‘Only deaths where primary cause is Covid-19 listed’: Delhi govt
Delhi recorded 425 new cases of Covid-19 on Friday, taking the city’s tally to 8,895. And eight deaths were added to Delhi’s coronavirus disease (Covid-19) toll , taking the total number of deaths in the state to 123, although none of the deaths pertain to the past 24 hours.
The health bulletin released on Friday stated that the cumulative deaths included only those “where the primary cause of death is found to be Covid-19”, as per report of the death audit committee on the basis of case sheets received from hospital.”
The Delhi government ordered the formation of the death audit committee on April 20, which started working two days later. The committee goes through the case sheets, investigations, and death summary of the deceased before classifying it as a Covid-19 death.
“The Death Audit Committee follows the guidelines prescribed by the ICMR. All hospitals have been mandated to submit their death summaries to the committee within 24 hours. Death Audit Committee is an independent body which examines each of these cases. Delhi Health Bulletin reflects the figures as declared by the Committee,” said a senior official from the CMO.
The guidelines for recording deaths released by Indian Council of Medical Research last week states that Covid-19 has to be recorded as the underlying cause of death when a person dies of pneumonia, acute respiratory distress syndrome, cardiac injury, and clotting throughout the bloodstream that the viral infection is known to cause. In Covid-19 patients co-morbid conditions such as asthma, heart disease, diabetes or cancer can lead to severe disease but cannot be considered as the underlying cause of death, the guideline states.
“ A person may have tested positive for the infection, but if their chest X-ray is clean, the arterial blood gas does not show any signs of acidosis, and their oxygen saturation is normal then clearly Covid-19 isn’t the cause of death,” said a senior official from Delhi’s health department who spoke on condition of anonymity.
Dr Prashant Mathur, director of ICMR’s National Centre for Disease Informatics and Research (NCDIR), which formulated the guidelines, said, “If a patient is admitted to the hospital for Covi-19 and dies, their death would be considered as Covid-19 death.”
“But these are just guidelines and it is ultimately the treating physician who has to use their clinical judgement to decide whether it was the infection that aggravated the other comorbid conditions leading to the death. The guidelines were more for awareness, especially about the new coding under the international classification of diseases that has now been added,” said Dr Mathur.
The international classification of disease coding present in the 11-page document clearly states that deaths of those who test positive and do not have Covid-19 like symptoms should still be recorded as Covid-19 death. So should the deaths of those who have the symptoms but either test negative or in whose case the test is inconclusive.
Delhi’s health minister said the growth rate of new infections is coming down
“Do not go by numbers, go by percentage growth. Yesterday, it was around 5%. At one point it was as high as 20%,” said Delhi health minister Satyendar Jain. Of the 5,254 people still living with the infection in the city, 154 are in intensive care units and 26 are on ventilators. Delhi has about 306 ventilators in the government sector and 800 in the private sector.