Is the TN government suppressing the real numbers on dengue? Govt says no

Over the last 72 hours, five people are suspected to have died in a government hospital in Coimbatore after unsuccessfully battling dengue. Amongst these victims is four-year-old Nishantani, who was rushed in from Pollachi for treatment to the Coimbatore Medical College And Hospital on August 2. But it was already too late.

Her condition was critical and she died on Wednesday, not even responding to medication.

Now, this little girl is merely a statistic in the rising number of dengue cases in Tamil Nadu in 2017. As of July this year, 5,474 cases of dengue have been reported in the state . In the last month alone, there were 629 new cases, according to reports. While these numbers are alarming by themselves, health officials and doctors who work in the state told TNM, under the condition of anonymity, that the figures are largely underplayed.

"Individual districts will report that many cases, if the real numbers are presented," claims a private medical practitioner from Madurai district. "The government's strategy has always been to not confront the magnitude of the actual problem," he adds.The practitioner alleges that this is a yearly phenomenon and instead of addressing the problem, the government chooses to wait for the winter to pass, so that the number of mosquitoes will automatically reduce.

But the first six months of 2017 have already seen more cases of dengue than the whole of last year (4000 cases). Despite that, officials suspect foul play.

"The numbers just don't add up," said an officer working closely with the Tamil Nadu government. "If you go to private and government hospitals across the state and ask them for number of patients diagnosed with dengue and then compare the total to the numbers being projected, it will not match," he adds.

Why is there a deliberate attempt to not provide the right figures?

"Several times doctors in the districts are not equipped to handle cases such as dengue and even when they do recognise it they are afraid to name it as such. They don't want government officials to enter the scene and tell them how to go about the matter. Private hospitals for instance, try to keep contact with the government to a minimum," says the official.

Practitioners in India, experts allege, are not trained in intensive care and are therefore not in a position to treat patients suffering from the virus.

"Thus, data is not reported by the districts to the state authorities correctly. And on their part, the state government doesn't conduct audits to check if they are receiving correct information," he adds.

The officer also admits that suppressing the real data could be an effort by the government to ensure that panic is not created amongst people. But this is bound to be more of a health hazard than of any help.

"You distribute resources based on the severity of the problem in a particular area. If you don't have your numbers right how do you do this?" asks the official. "If you report 100 cases in Chennai and 10 in Coimbatore, automatically more attention is given to Chennai. But in all probability the situation is far worse in Coimbatore," he explains.

Tamil Nadu Health Secretary J Radhakrishnan, however, denied the allegation that the state was hiding the real numbers. “There is no doubt that dengue remains a challenge for states like Kerala and Tamil Nadu this year. It is definitely a concern but our focus has been to not only control the virus but to eradicate it,” said Radhakrishnan.

The state government, he explained, is working on creating public awareness about how mosquitoes breed in freshwater and ensuring that the source of the virus is eradicated. “Mortality should be made next to nil. That is our focus,” said the Health Secretary.

But the huge rise in dengue cases is not the only cause of worry in the state. Experts believe that doctors remain ill-equipped to handle the growing epidemic causing more complications across the districts. 

TN government's actions hurting patients?

Four-year-old Nishantani for instance was diagnosed with the virus in Pollachi and was even undergoing treatment. Sources in the Coimbatore GH told Deccan Chronicle, "The child suffered multi-organ failure and eventually lost her battle. Early diagnosis of dengue and the right treatment can save lives."

"Most cases of dengue can be treated like any other virus but the problem here is that doctors need to be very alert," says the medical practitioner. "Five percent of these cases could turn for the worse and you need to constantly look out for the symptoms. This where we fail," he explains.

Private hospitals, he claims, focus on retaining patients for as long as they can, in order to make the case more profitable and tend to miss out on constant diagnosis. "Government hospitals are a different ball game altogether," says the practitioner. "They are severely understaffed and don't have the resources to look after so many patients. There is possibly one nurse for every 10 patients as opposed to a one on one ratio that is seen in private hospitals," he adds. 

Doctors in private hospitals across the state have allegedly received unofficial orders from the health department, asking them to refer all cases of dengue to government hospitals. "It said that we are liable to scrutiny and punishment if a patient suffering from dengue in our care dies," he says.

The practitioner shared the message he and other doctors received with TNM. 

Health Secretary Radhakrishnan, however, denied the allegation.

"WhatsApp has led to this rumour. We had a meeting where it was decided that if private and government hospitals don't have beds, then the cases should be referred to a government hospital. Someone has put this on WhatsApp," says Radhakrishnan, the state health secretary. "We are only saying that care should be taken to ensure there is no delayed treatment and that protocols are followed," he claims.

But on Wednesday, when the private hospital that the medical practitioner works in reported a case of dengue, the patient's family allegedly started receiving multiple phone calls. "Corporation officials were calling the relatives and asking why they went to a private hospital. But it was our duty to report it and we did," he states.