BENGALURU: In the last seven days, 12 districts in Karnataka have reported a 0% Covid-19 case fatality rate (CFR) while eight others have a CFR of below 1%. TNIE spoke to experts on why some districts such as Yadgiri, Shivamogga, Ramanagara, Mandya, Haveri, Gadag, Dharwad, Davanagere, Chitradurga, Chikkamagaluru, Belagavi, Bagalkot and others have been able to keep their death rate low, while districts susch as Ballari, Chamarajanagar, Hassan, Bengaluru Rural, Koppal, Bidar, Udupi, Raichur, Kodagu and Uttara Kannada had a high CFR in the last seven days.
The number of deaths depends on the number of Covid cases being reported, and the higher the number of infections, the higher the chances of fatality, said Dr K S Satish, senior pulmonologist and member of state COVID death audit committee. “In districts where the CFR is low, it shows that there is early access to treatment, awareness on the part of patients who are alert about symptoms of fever, Influenza Like Illness, immediate isolation on testing positive, and lack of Covid stigma, as there used to be before,” Dr Satish said, adding that in districts where fatalities are still high, it is an indication of a lack of public awareness.
Fewer cases and deaths do not mean that people become complacent, lest we face a second wave, he cautioned. Some districts report more deaths due to a higher number of patients who travel between states, said Dr Thrilok Chandra, head of the COVID-19 Critical Care Support Unit (CCSU).“For instance, people from Tamil Nadu come to Chamarajanagar, people from Andhra Pradesh come to Ballari, Tumakuru and Bengaluru which is a tertiary health care centre.
High CFR in some districts is not an indication of poor quality of care. The numerator is low and absolute numbers are declining and have been in single digits in some districts in the past few weeks. Level of care has improved across all districts,” Dr Chandra said. Nevertheless, the CCSU is tracking cases and deaths, looking at them from both clinical and public health perspectives. On the clinical side, most hospitals use the APACHE score to assess ICU performance which helps in better understanding the patient’s response to ICU care, Dr Chandra explained.
If deaths occur one or two days into hospital admission, it becomes a public health issue and factors such as delay in reporting, reference from private hospital before coming to government hospital, etc are analysed. A daily analysis is done and reports are sent to the respective deputy commissioners and BBMP zonal heads, so they can take remedial measures.
