The GHA’s Public Health department wish to explain some of the medical reasons as to how deaths related to COVID-19 may be confirmed long after a positive patient is considered as having recovered, for example as has been experienced recently in our Elderly Residential Services.

The World Health Organisation declared that the name of the Wuhan Coronavirus would become, on 11th February, SARS-CoV-2 and the disease caused by the virus would be known as COVID-19. The press has often confused the virus with the disease.

The swabbing and PCR analysis tests for SARS-CoV-2 identifies the genetic material found in the virus (RNA), not the virus itself. This viral material deteriorates as the body mounts an immune response, such that after 10 days, the only thing being identified by further tests are fragments of RNA, not of viable virus. This means that a person who tests positive for the virus is infectious for a maximum of 10 days from their positive test result. After those 10 days, the person is no longer infectious even though parts of the RNA may be found up to 84 days later.

The Contact Tracing Bureau identifies people as being positive for the virus when the person first tests positive, and automatically deems them to have recovered 10 days later. This means only that the person was infectious for that 10 day period, and has then recovered from that state. It does not mean the person who had COVID-19 has now fully recovered. Both the virus and illness can persist. This includes the state now being referred to as long-haul COVID; this may be where the virus persists in the organs, or the damage caused by the presence of the virus in the body can reveal itself over time. This damage can be detrimental to an individual by damaging cells in the lungs, heart, brain, kidney and also activating the clotting system, such that clots form in the organs, blood vessels and skin.

A person can therefore die from COVID-19, even though they are no longer infectious with SARS-CoV-2, and are therefore marked as recovered, but the disease they suffer from, COVID-19, can persist over time. Or they can die with COVID-19 where their death was inevitable, but they coincidentally also had COVID-19. The confusion is between the virus and the disease. CTB records the virus, and the death certificate records the disease.