As the Covid-19 cases have been exponentially increasing since the first week of January, some states have been reporting an increase in the number of Covid deaths in the country.
For instance, Delhi shows that Covid-19 deaths have gone up three to four times in the past ten days. On January 7, the state reported 9 deaths which went up to 40 just in five days on January 12.
The daily deaths are still above 30. It makes many people question, “If Omicron is a mild virus, why have Covid-19 death numbers gone up?”
Health experts and doctors working in Covid wards in various hospitals say that the norm to report Covid death is the reason behind it and not the Omicron.
The hospitals follow the norm, according to which, if a person dies due to any other reason but if his RTPCR test at the time of admission to the hospital is positive, it will be considered as Covid death.
“It is mandatory to conduct an RTPCR test on every patient who comes for admission to hospitals for any health issues. Many patients who get admission for chronic disease or any other severe health reason turn positive though the Covid-19 has nothing to do with their health complications. If such patients die, it is counted as Covid deaths,” Dr Vishal Gupta, an in-charge of Health Check-up Department, Fortis Hospital, Noida, said.
Health experts say that during a pandemic when millions of people are picking the infection, it is coincidental that some people with critical health situations will also contract it.
Suresh Kumar, Medical Director, Lok Nayak Jai Prakash Narayan Hospital, India’s biggest hospital with 2,000 beds for Covid patients in Delhi, also confirms the norm and says that the current wave hasn’t contributed an increase in the number of average daily deaths in his hospital.
“The number of deaths under the head “Death due to Covid-19” has gone up but if you ask the average death that was happening in hospital on a daily or weekly basis, it remains the same even today,” Kumar said.
Clarifying it further, he said, “Let’s say a patient gets admission in a critical condition for cancer and since the Covid test is mandatory for admission, he turns out to be Covid positive. Now if such a patient dies, the underlying cause might not be Covid-19 but since he is Covid-19 positive, it is marked as Covid death.”
Many other doctors in private hospitals do confirm the similar process being followed.
For instance, Bihar State Health Bulletin, released every day by the Health Department, has included several cases as Covid-19 deaths even if the underlying conditions were reported to be other medical complications. In its January 10 bulletin, it reported five deaths due to Covid-19 in which a six-year-old with severe brain disease and a 21-year-old road accident victim were also included.
“There are many such cases in which pre-Covid condition of the patients are chronic and severe whereas their Covid-19 status is asymptomatic,” a resident doctor from AIIMS, Patna said.
Health and legal experts say that it was after the Supreme Court intervention last year that the Covid-19 death registration norms were changed.
Advocate Sumeer Sodhi, who appeared for one of the petitioners in the matter, said that when the public interest litigations were filed before the Supreme Court, the government of India was paying no compensation either ex-Gratia or otherwise to those who had succumbed to the virus.
“It is important to note that at the relevant point of time there was under-reporting of deaths due to Covid during the second wave and therefore the need arose for Supreme Court to direct the government to frame guidelines as to how death certificates are to be issued showing the cause of death to be Covid in appropriate cases,” Advocate Sodhi, said.
Before that, the ICMR’s “Guidance for the appropriate recording of COVID-19 related deaths in India” dated May 10, 2020, had said that a Covid positive person with the comorbid condition would not be considered as Covid death.
“Patients may present with other pre-existing comorbid conditions such as chronic obstructive pulmonary disease (COPD) or asthma, chronic bronchitis, ischemic heart disease, cancer and diabetes mellitus. These conditions increase the risk of developing respiratory infections, and may lead to complications and severe disease in a COVID-19 positive individual,” the ICMR guideline had said.
It had added, “These conditions are not considered as UCOD (Underlying Cause of Covid Death) as they have directly not caused death due to COVID-19. Also, a patient may have many co-morbid conditions, but only those that have contributed to death should be recorded.
However, the Supreme Court while hearing the issue of compensation for Covid deaths passed a judgment on June 30, 2021, and said that the Centre should issue a simplified guideline for issuance of a death certificate stating the exact cause of death, i.e., “Death due to Covid-19”, to the family members of the deceased who died due to Covid-19.
The apex court had directed that a person might have died even due to other complications, however, if he tested positive for Covid-19, it will be registered as ‘Death due to Covid-19’.
In another judgement delivered on October 4, 2021, in the same case, the SC even went on to direct the government that if a person commits suicide within a month of testing Covid-19 positive, it will be also be registered as Covid death.
“I think the apex court did justice for common people. It is difficult for a common person and sometimes even a doctor to exactly know the complications caused by Covid-19. So, it is a landmark decision and this has made the family members of the deceased eligible to get Rs 50,000 as compensation. It is pro-people judgment,” Dr Ishwarprasad Gilada, an infectious diseases expert, said.