Confusion over Delhi’s Covid-19 deaths as state, hospitals not on same page

Death numbers are critical in analysing the spread of the disease and its impact. With only 66 listed deaths out of 5,980 infections in Delhi until Thursday, the fatality rate in Delhi of 1.1% is among the best in the country.

There was confusion on Friday over the Covid-19 death numbers in the Capital, with doctors from at least two centres designated to fight the deadly pathogen suggesting more people succumbed to the disease than was being reflected in the daily bulletins put out by the state government.

At Lok Nayak hospital -- the largest of the dedicated Covid-19 facilities in Delhi-- two doctors working in the Covid ward said on condition of anonymity on Friday that over 40 people have died in the hospital. (Yogendra Kumar/HT File Photo)

It was not immediately clear if such a discrepancy existed, and if it did, what was behind it -- poor data collection, tabulation, accounting, or simply a delay between a death and its announcement. The Delhi government denied any underreporting, but some officials indicated that there is a lag between when deaths take place and when they are reported.

The possible discrepancy in numbers was first highlighted in a news report on Friday in The National Herald, the Congress party’s paper.

On Thursday, the Delhi government’s daily bulletin put the total deaths caused by Covid-19 at 66. Of these, 53 were listed from 10 Covid-19 hospitals -- it gave a table for the number of deaths at each of these -- and the remaining 13 deaths were reported from “other hospitals”.

That suggested discrepancy of 12 between the two death numbers.

Over at Lok Nayak hospital -- the largest of the dedicated Covid-19 facilities in the Capital -- two doctors working in the Covid ward said on condition of anonymity on Friday that over 40 people have died in the hospital, which admits only patients afflicted with the coronavirus diseases, over the past few weeks. When contacted, the hospital’s medical director declined to give a definitive figure. “We are reviewing and reanalysing our death data. I will be able to comment on it only after a couple of days,” Dr JC Passey told HT.

The Delhi bulletin on Thursday put the total deaths at Lok Nayak hospital as five.

Death numbers are critical in analysing the spread of the disease and its impact. With only 66 listed deaths out of 5,980 infections in the Capital until Thursday, the fatality rate in Delhi of 1.1% is among the best in the country. With 1,931 (32%) patients now cured, the recovery rate is also more than almost three percentage points better than the national average.

Any anomaly in the numbers, however, could severely hamper the city’s fight against Covid-19 because all projections on infrastructure required to fight the disease going forward are based on these calculations.

When asked about the discrepancy, Delhi health minister Satyendar Jain said the hospitals have now been asked to submit their reports in a timely manner. “There is no question of hiding any data. If the Delhi government had to hide data, it would not have also released yesterday’s (Thursday) number of fresh Covid-19 cases which was an all-time high at 448. We would have told there were only 48 new cases, but we did not. Once the reports come, the hospitals have to inform the government immediately,” Jain told reporters on Friday.

The minister also said that the Delhi government has ordered all testing labs to give results within 24 hours of collecting the samples so that there can be better accounting. “Orders were issued on Wednesday that all tests results will have to come in 24 hours. For any result which comes beyond 48 hours, penal action will be taken. This decision was taken because some labs are taking 10-15 days to release the results of samples,” Jain said.

Delhi’s secretary (health and family welfare) Padmini Singhla said it was “not true” that Covid-19 deaths in Delhi were being underreported. “We have a dedicated death audit committee which audits every death. After ascertaining the causes of deaths, the committee accordingly gives its daily reports,” she said.

According to a senior government official, who asked not to be named, the problem could be a delay in logging. All Covid-19 deaths in Delhi are vetted by a three-member death audit committee, which was set up on April 20 to examine the reported deaths from government and private hospitals.

“The death audit committee goes through the patient case sheets, investigations, and death summary to include the death in the Covid-19 toll. The committee can report the cases as soon as all the relevant documents are received and this may take a while. Like for example, the one death reported yesterday was of a patient from May 1. So, yes, there is a lag but it is not deliberate underreporting,” said a member of the death review committee on condition of anonymity.

Whatever the reason, experts said the need for quick and correct data could not be stressed enough.

“It is shocking but not surprising. After all, there have been instances like cholera being reported as diarrhoea or chikungunya deaths not being reported at all. The problem is when the data is hidden deliberately; incompetence is still excusable. If it is deliberate, then we are in the same category as China. Using the death data to suggest the lockdown must be lifted is not correct either. The lockdown was put in place to flatten the curve, not to reduce the death rate. A low death rate is not an accurate measure of flattening of the curve, because it also depends on who got the infection. Low infection rate reflects the successful flattening of curve,” said Dr Jacob John, professor emeritus and former head of department of virology at Christian Medical College, Vellore.