The case fatality rate (CFR) among COVID-19 patients in Karnataka’s Chamarajanagara for the last seven days ending September 25 is at 4.6%, the worst among all districts. This is more than four times the state-wide average of 1.1% for the same period. CFR is the measure of the number of deaths per 100 positive cases.Incidentally, this comes a month after Chamarajanagara had one of the better CFRs in the state when otherwise the district is considered backward due to its longstanding poor socio-economic indicators.
While experts deem that analysing CFR for a week can be misleading subject to temporary accentuations due to reporting delays, there appears to be a consistent downward trend in the district. While the CFR for the whole state has improved steadily, the same for Chamarajanagara has deteriorated for the last 30 days.
A month ago, on August 25, the CFR for Chamarajanagara was at 1.3% when the state average was at 1.7%. As of September 18, the CFR for the district was at 1.6% which was then the state average. Now, the CFR is at 1.9% as of September 25 when the state average is at 1.5%.
Coupled with a considerable arrested growth in the COVID-19 caseload compared to the rest of the state, the district was being considered a dark horse in the pandemic management. But now a combination of slump in surveillance and testing activity seems to have undone the good work done by the district administration.
Slump in contact tracing, quarantine enforcement
Chamarajanagara’s COVID-19 indicators were attributed to the district’s effective surveillance and contact tracing work. The district had the highest number of incidents of action taken against violation of COVID-19 regulation and fourth highest contacts per patient. On August 25, the district had 33 FIRs (first information report) and institutional quarantine (IQ) initiated for every 1,000 violations of home quarantine norms and fifth highest (17) contacts per positive patient in the last 10 days.
Now on September 25, the number of FIR+IQ has reduced to 26.1 per 1,000 violations and contact tracing has reduced to 15th highest (9.8 contacts per patient).
Speaking on this, senior IAS officer Munish Moudgil, in-charge of Karnataka COVID-19 War Room, said that pandemic management was a continuous effort. “It’s like a new exam with a new syllabus every week. You don’t study for a week, you flunk. It’s a daily fight and those who sleep even for a day pay for it,” he said.
Dr Giridhar Babu, who is part of the Union government’s research task force on Epidemiology and Surveillance and also part of Karnataka’s Technical Committee, said the problem lies in strategy.
“How did India become a world leader in eradication of polio? Testing was strengthened in districts that were detecting less than expected minimum number of infections per population,” he said.
He added, “Instead in response against COVID-19, we seem to be doing exactly the opposite of our own successful model. Districts and states with poor reporting of cases (and therefore missing many deaths) are celebrated as success models.”