1205.0.55.001 - Information Paper: Cause of Death Certification Australia, 2008  
Latest ISSUE Released at 11:30 AM (CANBERRA TIME) 25/11/2008   
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This document was added 25/03/2020.

Guidance for Certifying Deaths due to COVID-19


This guide published by the Australian Bureau of Statistics is intended to provide some immediate guidance on how the new coronavirus disease strain, i.e. COVID-19, should be recorded on the Medical Certificate of Cause of Death. Examples are included in section 5 of this document.

    1. Recording covid-19 on the death certificate
    The new coronavirus strain (COVID-19) should be recorded on the medical cause of death certificate for ALL decedents where the disease caused, or is assumed to have caused, or contributed to death.
        2. Terminology

      The use of World Health Organization terminology COVID-19 or Coronavirus Disease 2019 should be certified on the death certificate. Terminology such as SARS-CoV-2 can be used but it must be clear that it is the 2019 strain of disease. WHO terminology is preferred.

      The term “coronavirus” should not be used in place of COVID-19 or Coronavirus Disease 2019. This will introduce uncertainty for coding cause of death which may lead to under reporting in national statistics.
          3. Chain of events

        Due to the public health importance of COVID-19, the immediate recommendation is to record COVID-19 in Part I of the Medical Certificate of Cause of Death.

        Specification of the causal pathway leading to death in Part I of the certificate is important and all conditions and symptoms should be included. For example, in cases when COVID-19 causes pneumonia and fatal respiratory distress, both pneumonia and respiratory distress should be included along with COVID-19 in Part I alongside the duration of each disease and symptom. Certifiers should include as much detail as possible based on their knowledge of the case, medical records, laboratory testing, etc.

          4. Co-morbidities

        Existing conditions, especially those which are chronic in nature, that may have also contributed to death should be certified in Part II of the Medical Certificate of Cause of Death. Chronic conditions may include but are not limited to: coronary artery disease, COPD, diabetes, cancer or disabilities.


          5. Example medical certificate of cause of death cases

          5.1 Example of train of events in part I of medical certificate of cause of death
        Medical Data: Part 1 and 2
        Disease or condition leading directly to death.

        Antecedent Causes that gave rise to the above cause, stating the underlying cause on the lowest line.

        1Cause of DeathInterval between onset and Death
        AAcute respiratory distress syndrome
        2 days
        BPneumonia
        10 days
        CCOVID-19
        10 days
        D
        Other significant conditions contributing to death but not related to the diseases or conditions causing it.2
          5.2 Example of chronic conditions in part II of medical certificate of cause of death


        Medical Data: Part 1 and 2
        Disease or condition leading directly to death.

        Antecedent Causes that gave rise to the above cause, stating the underlying cause on the lowest line.

        1Cause of DeathInterval between onset and Death
        AAcute respiratory distress syndrome
        2 days
        BPneumonia
        10 days
        CCOVID-19
        10 days
        D
        Other significant conditions contributing to death but not related to the diseases or conditions causing it.2Coronary artery disease, Type 2 Diabetes, COPD
          5.3 Example of other specified immunocompromised conditions in part II of medical certificate of cause of death

        Medical Data: Part 1 and 2
        Disease or condition leading directly to death.

        Antecedent Causes that gave rise to the above cause, stating the underlying cause on the lowest line.

        1Cause of DeathInterval between onset and Death
        AAcute respiratory distress syndrome
        2 days
        BPneumonia
        10 days
        CCOVID-19
        10 days
        D
        Other significant conditions contributing to death but not related to the diseases or conditions causing it.2Diffuse large B cell lymphoma, Immunosuppressant therapy
          5.4 Example of disability in part II of medical certificate of cause of death

        Medical Data: Part 1 and 2
        Disease or condition leading directly to death.

        Antecedent Causes that gave rise to the above cause, stating the underlying cause on the lowest line.

        1Cause of DeathInterval between onset and Death
        AAcute respiratory distress syndrome
        2 days
        BPneumonia
        10 days
        CCOVID-19
        10 days
        D
        Other significant conditions contributing to death but not related to the diseases or conditions causing it.2Cerebral palsy

          6. Coding of deaths due to covid-19


        The Australian Bureau of Statistics assign codes from the International Classification of Disease 10th Revision to all conditions listed on the Medical Certificate of Cause of Death. In response to the COVID-19 pandemic, the WHO has issued emergency code U07.1 COVID-19 to be assigned to all mentions of COVID-19 on the death certificate.

        Due to the public health importance of COVID-19, the WHO have directed that the new coronavirus strain be recorded as the underlying cause of death, ie, the disease or condition that initiated the train of morbid events, when it is recorded as having caused or contributed to death.

        Following the guidelines above will assist in the accurate coding of these deaths and the production of robust national mortality statistics.

        New ABS website

        The ABS will be launching a new website in 2020. You will soon be able to see how this release will appear on the new website by exploring our Beta site. Regular users of this information are encouraged to explore the Beta site and consider if this will affect the way you access and consume ABS data and information. If you would like more information on the new ABS website, or want to discuss how the transition to the new site might impact you, please email newABSwebsite@abs.gov.au.