Proper death certification in the time of the COVID-19 pandemic: Forensic perspective

Abstract

It is well known that the quality of death certificates determines the accuracy of public health mortality data. In the light of a pandemic, forensic pathologists must understand the true definition of a COVID-19 death and the requirements for filling out the death certificate, as these are critical for maintaining accurate and trustworthy mortality data. To determine the scope and evolution of the COVID-19 epidemic, accurate death certification is critical. We believe that COVID-19 should be enlisted under part II or section "note" (if it exists in DC form in a particular country) of the DC in all suicide instances and putrefied bodies with positive autopsy swabs for SARS-CoV-2. In addition to our suggestions for the completion of the DC in some COVID-19 instances, we feel that forensic pathologists should follow the WHO criteria for proper DC completion in COVID-19 cases. Better physician education at this stage of the pandemic would increase adherence to existing (WHO and CDC) standards. As a result, forensic pathologists with competence in death certification could help by teaching treating physicians in this area.

Keywords: COVID-19; Death certificate; autopsy; forensic; putrefaction; suicide.