By streamlining systems, Ghaziabad brings down fatality rate

From an all time high of about 3.4% last month, Ghaziabad has managed to pull down the fatality rate in the district to 1.79% by July 14. Experts said that although

From an all time high of about 3.4% last month, Ghaziabad has managed to pull down the fatality rate in the district to 1.79% by July 14. Experts said that although the decline is commendable, at least a month’s data is needed before any conclusion could be drawn.

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According to the latest state health bulletin released on July 15, Ghaziabad had 3,600 cases and 62 deaths. The bulletin adds that there were 1407 active cases in the district.

District officials said that entry of private hospitals roped in for paid Covid-19 treatment and streamlining of systems have helped bringing down the fatality rate.

Till May 31, the district had only four deaths from the disease and 305 cases (a fatality rate of 1.31%). By the end of the next month, however, this was up to 3.4% with 55 deaths and 1,615 cases.

In July, cases increased sharply, averaging at a rate of about 131 cases per day, but saw fewer deaths -- 11.

“There have been several procedural changes which have reduced the fatality rate even though our fresh cases per day are on all time high. We have now about eight private hospitals which have overall 544 beds available for paid treatment in the district. Now, with these hospitals having better specialists and infrastructure have aided recovery process of patients requiring L-2 and L-3 category care,” said Dr. NK Gupta, district chief medical officer.

Under the UP government’s three-tier Covid treatment facilities, L-1 category hospitals are meant for asymptomatic positive patients, L-2 are meant for patients having moderate complications and L-3 are for critical care.

The district has acquired 13 intensive care unit (ICU) beds in private hospitals and reserved them for patients lodged in government facilities.

“These beds were reserved for immediate referral of serious patients who were lodged in government hospitals. We have sent eight patients from our hospitals to these ICU beds for better treatment in last 10 days and all of them have recovered. Overall, 304 patients are presently admitted to various private hospitals while 711 are admitted to government or government acquired hospitals. Other patients from Ghaziabad are taking up treatment in outside districts,” Dr. Gupta added.

He said that the police helped them identify about 30 patients who were at home isolation without informing the authorities. Unlike in Delhi, home isolation of asymptomatic positive patients is not allowed in Uttar Pradesh. They have been admitted to hospitals, said Dr. Gupta.

But, 28 others had gone to other districts.

“Their information has been sent to the districts where they are staying,” Dr Gupta added.

The health team that referred patients to their respective hospitals too have been given an updated checklist to help them determine which type of hospital suited best for the patient. Earlier, this team, which was mandated to contact positive patients and refer them to the hospital, would at times send patients off to hospitals that probably was not suited for them -- such as referring a critical care patient to a hospital that served moderate cases. That process generally took anything between 24-48 precious hours.

“With the earlier system, gauging requirement of appropriate hospital was a bit tricky. With the checklist in place, identification and referral to an appropriate hospital has become lot easier. We now also immediately convey the information to ambulance system and the local police who physically visit patient’s address. So, this helps in early picking up of patient and also confirms his physical location. In case the patient goes missing or address found incorrect, help of police surveillance system is taken to trace the patient,” Dr Gupta added.

The district has now formulated three pronged strategy for tracing contacts of the patient.

The district now has local police (from the respective police station) who goes physically for contact tracing, a control room headed by additional district magistrate and another team from health department’s Integrated Disease Surveillance Programme (IDSP) laboratory who takes up contact tracing over the phone.

“Since we attended different meetings taken up by UP government nodal officers, there has been improvement in systems with focus on early detection and faster referral to appropriate hospitals. But for ascertaining that fatality rate is on decline, we need at least one month assessment before we can say that it has stabilized or reduced,” said Dr VB Jindal, president of Indian Medical Association, Ghaziabad.