This is how the mortality rate among corona patients is determined | NOW

3 writes daily about the number of COVID-19 patients who die. Where do these numbers come from, when, according to the definition, someone died from COVID-19 and what do the numbers do not tell you?

The GGD, RIVM, and Statistics Netherlands publish figures on the number of people who die with COVID-19. These figures often do not match exactly. What causes these differences?

Daily figures: GGD

Every day, the 25 GGDs report to RIVM how many new deceased COVID-19 patients have been reported to them. These figures are also published daily in a public database without further context.

All deceased persons in this file have been tested positive for the corona virus. COVID-19 may not be the direct cause of death. So it is possible that someone who has died of cardiac arrest and tested positive for the coronavirus will end up in these statistics. The CBS does have reliable figures on the cause of death and therefore the number of people who die as a result of COVID-19.

In addition, the day on which the GGDs report the death is often not the day on which someone died. In exceptional cases, the day of death is even very long ago. For example, on Saturday wrote that 38 deaths of Dutch COVID-19 patients had been reported by the GGDs in the past 24 hours. This was the largest number of reported corona deaths since May and it seemed as if there was a sudden surge in corona deaths.

The number of corona deaths is currently increasing, but not as fast as this figure would suggest. The GGD IJsselland appeared to have checked last week whether there had been deceased persons in the region since March who had tested positive for the coronavirus and who had not yet passed them on to the RIVM.

As a result, the GGD IJsselland reported 28 deaths of COVID-19 patients in one day. However, these were deaths from a long time ago. Last week, one person died of COVID-19 in the region of this GGD.

Weekupdate: RIVM

The date that confirmed COVID-19 patients died can be found in the weekly update of the RIVM. In this weekly update, RIVM explains how the corona outbreak is developing in the Netherlands.

In this update, RIVM has corrected the data of the GGDs if necessary and more context is provided. For example, the update includes the date of death, and it also reports for how many positively tested persons COVID-19 was certainly not the direct cause of death. Of the 6,291 positive persons who died, 86 persons certainly did not die from COVID-19. It is possible that the other 6,205 people also include people for whom COVID-19 was not the direct cause of death. The RIVM cannot provide precise figures on causes of death.

Cause of Death Statistics: CBS

Statistics Netherlands can provide the most reliable figures for the number of people who have died from COVID-19. If someone dies, a doctor always fills in a form stating the cause of death. These forms are sent monthly by the municipalities on paper to Statistics Netherlands. Only Statistics Netherlands is legally allowed to process these forms. This is done manually.

A doctor determines whether someone has died of COVID-19 on the basis of criteria set by the WHO health organization. A person dies from COVID-19 according to this definition, when someone has tested positive for the coronavirus and dies from a known possible consequence of a coronavirus infection, for example pneumonia. In addition, there must be no apparent other disease that caused death, and there cannot have been a full recovery between the COVID-19 diagnosis and death.

Example of a completed COVID-19 cause of death form. (source: CBS)

At the end of July, the CBS wrote that in March and April 6,331 people died from COVID-19. COVID-19 was the suspected cause of death in a further 1,891 people.

These are higher figures than the RIVM reported in this period. A possible explanation for this are registration errors at the GGDs. In addition, in some cases doctors can also enter COVID-19 as the cause of death on the causes of death form without a laboratory test. One situation in which this can occur is when an elderly person in a nursing home dies with COVID-19 symptoms and several people on the ward have laboratory-confirmed COVID-19. The CBS advises doctors in these situations to write down that someone has probably died from COVID-19.

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