedure to be followed by the committee will be as follows :
The next of kin of the deceased shall submit a petition to the district collector for issuing of the document.
The Official Document for COVID-19 Death will be issued in the format annexed to these guidelines by the aforesaid district-level committee after due examination and verification of all facts. The Official Document for COVID-19 death shall also be communicated to chief registrars of states/UTs and Registrar of Birth and Death, who issued the death certificates.
The committee will also examine the grievances of the next of kin of the deceased, and propose necessary remedial measures, including issuance of amended "Official Document for COVID-19 Death" after verifying facts in accordance with these guidelines.
The applications for issuing the document and for redressal of grievances shall be disposed off within 30 days of submission of the application/ grievance.
In its June 30 verdict, the top court had also ordered steps to simplify guidelines for issuance and correction of death certificates/official documents, stating the exact cause of death, that is, 'Death due to COVID-19' for enabling dependents to get benefits of welfare schemes.
What was the Supreme Court's verdict?
The directions were issued by a bench comprising Justices Ashok Bhushan and MR Shah in the judgment delivered on June 30 in the cases Gaurav Kumar Bansal vs Union of India and Reepak Kansal vs Union of India and Others.
The bench had made it clear that a death certificate issued in respect of a COVID fatality must clearly specify the cause of death as COVID itself. Also, if a person has died due to any other complications or disease due to COVID, then also the death certificate should specifically mention the cause of death as COVID.
"In the death certificate also, if a person has died due to Covid-19 and/or any other complications/disease due to Covid-19, it should be specifically mentioned in the death certificate", the Court said.
".we feel that the procedure should be as simplified as it can be. Therefore, a simplified procedure/guidelines is/are required to be issued by the Central Government and/or appropriate authority for issuance of an official document/death certificate stating the exact cause of death, i.e., "Death due to Covid-19", to the family members of the deceased who died due to Covid-19", the Court observed.
Illustratively, the Court suggested :
"For guidance, such guidelines may provide if a person has died after he was found covid positive and he has died within two to three months, either in the hospital or outside the hospital or at home, the death certificate/official document must be issued to the family members of the deceased who died due to Covid-19 stating the cause of death as "Died due to Covid-19". He/she might have died even due to other complications, however, due toCovid-19"
The Court also said that guidelines should provide a remedy to a person who may have a grievance that an incorrect death certificate was issued in respect of a COVID fatality.
"The Appropriate Authority is directed to issue simplified guidelines for issuance of Death Certificates/official document stating the exactcause of death, i.e., "Death due to Covid-19", to the family members of the deceased who died due to Covid-19", the Court directed.
On September 3, the Court had expressed displeasure at the Central Government for its delay in issuing the guidelines for COVID death certificates.
"By the time you frame the guidelines, the third phase will also be over", Justice Shah had remarked while asking the Centre to file the compliance affidavit by September 11 without fail.