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Friday, June 05, 2020

Expert audit reveals: Behind Punjab’s Covid fatalities — comorbidity, older patients, and delay in getting treatment

"It has been observed that majority of the patients who suffered from COVID-19 and died were comorbid. Coronavirus infected persons having co-morbid conditions like diabetes, hypertension, cancer and HIV are more prone to death," said former PGI Director Dr K K Talwar.

Written by Navjeevan Gopal | Chandigarh | Published: May 5, 2020 12:52:22 am
Coronavirus death, covid 19 cases, corona test, Punjab news, Indian express news “People in Punjab do not report to government hospitals easily,” said former PGI Director Dr K K Talwar, adding that anyone with few means first prefer to go to private hospitals. (Representational)

Comorbidity, patients reporting late to government health facilities and more seniors turning up for treatment were among the factors which pushed the COVID-19 fatalities in the state. According to former PGI Director Dr K K Talwar, the head of the experts’ group constituted by Punjab CM Amarinder Singh to carry out an audit of COVID-19 deaths in the state, these are the three factors that have contributed majorly to Covid deaths in the state.

“It has been observed that majority of the patients who suffered from COVID-19 and died were comorbid. Coronavirus infected persons having co-morbid conditions like diabetes, hypertension, cancer and HIV are more prone to death,” Dr Talwar told The Indian Express.

He, however, did not divulge the exact break-up and percentage of Covid deaths caused by the said factors in the state, saying that an expert from All India Institute of Medical Sciences (AIIMS) had also been roped in for his opinion. “I am taking the help of a colleague from AIIMS and have sent details of the patient for an analysis,” said Dr Talwar.

Another factor responsible for deaths reported due to COVID 19, Dr Talwar said, was that patients reported to government hospitals at a late stage.

“People in Punjab do not report to government hospitals easily,” said Dr Talwar, adding that anyone with few means first prefer to go to private hospitals.

“All the patients who came to government hospitals, came at a late stage. At late stage, there are complications in breathing and patient has to be taken to ICU. Even in best of the countries, when patients report late to the hospitals, the mortality rate is very high,” said Dr Talwar.

“Now, we are trying that patients infected with coronavirus be identified and picked early,” Dr Talwar added.

On April 30, Punjab Health and Family Welfare Principal Secretary Anurag Agarwal in a letter to Deputy Commissioners had asked them to motivate the private health facilities to start COVID-19 treatment by assuring them that Punjab government was committed to providing best possible assistance to operationalise their facilities.

Dr Talwar termed this a step in early detection of coronavirus positive patients and their monitoring by the government.

He added that it was observed that older COVID-19 patients were more prone to death and majority among the 23 Covid deaths were elderly. On the persons with travel history to foreign countries, Dr Talwar said it could also be one of the factors as persons coming from countries like US, UK and some other European countries may have a much higher viral load. He, however, said that it was not possible to calculate viral load in normal testing and that only drug manufacturer companies had the technical know-how to do that.

As per an analysis by the Punjab Health department, out of 23 COVID-19 deaths in the state, at least 8 patients were more than 50 years old, while nine were over 60. “One patient was just 6-month-old and had Acyanotic Congenital Heart Disease. Almost all patients had associated comorbidity like hypertension, diabetes, chronic bronchitis, obesity etc. Many of these patients had more than one comorbidity,” said Punjab Health and Family Welfare Director Dr Avneet Kaur.

Three more COVID-19 deaths were reported from Punjab on Sunday, taking the total tally to 23 deaths in the state. Health authorities said that in all the three cases there was comorbidity.

Ludhiana Civil Surgeon Dr Rajesh Bagga said the 62-year-old woman from Jodhewal who died in Ludhiana was also having a “heart problem” and 65-year-old man from Phagwara in Kapurthala district, who died in Ludhiana, was also suffering from “pneumonia”.

A 42-year-old man from Ferozepur district, who died in Faridkot on Sunday due to COVID-19, the health authorities said, was also “diabetic” and had “lung abscess”.

Punjab had a mortality rate of 2 per cent by Sunday. In the recent past, the mortality rate had been much higher, something which officials said was due to “lesser denominator of persons testing positive due to relatively lesser number of tests conducted”.

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