Updated: September 17, 2020 8:18:55 am
The interval between hospital admissions and deaths in Covid-19 cases in Karnataka has seen a gradual improvement from an average of two days in July to around six days in early September, according to data provided by the state government in its daily health bulletins.
The data shows that nearly 45 per cent of the total 6,462 Covid deaths between July and early September occurred within two days of admission in a hospital while seven per cent died at home or were already dead before reaching hospital.
The July-September data shows a gradual improvement in the time spent by critically ill Covid patients in hospitals through August and September in worst-affected places like Bengaluru as opposed to July when nearly 55 per cent of 932 deaths occurred within 24 hours of hospital admissions and nearly 10 per cent deaths occurred before patients reached a hospital in Bengaluru.
The interval between hospital admission and Covid mortality in Bengaluru, as per the data, has increased from an average of one day in July to around six days in early September.
“Earlier we were thinking of treatment only in terms of an infectious disease. Now there is an understanding of thromboembolic developments (blood clots) linked to the infection. Changes have taken place after learning from many countries. We are giving blood thinners to prevent thromboembolism after conducting D-Dimer tests. After starting Remdesivir and change of treatment protocol the deaths have reduced in all hospitals,” said Dr C Nagaraja, the director of the Rajiv Gandhi Institute of Chest Diseases who is a member of the state death audit panel.
A total of 2,068 patients died in Karnataka in July, 3,388 in August and 1,106 till September 10 while 932 died in Bengaluru in July, 936 in August and 342 till September 10.
Statistical analysis of Covid deaths reported in Karnataka between July 14 and September 10—carried out by a social media user @shananalla and shared by epidemiologist Dr R Giridhar Babu—also suggests a gradual improvement of the interval of time between hospitalisation and deaths.
According to the statistical analysis of mortalities in Karnataka, the average time spent in hospitals by patients who have died has been 5.2 days in September, 4.6 days in August and 2.7 days in July. In Bengaluru, the average time in hospital for patients has been 6.2 days in the September 1 to 10 period compared to 6.1 in August and an average of two days in July.
The longer interval between admission and deaths has been attributed to improvements in the care and handling of patients since July. “With the use of steroids and other means, patients are being managed better if they reach hospital on time,” said a senior doctor at the St John’s Medical College.
An increase in ICU beds with oxygen supply after the state government roped in private hospitals in late July has also helped in reducing the number of rapid deaths that occurred through July, the experts said.
Karnataka has reported a total of 7576 Covid deaths till September 15 with Bengaluru accounting for 2514 deaths. Statistical analysis presented on social media for 5753 mortalities that occurred in Karnataka between July 14 and September 10 has reported that an overall 44.5 per cent deaths occurred within two days of hospital admission, while 30 per cent between 3-7 days and 18 per cent over eight days later. The analysis has also reported that seven per cent of deaths have occurred at home or has involved patients who were brought dead to hospitals.
An early analysis of Covid deaths in Karnataka conducted in June had revealed that late presentation, age and comorbidities were key factors in Covid-linked mortalities. Another analysis at the state Covid war room had revealed that elderly persons with Severe Acute Respiratory Infection who test positive for Covid are more likely to succumb to the infection than other categories of patients.
Analysis of 72 Covid deaths in Karnataka between March 10 and early June at the war room revealed that 64 per cent of people above the age of 60 who presented themselves in hospitals and clinics with SARI and then tested positive for Covid died.
As part of efforts to reduce the mortalities, treatment protocols at hospitals are now tuned to consider all patients arriving with severe respiratory illness and influenza-like illness as Covid cases.
New areas of concern, in recent weeks, has been that of seriously ill patients who are on ventilators in private hospitals being shifted to government hospitals for treatment at the eleventh hour and of a growing number of patients dying at home without treatment, Dr Nagaraja said.
“Although mortalities in the hospital set up have stabilized through August and early September, we are seeing a trend again of patients being brought dead or dying within a few hours of reaching the hospital. Last week we had seven deaths which was a spike from the one to two we were seeing in a week. Two of the seven were brought dead and three died within two hours,” Dr Nagaraja said.