Death rate up despite dip in positivity rate

Despite a steady decline in the test positivity rate of Covid-19 cases in Gurugram, an indicator of a deceleration in the growth rate of new infections, the district

Despite a steady decline in the test positivity rate of Covid-19 cases in Gurugram, an indicator of a deceleration in the growth rate of new infections, the district has continued to see an uptick in the number of the Covid-related deaths over the past four weeks, health department data shows.

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Official data also reveals the frequency of deaths to be increasing — from about one death per day in September to now nearly five deaths each day — in spite of apparent improvements in Gurugram’s test-positivity rate, which indicates a slowdown in the spread of the virus.

Between November 20 and November 26, the district registered over 4,500 new Covid-19 cases, with a test positivity rate of 11%. With 18 deaths occurring during the same period, the death rate for the week was 0.4%.

However, the death rate over the next seven-day period, between November 27 and December 3, shot up to 0.9%, despite the test positivity rate dipping to 6%. During this period, close to 3,000 new cases were registered, along with 28 deaths.

Acknowledging the increase in the death rate (or the ratio of new deaths to new cases, taken as a weekly aggregate), health department officials speculated that unfavourable weather, coupled with poor air quality, maybe aggravating patients’ symptoms to a greater degree than witnessed earlier in the outbreak.

Moreover, Gurugram has also noted an increase in the death rate among patients who do not have comorbidities. Between November 20 and December 3, for instance, a total of 13 deaths without comorbidities were reported, a spike from the six deaths reported over the preceding fortnight.

“This trend requires a little more investigation because we typically see mortality increase alongside the growth of new cases, whereas presently, the death rate has been trending upward in spite of new cases slowing down,” said Dr Jai Prakash Sharma, district surveillance officer, Gurugram.

Addressing the ongoing spurt in Covid deaths, Sharma said, “We have just been through a third wave, in terms of new daily infections, so an increase in deaths was to be expected. If past experience is any indicator, then daily deaths will reduce over the next week along with a further slowing down in daily cases. If that doesn’t happen, then we can say with a little more certainty that air pollution and cold weather are responsible for exacerbating symptoms among some patients.”

The district had last seen such frequent mortality in June, when 93 deaths were recorded over 30 days. At the time, experts and officials attributed the spike in mortality to under-preparedness of healthcare systems. Presently, though, they said that the spurt in deaths was to be expected, given the extent of Covid-19 spread over the past two months.

“On a hopeful note, our positivity rate has come down significantly over the past two weeks, and has remained under 10% for a few days. From about 800 cases per day in mid-November, we are now getting fewer than 500 new cases daily and testing numbers have been consistent,” Sharma said.

However, given that Gurugram has also begun seeing more deaths among healthy individuals, Sharma said the role of extant environmental conditions cannot be ruled out.

“Overall though, we are responding well and the situation is under control. Gurugram’s cumulative mortality rate is 0.6%, which is far better than neighbouring cities and districts. We also have enough beds and ventilators and there is no shortage of resources. We are stringently monitoring clinical symptoms among hospitalised patients so that we can make quicker interventions in case complications arise,” said Dr Ram Prakash, district epidemiologist, Gurugram.