Should Covid-19 be recorded as a cause of death?
The Chief Coroner supports the position, communicated by NHS England and the Chief Medical Officer that Covid-19 is an acceptable direct or underlying cause of death for the purposes of completing the Medical Certificate of Cause of Death (MCCD) and is considered a naturally occurring disease. This cause of death alone is not a reason to refer a death to a coroner under CJA 2009.
If the cause of death is believed to be due to confirmed Covid-19 infection, there is unlikely to be any need for a post mortem to be conducted and the MCCD should be issued, and guidance is given on how this is delivered to the Registrar in the event of the next of kin/informant being in self-isolation.
In a hospital setting the MCCD process should be straightforward because of diagnosis and treatment in life. This may be more complex in a community setting. The Coronavirus Act 2020 however expanded the window for last medical review from 14 to 28 days. Outside of this, the death will need to be reported to the coroner.
Although Covid-19 is a naturally occurring disease, there may be additional factors around the death which mean it should be reported to the coroner; for example, the cause of death is unclear, or where there are other relevant factors. Guidance is given to coroners on how to manage such reported deaths, particularly where post mortem examinations may not be readily availability.
Related FAQs
There have always been ways for public bodies to assist without being required to notify these for approval. These continue to be available during the financial crisis, and are likely to be increasingly useful for measures which need to be introduced quickly. The measures include:
Those where it is possible to conclude that there is no effect on trade between Member States – for example, measures which are likely to have only a limited local effect. The European Commission has concluded, for example, that measures to assist locally-focused cultural activity can be assumed to have no effect on inter-State trade.
Those where it is possible to conclude that the State is acting in a way consistent with a commercial operator (the so-called Market Economy Operator Principle) – particular care will need to be taken in the context of current economic conditions to ensure that it can reasonably be asserted that a commercial operator would act in the same way as the public body.
Measures under the General Block Exemption Regulation – this legislation allows various types of aid, or aid schemes, to be employed.
Examples include aid for SMEs, aid for research and development, aid for local infrastructure and aid to ports and airports.
De Minimis Measures – Member States are permitted to grant small amounts of aid to undertakings over three fiscal years (the current year and the previous two years). This allows undertakings to receive up to €200,000 (or €500,000 where they are providing public services).
The government has announced a number of measures to try to protect businesses during the current period of uncertainty. However there is no outright ban on creditors being able to take legal action to recover money they are owed, though there are temporary restrictions on some forms of legal action, like winding up petitions.
However, it is important to note that these measures only relate to winding up proceedings. Creditors will still be free to commence county court claims.
The new Corporate Insolvency and Governance Act 2020 brings in a new “moratorium” procedure. Businesses in financial difficulty that are viable and can be rescued will now be able to work with an insolvency practitioner to obtain at least 20 business days’ breathing space from creditors to allow the business to formulate a plan to deal with its financial problems.
For more information on the Corporate Insolvency and Governance Act, click here
As part of the raft of measures put forward by the government over recent months, there are also restrictions on landlords taking action to evict commercial tenants who miss rent payments. Various payment holidays and forbearance have been put in place in respect of certain tax liabilities and some business rates.
If your business is going to go into an insolvency process like administration or a company voluntary arrangement, there is the ability to obtain a freeze on creditors taking action whilst those procedures are put in place. However, these sorts of moratoriums will not be available to everyone and in any event not unless an insolvency process is being instigated.
Regardless of whether a business has formal protection from creditors or not, engagement with creditors and trying to reach agreement with them to deal with the debt is therefore vital. Much of the protection measures that the Government has introduced like curbing the ability of landlords to evict a commercial tenant, do not wipe out the debt. They simply prevent action being taken or a payment becoming due for a short time. All businesses should use that time to consider how those debts can be dealt with and engage with the relevant stakeholders sooner rather than later.
Some organisations are prioritising properties, known to be higher risk, such as properties with open flues, or near to the certificate expiry date.
Vulnerable staff and tenants need protection, safe working practices need to be established, and communicated. Organisations should bring forward servicing for people known to be vulnerable – but bearing in mind the guidance as to preserving the annual test date.
The Commission has provided guidance as to measures which Member States can introduce without notification. These include:
- Measures which apply to all businesses within a Member State (for example the furloughing measures introduced by the UK Government)
- Measures providing support direct to consumers
- Measures which are already exempt from the notification requirement (discussed further below).
To respond to the crisis the European Commission has also issued a temporary framework to provide a basis for emergency aid to be notified for approval. The framework is initially in place until 31 December 2020. The Commission continues to keep this under review and has twice widened its scope to allow more types of aid to be notified. The type of measures covered include:
- The provision of guarantees (including guarantees for 100% of loans)
- The provision of loans at low interest rates, at zero interest rates or subordinated to senior debt
- Measures to support liquidity needs or to alleviate difficulties caused by the current crisis
- Measures to recapitalise businesses
- Measures to assist sectors hit particularly hard by the current crisis (eg transport)
- Measures targeted at COVID-19 such as research and development or production of products related to tackling the virus
The Commission has approved a UK Government “umbrella” notification to allow UK public authorities to adopt the measures permitted by the Commission framework. Therefore public authorities in the UK can use the Framework without notifying individual measures or schemes to the Commission.
It is the individual assessment by an organisation of its Covid-19 risk in its workplace that will be central. There may be common features across sites or areas of a site but every workplace will have a different risk profile depending on the service it offers and the workers who deliver those services. No one size fits all.
The context of managing Covid-19 risk is the need to tie in with UK government guidance and HSE advice – which despite being a lot more comprehensive than it was, is not a panacea and will continue to evolve. The difficulty we have with this in the context of the known increased risk to BAME employees from Covid-19 is that our understanding of the risk is, we would suggest, at a pretty early stage which makes it more difficult to address. However we know the increased risk exists and we owe our BAME workers a duty to manage that risk and keep them safe.
We also have a duty to consult employees. This is critical in managing this risk – ensuring BAME workers have a loud voice in the assessment process will be very important.
Where an individual has a particular characteristic, for instance they’re pregnant, they have physical or mental disabilities etc, the law requires us to look at that individual or, where it is a group, that group of individuals and assess the risk to them and take any reasonably practicable steps to control the risk to them.
Risk control hierarchy is key. In “normal” businesses we reduce our Covid-19 risk by keeping people away from the workplace – “avoid, eliminate and substitute” then changing work practices (e.g. social distancing measures) before we arrive at PPE. In a healthcare context, we arrive at PPE a lot more quickly.
We need to ensure our people are given sufficient information, instruction and training so they can do their jobs safely and we must consult workers and involve them in workplace safety – this is going to be critical in the context of Covid-19.