Updated: April 25, 2020 2:09:10 pm
A death audit report submitted by a committee set up by the Brihanmumbai Municipal Corporation (BMC) has found that while the average time between the onset of COVID-19 symptoms in a person and death is 6.4 days in Mumbai, the average time between hospital admission and death is 2.4 days.
The committee also found that patients were reaching hospital late and dying soon after.
After scrutinising 133 deaths in Mumbai, Vasai-Virar, Navi Mumbai and Palghar, the committee has now come up with 11 recommendations. “Mumbai must plan for larger capacity,” the report stressed in bold, stating that there is a need to make intense preparation in the next four to six weeks.
The report’s top recommendation is “need to identify early warning signs” to prevent deaths and provide early intervention. It stated that health care workers in Covid Care Centers must look for the slightest of symptoms such sd fever, low blood pressure, bluish lips, breathlessness, persistent pressure or pain in chest and test such people immediately. It added that a liberal testing approach is required for pregnant women, elderly, people with co-morbidities like hypertension, diabetes, asthma, kidney ailment and cancer if they develop even slight symptoms.
The seven-member team for Mumbai headed by Dr Avinash Supe, former KEM dean and now director in Hinduja hospital (Khar), was formed to study the high mortality rate in Mumbai and recommend ways to curb them. A second six-member committee, appointed by the state government, was formed to review deaths in the rest of Maharashtra. It is chaired by Dr Archana Patil, additional director in Directorate of Health Services.
The Mumbai death audit report found 79 per cent of those who died had co-morbidity. In 74 cases the person suffered from either hypertension or diabetes or both, in 14 cases the person suffered from pulmonary illness, in eight cases the person also had kidney ailment. A significant observation was that 28 people who died had no comorbidity, and died either due to age or purely due to Covid-19 infection. Maximum deaths occurred in the age bracket of 61-70 years, about 42 people in that age group succumbed to the infection followed by 37 people in the 51-60 age bracket. Of 133 deaths, 41.3 per cent deaths occurred in medical colleges, and 17.2 per cent in private hospitals, the rest were in peripheral hospitals or smaller centres.
The report found that 80 of 133 deaths analysed had died within two days of hospitalisation, 34 had died within 3-5 days and the rest died after five days of hospital care. The audit also analysed time taken between patient first developing symptoms till the time they got admitted. In 33 cases it took more than six days for a person to get hospitalised, in 51 cases it took 3-5 days and in only 48 cases did a patient manage to get admitted within two days of developing initial symptoms. Experts observed that in only 36 per cent cases did a person immediately seek and got medical aid.
The death audit report advised that ambulances must be made available in slums so that symptomatic patients can be quickly transported to hospital. Each hospital with Covid-19 treatment facility should also thave two neonatal intensive care beds to ensure paediatric Covid-19 cases can be handled if they turn critical. A point to have only one-third staff on rotation basis to handle Covid-19 patients was also made
“There is a need to test faster, admit patients early and watch over their oxygen saturation levels,” a committee member said, adding that in most patients the oxygen levels were low and no medical intervention was possible to save their life.
“The committee has made a recommendation to open a helpline for patients to call for immediate assistance,” a state official said.
The state-appointed committee also submitted its report to the state government earlier this week. It found infrastructural lapses in intensive care support in Pune hospitals for patients.
Mumbai has recorded 167 deaths and 4,205 cases till Thursday night while Maharashtra had recorded 6,427 cases and 283 deaths, the highest in any state in India.
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