Even as Covid-19 cases are beginning to taper off, the high case fatality ratio (CFR) remains a concern for health authorities in Himachal Pradesh.
In May, the state had witnessed 91,043 Covid-19 cases and 1,643 deaths, recording a CFR of 1.8%, the highest in 15 months of the pandemic. Comparatively, the CFR was 1.2% in April when the state recorded 35,682 infections and 449 deaths.
The overall CFR in the state is 1.6%, which is higher than the national average of 1.2%.
Shimla has the highest CFR of 2.34% followed by Kangra at 2.14%. However, when one looks at absolute numbers, Kangra’s fatalities (559) outnumber Shimla (211).
The other two districts having a CFR above the state average are Hamirpur and Una (1.7% each).
Kangra chief medical officer Dr Gurdarshan Gupta said the district’s overall CFR since the outbreak is 2.14% while in May, it was 2.18% and in April, it was 1.81%.
“We don’t have a very high CFR but the absolute number of deaths is high,” said Dr Gupta, adding that this was primarily due to the high number of infections. Kangra recorded 8,207 infections in April and 25,628 in May, he said.
Dr Gupta further said that another reason is that Dr Rajendra Prasad Government Medical College (RPGMC), Tanda, is a tertiary care centre and people are referred here from at least five districts. “If a patient is detected positive here and eventually dies, the death is counted in Kangra,” he said.
{{/usCountry}}Dr Gupta further said that another reason is that Dr Rajendra Prasad Government Medical College (RPGMC), Tanda, is a tertiary care centre and people are referred here from at least five districts. “If a patient is detected positive here and eventually dies, the death is counted in Kangra,” he said.
{{/usCountry}}Meanwhile, National Health Mission director Dr Nipun Jindal said some of the deaths were of patients in home isolation. In such cases, patients fall in two categories – the first were those who had come in contact with an infected patient and were recommended home isolation while the second type were those who neglected their symptoms and eventually died.
Presumptive treatment protocol
For suspected Covid-19 patients, the state Covid clinical team has recommended presumptive treatment. It is advised that patients in home isolation and all patients who are suspected to have Covid-19 infection and are waiting for their test reports should be put on presumptive therapy, which includes recommended medicine, said Dr Nipun Jindal.
Suspected Covid-19 patients, whose RT-PCR test report is awaited or is negative but show features of severe acute respiratory illness, shall be admitted in the Triage area of the hospital and will be considered for chest scan.
Covid-19 treatment of such patients shall be started with the aim to maintain target oxygen saturation, he said.
Apart from that, Dr Jindal said, panchcyat-level task forces have been constituted to keep tabs on health vitals of home isolated patients so that they can be immediately shifted to a hospital if required.
An IEC programme has also been launched to encourage people to seek treatment and report to the authorities if they have symptoms.