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Published On: Sat, Jun 12th, 2021

States must audit deaths to get data on mortality rate, says AIIMS chief

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guleriaNEW DELHI : AIIMS Chief Dr Randeep Guleria called for all hospitals and states to do a death audit to ascertain the causes of mortality and measures to bring down the country’s death rate. “Unless we have clear data, we will not be able to develop a strategy to decrease our mortality,” he said.
A “mis-classification” of Covid-related deaths by hospitals and state governments can be unhelpful in India’s efforts to form strategies to fight the pandemic, one of the country’s top doctors has said. For a better picture of mortality in these circumstances, they must perform a death audit to reconfigure the numbers, according to Dr Randeep Guleria,
His comments come amid reports and allegations of various state government underplaying the number of deaths. In Madhya Pradesh, for instance, there seemed to be a mismatch between official figures and the number of last rites performed in April. “Let’s say a person dies of heart attack, and if he had Covid, then Covid may have caused the heart attack. So, you may have mis-classified this as a non-Covid death…as a cardiac problem, rather than directly linking it to Covid,” Dr Guleria said.
India reported 84,332 new coronavirus cases over the last 24 hours, taking its overall tally to 2,93,59,155 since the pandemic broke out in January 2020. For the fifth consecutive day, the country recorded less than 1 lakh cases. Deaths rose by 4,002 to 3,67,081.
The Centre refuted a report that claimed that India’s coronavirus deaths could be “five-to-seven times” more than the official figures. “The unsound analysis of the said article is based on extrapolation of data without any epidemiological evidence,” the government said. Delhi registered 213 new Covid-19 cases, 28 more fatalities, pushing the case count to 14,30,884 and toll to 24,800. This is the lowest single-day jump since March 9. Chief Minister Arvind Kejriwal said the possibility of a third wave hitting the Capital is real and announced steps to increase oxygen supplies.
The Madras High Court on Friday observed that there were grievances all over the country that deaths due to the coronavirus disease may not have been appropriately recorded. The immediate concern, the judges said, was that families of those who died cannot get compensation from state and central government unless cause of death is attributed to Covid-19.
. The Kerala Legislative Assembly recently debated who should decide if a patient has died of Covid or not. “There is a need for all hospitals and states to do a death audit…because we have to know what are the causes of mortality and what can be done to bring down our death rate. Unless we have clear data, we will not be able to develop a strategy to decrease our mortality,” the veteran doctor said, hinting at preparing for the next wave of Covid-19.
Since most aspects of COVID-19 and the vaccines against it are still relatively new, Dr Guleria said, the matter of duration of the gap between doses, especially for the AstraZeneca-developed Covishield, was still being studied. Going by the medical community’s present understanding, he said, 12-13 weeks’ time was “good enough”, although this may change as new data emerges. One key difference between the first and second waves of the pandemic in India was, according to him, the return of some patients of the latter with symptoms even weeks after recovery. This, he said, needs to be examined, too.

Meanwhile, the Central government on Saturday slammed a recent New York Times report claiming an incredibly high number of deaths in India due to COVID-19 than the official data. The government stressed that the report is speculative and seems to be misinformed. In an official statement, the Union Health Ministry said, “States/UTs to record COVID-19 deaths as per the guidance for appropriate recording of COVID-19 deaths in India issued by the ICMR.”
Taking an aim at the NYT report, the ministry said, “A renowned international magazine in an article speculated that India suffered perhaps 5-7 times excess deaths than official COVID-19 deaths. Studies used by the magazine as an estimate of excess mortality aren’t validated tools to determine the mortality rate of a country/region.”The Health Ministry continued saying that it is a speculative article, which is without any basis and seems to be misinformed. “The unsound analysis of the said article is based on the extrapolation of data without any epidemiological evidence,” it added.

On May 25, New York Times published an article claiming that India’s actual COVID-19 death numbers are exponentially more than the officially published numbers. They predicted that India’s death numbers range between 6 lakh to 42 lakh, against the official number of 3 lakh. The article by Lazaro Gamio and James Glanz also estimated that the total COVID-19 cases in the country should be 40 crore to 70 crore, while the official number is 2.7 crore.
(Bureau Report with Agency Inputs).

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