Covid-19 deaths could be 8-9 times official count in TN: NGO report
The report by NGO Arappor Iyakkam said only six of the hospitals uploaded month-wise death certificates online and they represented all regions of Tamil Nadu. The report has also analysed the daily data on fatalities at the hospitals in 2019-21 from January to May
Deaths due to Covid-19 are likely to have been underreported at least 8.4 to 9.8 times at six Tamil Nadu government hospitals in April and May, NGO Arappor Iyakkam has concluded in a report based on an analysis of data on the mortality there. The report has approximated the underreporting for the entire state and concluded the likely number of deaths due to Covid in Tamil Nadu may be between 108,721 and 126,841 against the reported number of 12,943.
“There was no other major disease or cause that could have led to this drastic increase in deaths during this time other than Covid-19,” said Arappor Iyakkam founder Jayaram Venkatesan.
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The report said only six of the hospitals uploaded month-wise death certificates online and they represented all regions of Tamil Nadu. The report has also analysed the daily data on fatalities at the hospitals in 2019, 2020, and 2021 from January to May.
The report said the number of death certificates issued at these hospitals in April and May was 4,437 and 3,261 for 2019 and 2020. The number has increased to 11, 699 this year.
The report said there has been an increase of at least 8,438 deaths in April and May this year, compared to these months in 2020. The report said Covid-19 related deaths at the six hospitals during the same period by the health department were just 863.
The second Covid-19 wave peaked in May in Tamil Nadu. A lockdown was imposed in the state on May 10 to check the wave. The state has begun opening up in a staggered manner from Tuesday.
The report said the increased mortality is directly proportional to the rise in the cases during the second wave. “Therefore, the increased numbers (of fatalities) in April and May compared to previous years are most likely due to Covid and its complications,” the report said. It added the number of likely deaths due to Covid-19 and its complications in these six hospitals are between 7,262 and 8,438 in April and May. “Given the government has consistently underreported (deaths) in each of the hospitals, it could be attributed that this phenomenon exists throughout the state as well,” the report said.
State health minister M Subramanian said they do not need to hide Covid-19 deaths and questioned what they will achieve by underreporting. “...We have been following ICMR guidelines for certifying Covid-19 deaths.” He said they do not want to dismiss the report, so they are directing an investigation in these hospitals. “We only want to be transparent.”
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There have been reports of underreporting of deaths also from other states.
Dr A Rathinavel, the dean of Government Rajaji Hospital (Madurai), which is one of the six hospitals, denied underreporting of deaths. “We are 100% following ICMR (Indian Council of Medical Research) guidelines (on Covid mortality),” he said.
The hospital issued 3,152 certificates for deaths in April and May out of which only 172 were attributed to Covid-19. “The swab test of a person has to be positive for the death to be certified as Covid-19 related,” said Rathinavel.
Subramanian last week cited ICMR guidelines and said even if a patient is positive at the time of admission to a hospital and turns negative before death, it will not be considered as a Covid-19 fatality.
Coimbatore Medical College Hospital dean A Nirmala said they certify causes of death after analysing every individual patient and not by just following guidelines. “Every day, our panel of doctors meets to analyse the deaths. Deaths can be due to incidental Covid which we brand as fatalities due to other causes. For instance, an incidental death is directly due to other causes such as uncontrolled hypertension, kidney disease. While treating that cause we have to take a swab. If it turns positive but the patient does not have Covid-19 related symptoms, it will be reported as death due to other causes. Just because people are infected, it does not mean they are dying due to Covid-19 alone.”
The Coimbatore hospital issued 3,464 death certificates in April and May out of which only 323 related to Covid-19.
Arappor Iyakkam said it has sent the report to chief minister MK Stalin and Subramanian while asking the government to provide data on deaths at hospitals and homes compared to the previous years for the state.
The NGO said it carried out the exercise to help families avail compensation announced by the government in cases of Covid-19 deaths. “Underreporting can cause a huge problem for thousands and thousands of families who require documentation to avail compensation,” the report said.