Count Covid deaths as such despite comorbidities: Centre

Govt orders dedicated panels in all states, where all hospitals must submit their death summaries within 24 hours

NEW DELHI: The Centre has told the Supreme Court in an affidavit that all deaths of people diagnosed with Covid-19, irrespective of comorbidities, will be treated as Covid-19 deaths.

In its submission on June 19, the government said that a Covid-19 death must be certified as such and any lapse in that will invite penal action, even on the certifying doctor. “The only exception could be where there is a clear alternative cause of death, that cannot be attributed to Covid-19 (e.g. accidental trauma, poisoning, acute myocardial infarction, etc), where Covid-19 is an incidental finding...” the statement read.

The affidavit cited an October 9, 2020 letter issued by the ministry of health and family welfare to all states and Union Territories.

Reproducing the text from the letter, the affidavit said: “All deaths with a diagnosis of COVID-19, irrespective of co-morbidities, are to be classified as deaths due to COVID-19.”

Last year, the Union health ministry issued broad guidelines prepared by the Indian Council of Medical Research (ICMR) to standardise the Covid-19 documentation process. According to them, Covid-19 must be identified as the underlying cause of death when a person dies of pneumonia, acute respiratory distress syndrome, cardiac injury, and blood clotting that the viral infection is known to cause.

The guidelines also say that co-morbidities such as asthma, heart disease, diabetes or cancer can lead to severe disease but cannot be considered as the underlying cause of death.

The Union health ministry also asked the states to form dedicated committees to investigate Covid-19 deaths under which all hospitals were mandated to submit their death summaries to the committees within 24 hours. These were death audit committees that were meant to look at the reasons that led to death and if it was possible to avoid it.

In a statement issued on June 12, the Union health ministry said that it had emphasised the need for a robust reporting mechanism for monitoring district-wise cases and deaths daily.

“States consistently reporting lower numbers of daily deaths were told to re-check their data,” the ministry had said, giving the example of Bihar which was told to provide detailed data on the number of deaths.

The government has faced criticism over the official Covid death count, with many alleging discrepancy in data. A senior government official rebutted this and said on the condition of anonymity that states have been told time and again to register deaths of Covid-19 patients as Covid deaths.

“All Covid-19 deaths are being reported; there is no data discrepancy. At times it may take a little longer to reconcile figures but eventually everything gets documented. Death audits are also being done to cross-check if a life could have been saved by making certain modifications in the system,” the official said.

He elaborated on the purpose of death audits and said these were necessary as in some states it was found that patients were reaching hospitals late, which impacted the treatment outcome.

The affidavit also mentions that a death audit is an administrative exercise to identify gaps that contribute to deaths of patients. The aim is to improve the quality of healthcare services.

“It can be a fruitful exercise that immensely helps in identifying and plugging the gaps,” said a member of a death audit committee in Delhi.

India on Sunday recorded 53,035 new Covid-19 cases, taking its tally to 29,934,343. The toll, meanwhile, reached 388,182 with 1,424 fatalities within 24 hours.

READ: Covid toll rises as states reconcile numbers