Recorded COVID-19 Deaths Likely To Change As ICMR Issues Guidance For Suspected, Inconclusive Cases

Amid reports of under-reporting of COVID-19 deaths in the country, the Indian Council of Medical Research (ICMR) has issued guidance for the appropriate recording of deaths due to the disease in India.

ICMR said COVID-19 is a new disease and is a pandemic affecting all communities and countries and a robust data is needed in India to measure the public health impact of the ailment and to plan for timely health interventions.

AFP

According to the guidance, COVID-19 would be recorded as an "underlying cause of death" when leading to pneumonia, cardiac injury and clotting in the bloodstream, among others.

Deaths with inconclusive test results, but in which coronavirus symptoms are present will be recorded as "probable COVID-19" fatalities.

Deaths in which tests are awaited with the presence of symptoms will be recorded as suspected deaths, while those testing negative but have symptoms will be mentioned as clinically-epidemiologically diagnosed COVID-19.

BCCL

Its clinical presentation ranges from mild to severe, and fatality depends on the severity of the illness, associated comorbid conditions and age of patients. "Patterns of disease and patterns of death can come from only standardised recording of clinical disease history and cause of death, and therefore epidemiological surveillance of disease and death are important.

"Robust data is needed from every district and state in India to measure the public health impact of COVID-19 and to plan for timely health interventions and protect communities. "At the same time, other health conditions affecting populations need to be also monitored so that the health system is prepared for responding to the needs of the population,"' the document stated.

BCCL

It lists forms where a health facility or a medical practitioner has to mention the sequence of events leading to death, which includes the immediate cause of death, cause of death antecedent to immediate cause, underlying cause of death and the manner of death, among others.

It is likely that COVID-19 is the underlying cause of death (UCOD) that leads to pneumonia in most of the deaths due to COVID-19. Patients may present with other pre-existing comorbid conditions such as asthma, chronic bronchitis, ischemic heart disease, cancer and diabetes mellitus.

These conditions increase the risk of developing respiratory infections, and may lead to complications and severe disease in a COVID-19 positive patient.

AP

"These conditions are not considered as underlying cause of death as they have not directly caused death due to COVID-19. Also, a patient may has many comorbid conditions but only those that have contributed to death should be recorded," the guidance document stated.

Earlier there were allegations that there is a mismatch between the number of COVID-19 death in Delhi hospitals and the numbers published by the government.

While the official death toll in Delhi due to COVID-19 is 73, data from hospitals suggest it is much higher.

Officials of the 10 hospitals treating Covid-19 patients have said the number of people dead due to the virus is higher than what the Delhi government's bulletin reflects.

BCCL

The Delhi government on Sunday warned hospitals and other health facilities of strict action in case of any delay in reporting of coronavirus fatalities and also issued an SOP.

Delhi chief secretary Vijay Dev issued the order along with the Standard Operating Procedure (SOP) under which all Covid-19 hospitals and other facilities will e-mail a 'death report' to the district and state surveillance units everyday by 5 pm.