NEW DELHI: The number of active Covid-19 cases in India may be going up, but there has been a considerable fall in the requirement for ICU beds, ventilators and oxygen beds in the last two months, an analysis of the government data shows.
On May 20, when the number of active cases in the country was 61,149, 3% of the cases or 1,834 patients were in the ICU, 0.45% or 275 patients were on ventilator while 2.94% cases or 1,797-patients were on oxygen support, according to details shared by the Union Ministry of Health and Family Welfare.
In comparison, on July 31, when the country had 5,28,242 active Covid-19 cases, 1.61% or 8,504 were in the ICU, 0.28% or 1,580 patients were on 1580 patients are on ventilator and 2.3% or 12,255 were on oxygen support.
This drop in the number of severe cases also reflects the declining case fatality rate. While this figure stood at above 3% in May-end, it's 2.15% now. It's also supported by the clinical experience of doctors treating Covid-19 patients in various parts of the country.
Experts point out that this improvement in the clinical outcome of many severely sick patients could be attributed to better medical management of patients that includes early use of steroids, quick detection of cases owing to increased testing rates, and avoiding the use of invasive ventilators.
“The health ministry statistics confirm what clinicians like us are experiencing across the board,” said Dr. Anupam Singh, an infectious disease expert from Ghaziabad in Uttar Pradesh.
“In the course of the pandemic we have been learning on the go and are definitely seeing the number of deaths and moderately and severely ill patients declining,” he said, adding that a dramatic change has been noticed after the use of steroid in patients requiring which arrests the progression of moderate illness.
Evidence worldwide so far has suggested that some steroids—such as dexamethasone and methylprednisolone -- cut down the mortality rate by nearly one third.
In its Covid-19 clinical management protocol, AIIMS Delhi on June 1 had recommended using steroid and anti-coagulants or blood thinners as blood clotting is also a main cause of mortality in Covid-19 patients.
“This guideline has been extensively followed since mid-June in most parts of the country and the clinical outcomes have improved considerably,” said Dr. Singh. “Starting mid-May steroid was being used in very few patients and in probably only in very late stages of the disease.”
Dr. Yatin Mehta, head of critical care medicine department in Medanta hospital in Gurugram said that introduction of rapid antigen tests as a quick testing method to identify Covid-19 cases may have been a very helpful tool in saving lives, despite its limitations.
“It allows a large number of mild cases to be identified who can then be observed and medically managed even if at home,” he said. “That way, a large number of mild cases are being prevented from progressing to advanced stages of illness as is reflected in decreasing need for oxygen support.”