CHENNAI: Deaths related to COVID-19 in six government hospitals in Tamil Nadu during April and May could be 8.4 to 9.8 times higher than the actual deaths of 863 issued by the government in its daily health bulletin in the same period, a report by NGO Arappor Iyakkam has claimed.
The NGO arrived at this conclusion after examining the death certificate data issued by the six hospitals - Government Rajaji Hospital in Madurai, Coimbatore Medical College Hospital, Mahatma Gandhi Memorial Medical College Hospital in Tiruchy, Vellore Medical College Hospital, Kaur Medical College Hospital and Tiruppur Government Hospital.
According to the report by the NGO, during April and May 2021, the six hospitals issued 11,699 death certificates.
Convenor of Arappor Iyakkam, Jayaram Venkatesan, said the NGO could only work on these six hospitals as only they had uploaded their death certificate data on the state government’s portal for 2019, 2020 and 2021. The NGO drew the data of deaths recorded during April and May this year and compared it with the health bulletin which indicated a gross mismatch.
During the period of April and May, while there were 3,152 deaths in Madurai GH, the Health Department's bulletin recorded only 172 COVID-19 deaths. In the absence of any other natural calamity and road traffic remaining less, due to a full lockdown, the NGO has said many of the deaths could possibly be related to COVID-19 or complications related to it.
Similarly, in Coimbatore GH, out of the 3,464 deaths, only 323 were recorded for COVID, and in Tiruchy GH, out of the 1806 deaths, 55 were due to COVID, and in Vellore, out of 1416 deaths, 104 were due to COVID-19, and in Karur, it was 115 deaths out of 960, and 94 out of 901 in Tiruppur.
The report also highlighted that in Tiruppur GH, zero COVID deaths were declared in the state bulletin from April 1 to May 19 2021 but the total death certificates issued in these dates came to 489 for this hospital during that period, while the NGO also flagged Tiruchi GH for grossly underreporting, saying that the mortality was 32.8 times more than the reported COVID deaths in April and May 2021.
To prove its claim further that the deaths may be related to COVID-19, the NGO compared the data of total deaths in April and May of 2019 and 2020, with the deaths recorded in the same period in 2021.
The report said that the number of deaths in the six hospitals remained around 2000 per month for January to March in 2021. The deaths in 2019 and 2020 also remained around 2000 per month in April and May respectively.
In 2019, the deaths in April (2117) and May (2320) together were 4437 while in 2020, the deaths in April (1440) and (1821) together were 3261.
It also remained around 2000 deaths per month in the previous years for April and May. However, this increased to 3,009 in April 2021 and 8690 in May 2021, as per the report, totaling 11,699 deaths in April and May together.
The report concluded that there have been 7,262 more deaths in April and May 2021 compared to the numbers in 2019, and 8,438 more deaths compared to the deaths in 2020 during the same period. Convenor Jayaram Venkatesan said the NGO took into account COVID-19 deaths from May that were added to the bulletin in June as well but even then, there seemed to be a large mismatch.
The report has several accounts of people who had lost their kin while undergoing treatment at the hospital. They said that the names of their kin have not appeared in the health bulletin nor were they handed over any medical certificate by the hospital.
Venkatesan said that the medical certification for the cause of death (MCCD) was not handed over to the patients as per ICMR protocols and the deaths were under-reported by skipping the protocols.
“The COVID mortality code U07.2 has been completely skipped and anyone who dies due to symptoms/ complications arising out of it is not given any cause of death certificate mentioning COVID at all,” said Venkatesan.
The NGO called for transparency in putting out death certificates and also asked for an independent committee to be set up immediately that will do an audit of all deaths that happened during the COVID-19 period.
‘Government will look into the issue’
Health Secretary Dr. J Radhakrishnan said that all the hospitals have been instructed to follow the ICMR guidelines and the health department would look into the issue.
“In case kin of the deceased could not get the deaths classified at that time, they can reach out to the health authorities now to get the deaths reclassified. There is no time limit for this,” he told The New Indian Express.
He said that the health department’s priority is to record all the deaths accurately for COVID-19 and other non-communicable diseases as well.
“Many people also die due to post COVID-19 complications. We will look into the issue,” he assured.
What ICMR rules say:
As per the ICMR code U07.1, the hospital must call it a COVID death if the person was RTPCR positive (with symptoms, without symptoms, has comorbidities).
As per the code U07.2, hospitals must report a death as clinically-epidemiologically diagnosed COVID-19, if they test negative but have symptoms. They must mark it as suspected COVID if tests are awaited and the patient has symptoms. They also must mark it as probably COVID if tests are inconclusive but patients have symptoms.