BENGALURU: The case fatality rate (CFR) is above 1 per cent in 15 districts of 4 Revenue divisions of Kalaburagi, Belagavi, Mysuru and Bengaluru (excluding Bengaluru Urban), as per data submitted by the war room Covid at a recent review meeting.As per data from the last five days, some of the districts with the highest CFR are Koppal with 4.8%, Dharwad with 3.4%, Mysuru with 3.9%, Bidar with 3.3% and Dakshina Kannada with 3%.
Dr Anoop Amarnath, Head, Scientific Board and Chairman- Geriatric Medicine, Manipal Hospital and member of state Critical Care Support Team, said, “We observe that one of the reasons for high case fatality rate in certain districts is that patients report at the end stages where their chances of mortality are high. Apart from this, people with more than three co-morbid conditions are found to be getting into a severe stage, thereby leading to their death.”
Koppal district, for example, has seen many patients with kidney ailments succumbing to the disease. Hence, ASHA workers have been asked to carry out Covid-19 tests on vulnerable population every 15 days, to trace the patients at an early stage, said Koppal Deputy Commissioner, Vikas Kishore.Mysuru, a quasi metro district, has high CFR as people from Chamarajanagar go there for treatment instead of going to taluk hospitals, said Dr Pradeep Rangappa, Senior Consultant - Critical Care, Columbia Asia Referral Hospital, Yeshwantpur, also part of the tele-ICU team overseeing Covid-19 patients.
“This not only increases the caseload and deaths in Mysuru, it also puts patients at risk. Bengaluru is doing far better in terms of CFR and other districts need to improve. This is because maximum caseload in districts is taken by government hospitals, unlike Bengaluru where the load is shared by private hospitals,” he said.To reduce fatalities, the Karnataka Critical Care Support Team has taken certain measures. Dr Anoop Amarnath said the team has decided to observe four Covid inflammatory markers – ferritin , LDH, IL6, D- Dimer – every 72 hours.
“If we see the markers have increased, the chances of severity increase and we go to the next mode of treatment by providing them Remdesivir. Timely monitoring of the markers will help to bring down the CFR,” Dr Amarnath said.There are two aspects to addressing CFR: public health and clinical management. The state is analysing both aspects for each district separately.
“At present, 50-60% of the patients die in 72 hours, leaving little time for treatment. This is the public health aspect of it. This would mean we need more testing to be done and earlier. On the clinical side, we are now using the APACHE score to assess ICU performance,” said Dr Trilok Chandra, head of Covid-19 Critical Care Support Committee.