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Saturday, July 11, 2020

Keeping count

Fatality rate is a key metric in the battle against the coronavirus. States must urgently correct lags and ambiguities

By: Editorial | Updated: June 18, 2020 8:48:49 am
Keeping count Some states have set up death audit committees to assess whether a death is due to COVID or a result of a co-morbidity.

Till Monday, the case fatality rate (CFR) of India’s most coronavirus-hit state, Maharashtra, stood at 3.7 per cent, substantially higher than the national average of 2.8 per cent. A day later, the state’s CFR shot up to 4.8 per cent. This rise is not because of a dramatic increase in COVID deaths on Tuesday. On a day when 81 people succumbed to the disease in Maharashtra, the state added 1,328 more deaths — 862 of them in Mumbai — to its COVID toll because of a data reconciliation process initiated by the state government. A mismatch was noticed between the Maharashtra government’s figures and the numbers uploaded on the ICMR’s portal. This exercise is only halfway through and state government officials have expressed apprehensions that more unaccounted deaths may emerge. Maharashtra is not the only state where the fatality data of different government agencies have not tallied. In May, this paper reported a mismatch between the figures of the Delhi government and that of the city’s hospitals. Last week, the fatality data of the Delhi government and the city’s three municipalities did not tally. On Tuesday, the city added more than 400 unreported deaths to its COVID toll. The corrections by Maharashtra and Delhi have pushed up the country’s CFR from 2.8 per cent to 3.4 per cent and raised troubling questions over the methods adopted by states to audit COVID deaths.

Even after Tuesday’s increase, India’s CFR is almost two percentage points below the global average of 5.3 per cent. But ambiguities have dogged the reporting of COVID-19 deaths. In mid-April, for instance, the West Bengal government admitted that it did not count 72 deaths because these were reckoned to have been caused by co-morbidities. Other states are also reportedly reluctant to count all COVID deaths and have set up death audit committees — Maharashtra, in fact, has two — to assess whether a death is due to the infection or a result of a co-morbidity. None of the states reveal the number of cases they refer to such committees and there is a lag of several days in reporting deaths.

As COVID cases have surged following the easing of the lockdown, epidemiologists have underlined that the death toll is the key metric to ascertain the disease’s burden. Establishing and implementing transparent and rigorous data standards to ascertain coronavirus fatalities is not just crucial to this process, it’s also essential to develop public confidence in the battle against the pandemic.

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