Why was there a sudden spike in coronavirus deaths in Delhi?

The Arvind Kejriwal-led Delhi government added 437 coronavirus disease (Covid-19) deaths to its tally on Tuesday’s health bulletin, as the state’s mortality rate from the viral infection rose to 4.1% from 3.27% on Monday.

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While the pan-India Covid-19 mortality rate stands at 3.3%.

Why did Delhi add over 400 deaths on a single day?

Of the 437 deaths recorded in Delhi on Tuesday, 93 occurred over the past 24 hours. The rest were added after the state government’s three-member death audit committee reviewed electronic records of suspected Covid-19 deaths over the past four days to check for cases that might have been missed, according to an official from Delhi’s health department.

Is there a possibility for more revisions?

Unlikely. There is just one pending death for which the committee is yet to assess the records, according to the official. Now, most hospitals in Delhi are reporting Covid-19 related deaths within 24 hours.

Why isn’t the death tally updated within 24 hours of a Covid-19 death?

According to the state government’s standard operating procedures (SOPs), all hospitals in Delhi must report Covid-19 deaths on the day they occur to the Integrated Disease Surveillance Programme by 5pm. Then, the death-review committee goes through the patients’ files and the deaths are declared in the next day’s bulletin. Initially, the state government had said the delays occurred because the hospitals were not sending the patients’ reports on time. Delhi government had sent show-cause notices and memorandums to seven government-run hospitals on May 30 for the delay in sharing their daily reports.

Was Municipal Corporation of Delhi (MCD) right all along?

On June 11, the MCD authorities had said that there were 2,098 Covid-19 deaths, which was close to double of the Delhi government’s cumulative death toll of 1,085. Not all deaths are related to Covid-19, said Delhi government as it had specified that a death certificate is not enough to categorise such fatalities.

The state government has set up a three-member death audit committee to go through the patient’s medical case sheets, diagnostic investigations, and death summary to determine whether Covid-19 is the primary cause of death before adding it to the daily bulletin.

What are cumulative Covid-19 deaths?

The cumulative number of deaths due to Covid-19 that have occurred in Delhi since March 2, when the first case of the viral infection was diagnosed in the national capital. Delhi recorded its first death on March 12. The deaths added to the final toll are of those patients, where Covid-19 was the primary cause of fatality, which is usually from respiratory failure, multi-organ failure, and septic shock.

What is the definition of a Covid-19 death?

According to Delhi government, Covid-19 is the cause of death only if the disease directly leads to respiratory failure, multi-organ failure or septic shock, leading to death, or if it is the underlying reason that leads to aggravation of existing conditions, such as heart condition or kidney ailment leading to death.

What does the Covid-19 death audit committee do?

The death audit committee goes through a Covid-19 patient’s records to understand the modality and precipitating factors before declaring that the person has expired due to the viral infection.

Why are deaths of all those patients, who test Covid-19 positive, are not counted as a viral infection death?

The Delhi government has said that not all deaths of Covid-19 positive patients are due to the viral infection because they may have died of other terminal comorbid conditions, like cancer or heart failure, and Sars-CoV-2, which causes the disease, has no role in it.