The leading government hospital in Bengaluru for treatment of Covid-19 has seen a 97% death rate among patients put on ventilators — far in excess of comparative numbers for countries like the UK, US and Italy with high coronavirus fatalities.
Since April, when the 100-year-old Victoria Hospital attached to the Bengaluru Medical College and Research Institute (BMCRI) was designated the city’s first Covid-19 hospital, it has seen 91 deaths. Of them, 89 had been put on ventilators for advanced respiratory support.
Of the 1,500 patients admitted at the hospital so far 92 have required intubation to help in breathing, with 89 of them dying, senior BMCRI officials said. At 50, Victoria Hospital has the most ventilators of any government facility in Bengaluru.
“A death rate of almost 97% for patients on advanced respiratory support suggests something is going wrong in intensive care. Even in Italy at the peak of the Covid-19 incidence, the death rate of people on mechanical ventilation was around 65%,” a senior professor at St John’s Medical College and Hospital in Bengaluru said.
While Victoria Hospital was initially supposed to dedicate 1,200 beds for Covid-19 patients, it set aside only 550. It has now been swamped, with all its 550 beds filled at the beginning of July. In the past fortnight, the hospital has seen more than 30 deaths, compared to 58 between April and June.
“We have seen 206 admissions and 91 deaths in ICU (44% of the total) as of July 15. As many as 103 (50%) have been discharged from ICU,” Dr Smitha Segu, nodal officer of the hospital’s Covid-19 core committee and a professor at the BMCRI said, adding that the reason for the high mortality among patients put on ventilators was that they reached Victoria after other hospitals had failed to treat them.
“These deaths are occurring due to very late referrals. Among patients who have come on time very few have gone into ICU. They come in a totally bad state and 39 patients have been lost within 24 hours of arrival,” Dr Segu said.
She added that 95% of the fatalities had comorbidities, while around 30% were above 60.
Dr Segu said they used a ventilator only as the last resort. “High flow oxygen (basic respiratory support) is so much better… We want to treat patients with that, but when they do not get better, we have to use ventilators.”
About the surge in cases, she said, “Who knows tomorrow? We don’t know how it is going to increase.”
Dr S Sacchidanand, the head of the expert panel auditing Covid-19 deaths in Karnataka since March, said they are yet to analyse the technical reasons behind the high mortality rate at Victoria Hospital. “We have not got the papers. We have done around 100 audits so far. With the number of deaths crossing the 1,000 mark, we have decided to decentralise the audit. It is humanly impossible for one team to do it now,” Dr Sacchidanand, who is the vice-chancellor of the Rajiv Gandhi University of Health Sciences, said.
Data released on July 9 by the Intensive Care National Audit and Research Centre in the UK for ICU treatment of 7,185 Covid 19 patients shows 48.4% mortality among patients who received advanced respiratory or ventilator support. In contrast, it said, 80% of patients given only basic respiratory support recovered.
Studies covering Covid-19 patients put on ventilators have all shown high mortality rates—between 50% and 97% in parts of China, Italy and the US.
Although the Karnataka government claims to have access to over 300 ICU beds with ventilators in Bengaluru, there are only 80 in the government sector. As of Thursday, 317 patients were admitted in ICUs across Bengaluru.
Thursday saw the highest one-day rise in cases in Karnataka (4,169) and deaths (104). While Bengaluru accounted for nearly half the cases, 70 of the 104 deaths were reported in the city.
The city is currently in a week-long lockdown to try contain the surge.
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