Why COVID-19 death audit is a must in Kerala
Kerala reported its first Covid death on 28 March 2020, almost two months after the first infection was detected. Since day one, preventing deaths has been a priority for the state government and during the initial months of the pandemic, it took pride in the lower number of deaths. For a long period, the mortality rate hovered around 0.3, and the state earned accolades for its handling of the outbreak. However, as things stand now, the acclaimed Kerala model has taken a thorough beating.
With more than 57,000 lives lost, Kerala is second only to Maharashtra in terms of the number of deaths, and its case fatality ratio stands at 0.91, closing in on the national average of 1.19. In October last year, Kerala, prodded by the Supreme Court, began an attempt to correct past mistakes in identifying Covid deaths. Since then, more than 19,000 backlog deaths have been added to its Covid toll—the primary reason for the increase in mortality rate.
What’s puzzling, however, is the surge in deaths during the third wave that is dominated by the milder Omicron variant. Kerala recorded the most number of deaths—1,386—among the states in January. While Maharashtra recorded 1,043 deaths in the same period, the corresponding figures for Tamil Nadu and Karnataka are 788 and 669 respectively.
A recent analysis of Covid mortality in the UK showed that the risk of death due to Covid for the elderly has come down to just twice that of flu. In the initial phase, Covid was found to be 13 times deadlier than flu for the elderly. Kerala’s mortality data should be viewed in this background. The high proportion of the elderly in the population and the increased prevalence of lifestyle diseases are the common reasons cited for such a phenomenon.
But, Kerala has achieved universal vaccination and booster doses are now being administered to the elderly. The fact is the government’s attempts to hide information on Covid deaths in the initial phase had denied opportunities for independent studies to identify the real reasons for Covid mortality. What the health department needs to do urgently is to launch a comprehensive Covid death audit. Finding out the real causes is the first step in improving the treatment protocol that will eventually help prevent more deaths.