COVID-19 deaths in Thiruvananthapuram Medical College underreported?
A statement by the Kerala Government Postgraduate Medical Teachers Association on deaths in the Thiruvananthapuram Medical College Hospital has once again cast doubts that the state bulletin is not reflecting the actual number of COVID-19 related deaths. The KGPMTA’s statement on May 24, said that 70 COVID-19 related deaths had occured in the Thiruvananthapuram Medical College Hospital on May 12 alone. However, the state bulletin reported only 32 deaths from Thiruvananthapuram district on May 12.
The KGPMTA was reacting to reports that a dead body was left unattended in the hospital for around 15 hours. Defending the health care workers on duty, the association gave a statement, which has put the focus on two aspects- that hospitals are understaffed and that deaths are being undercounted.
“On that day (May 12) the duty doctor had to take care of 80 critical patients. There were only two nurses and two attenders to help the doctor. In 24 hours, there were 70 covid-19 deaths. The mortuary, which has the facility to keep 50 dead bodies, had more numbers that day. Hospital authorities who are in charge of COVID-19 could not do anything for 15 hours, which resulted in no one attending the dead body for 15 hours,” the note by KGPMTA says.
Though KGMPTA says the number of COVID-19 related deaths on May 12 was 70, the state bulletin till May 24 has listed only 32 deaths.
When asked about this discrepancy, Thiruvananthapuram District Medical Officer Dr Shinu KS said that not all deaths were due to COVID-19 and those that were will reflect in the bulletin later.
“Many of these people could have turned negative while dying. There are many factors to be considered while declaring a death as COVID-19. Also, some deaths are declared even two or three months later,” he told TNM.
He added that the declaration is done by the State Health Department. “Details of all deaths are sent to the state, they will look at all details and then decide. Certain deaths are also sent to the Audit Committee which can also add deaths to the count,” he said.
The DMO insisted that more deaths will be added to the state bulletin in the days to come. However, it is to be noted that KGPMTA’s statement is about one hospital. Though the Medical College hospital is the biggest in the district, there are other hospitals too reporting COVID-19 related deaths, which means the death toll that day exceeded 70.
ToI, which reported this discrepancy first, also says that the total number of deaths from the district crematoriums do not match the bulletin.
Kerala has come under criticism earlier too for underreporting COVID-19 deaths. The state was excluding the names of those patients who had pre-existing medical conditions like cancer or cardiac issues. This despite the WHO guidelines in April 2020 stating, "A death due to COVID-19 may not be attributed to another disease (e.g. cancer) and should be counted independently of preexisting conditions that are suspected of triggering a severe course of COVID-19." The WHO guidelines further note that while persons with comorbidities are at higher risk of death due to COVID-19, the cause of death must be listed as COVID-19. Pre-existing conditions must be listed under the column 'Other significant conditions contributing to death' in the medical certificate, it recommends. The WHO guidelines also say that in cases where COVID-19 is not confirmed, the underlying cause of death must be reported as 'suspected COVID-19'.