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The Importance of Proper Death Certification During the COVID-19 Pandemic

Educational Objective
To understand the importance of providing a proper death certificate during the COVID-19 pandemic
1 Credit CME

Death certificate data are used to monitor local, regional, and national mortality trends to improve public health and public safety. Accurate death certification related to coronavirus disease 2019 (COVID-19) is vital to understand the extent and progression of the pandemic. Death certificate data can inform the public and policy makers on the progress of the COVID-19 pandemic and provide important information about who is dying, where they are from, and what were their associated medical conditions. Public health mortality data are only as good as the quality of the death certificates, but proper death certification has been a long-standing challenge in the US.13 The COVID-19 pandemic has highlighted shortcomings that may compromise an accurate count of COVID-19 deaths.

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Article Information

Corresponding Author: James R. Gill, MD, Office of the Chief Medical Examiner, State of Connecticut, 11 Shuttle Rd, Farmington, CT 06032 (jgill@ocme.org).

Published Online: June 10, 2020. doi:10.1001/jama.2020.9536

Conflict of Interest Disclosures: None reported.

References
1.
McGivern  L , Shulman  L , Carney  JK ,  et al.  Death certification errors and the effect on mortality statistics.   Public Health Rep. 2017;132(6):669-675.PubMedGoogle ScholarCrossref
2.
Pritt  BS , Hardin  NJ , Richmond  JA , Shapiro  SL .  Death certification errors at an academic institution.   Arch Pathol Lab Med. 2005;129(11):1476-1479.PubMedGoogle Scholar
3.
Messite  J , Stellman  SD .  Accuracy of death certificate completion.   JAMA. 1996;275(10):794-796.PubMedGoogle ScholarCrossref
4.
Cambridge  B , Cina  SJ .  The accuracy of death certificate completion in a suburban community.   Am J Forensic Med Pathol. 2010;31(3):232-235.PubMedGoogle ScholarCrossref
5.
Richardson  S , Hirsch  JS , Narasimhan  M ,  et al.  Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York City area.   JAMA. 2020;323(20):2052-2059.PubMedGoogle ScholarCrossref
6.
National Center for Health Statistics. Guidance for certifying deaths due to coronavirus disease 2019 (COVID-19). Accessed June 2, 2020. https://www.cdc.gov/nchs/data/nvss/vsrg/vsrg03-508.pdf
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