THIRUVANANTHAPURAM: From April 1 to May 26, when Covid-19 second wave raged across state, Thiruvananthapuram district recorded 658 deaths due to the pandemic. The number of positive cases recorded during this period in the district was 1,28,731. On Saturday, 50 deaths were reported in the district while the figure was 41 and 24 on Friday and Thursday, respectively. The case fatality ratio (CFR) of the district during the second wave is 0.51%, which is much higher than the state average of 0.30%. If the figures of death during the first wave are included, the case fatality ratio of the district is 0.66 which is exactly double the CFR of the state, 0.33%.
In comparison, Kannur district which is second in chart stands at 0.43% while Thrissur with 0.42 and Alappuzha with 0.39 closely followed. The lowest CFR was recorded in Idukki - 0.09%. The unusually high number of deaths reported in the capital district where advanced medical care, including enough number of ICU and ventilator beds, is available for Covid-19 treatment has puzzled medical community and health department officials. Sources in the medical fraternity cite factors ranging from the transferred cases which are of very serious nature from adjacent districts to Government Medical college hospital which is declared as a tertiary Covid-19 care centre to more accurate reporting of death counts as reasons for the high number of deaths.
However, the major factor that adds to the number of Covid-19 deaths in the district seems to be the insistence by district administration and district health department that mandatory RT-PCR test or TrueNat test need to be conducted on bodies of all who had been suspected of Covid-19. According to doctors, even after a person tests negative in the antigen test, he could continue to test positive when RT-PCR or TrueNat test is performed.
“The number of deaths has been high from early on and the reason is that we perform RT-PCR test on every body. That has been the norm from the start and we continue to do it. Moreover, the population of elderly is also high here. Further, the number of Covid positive people getting treatment from home is also more,” said a top official in the health department. The crematoriums in the districts also insist that RT-PCR test result needs to be submitted in suspected cases. In other districts, antigen tests are mostly done on bodies to check whether the death happened while the patient had been positive. Dr Santhosh Kumar S S, deputy superintendent, Medical College, cite the increased load of transferred cases from other districts as the reason.
“The mortality has been high from the start. All category C patients are referred here from neighbouring districts. Our hospital has more beds, including ICU and oxygen beds and category C patients requiring care gets referred to here. This is the same case with general hospital as well,” said Dr Santhosh.
According to him, category C patients from Kollam, Pathanamthitta and Alappuzha are referred to the capital and their deaths get reported as that from Thiruvananthapuram. Health activist and internal medical consultant Dr Arun N M sought a detailed probe into the death statistics of Thiruvananthapuram district. “I believe it is manipulated data. Confirmatory RT-PCR test on bodies is being done in other districts too and the capital doesn’t come first in the number of elderly population. With the capital having the best treatment facilities, such an increase in number of deaths needs to be studied,” Dr Arun told TNIE.
Dr R C Sreekumar, chairman, IMA Research Cell, also demanded a detailed study. “The treatment data is controlled by government. The patient treatment data is key to understanding reasons. Only if proper studies are conducted will we know more about these issues,” says Dr Sreekumar.
