Srinagar, June 17: While the deaths attributed to COVID19 continue to drop in J&K, many professionals in the UT have joined the country-wide voices calling for a revision in guidelines for classification of deaths ascribed to SARS-CoV2.
From April 1 this year when the Wave-2 started in J&K to 16 June, as many as 2223 fatalities have been categorized as COVID19 deaths in J&K. During this period, 1,78,401 people tested positive here. The fatality as per official statistics is 1.2 percent of the infected cases. In the first wave, 1994 deaths had taken place out of 130960 confirmed cases. The death rate among those testing positive during this phase, taken up to 31 March 2021, has been 1.5 percent.
Many doctors are of the opinion that the dominantly circulating mutated SARS-CoV2 strains are less fatal than the previous wild strains. However, many other doctors believe that the present guidelines on classification of the deaths are “flawed” and need to be revamped.
A senior infectious diseases specialist at SKIMS Soura said the entire subcontinent was “hiding deaths under the garb of guidelines”.
He said the World Health Organization was clear that a death resulting from a “clinically compatible illness” in a “probable or confirmed COVID19” case is a COVID19 death, except of course if there is a “clear alternate cause” such as an accident.
He said that in Jammu and Kashmir hospitals, many patients admitted for COVID19 remain admitted for months. “During the course of treatment, they test negative but they never recover from the complications caused by the viral illness,” he said, adding that if such patients die, they are not being labeled as COVID19 deaths although it is amply clear that the “death is caused by the issues triggered by the virus”.
Dr Naveed Nazir Shah, head department of Chest Medicine at GMC Srinagar termed the matter as a “complicated” one. He said that at times a patient who has serious pre-existing ailments such as cancer, kidney failure or others may test positive for the virus during routine testing “as is the practice” and later succumbs to his/her existing ailments. “He or she will be labeled as a COVID19 fatality,” he cleared.
Dr Shah said that on the contrary a patient who turns COVID19 negative while continuing to have complications due to the viral illness will be called a non-COVID19 death, in case he/she dies. Dr Shah said a committee or an audit team consisting clinicians must be formed to discuss and decide individual cases.
Epidemiologist working with Divisional Level Control Room Dr Rouf Hussain agreed that COVID19 deaths may be underestimated. He said in-depth analysis into the cause of each death was required. “Verbal autopsies into cases where clinical history is not known or clear would also help,” he said.
Recently, AIIMS Chief Dr Sandeep Guleria had called for an audit of deaths to have a better picture of COVID19 deaths, as reported in the media. He had termed the “misclassification” of deaths “unhelpful” in India’s fight against the pandemic.
“Let’s say a person dies of a heart attack, and if he had Covid, then Covid may have caused the heart attack. So, you may have misclassified this as a non-Covid death…as a cardiac problem, rather than directly linking it to Covid,” Dr Guleria told a popular news channel in an interview.