As the number of virus cases in India are increasing, questions on the death toll arise.


New Delhi (AP) – When Narayan Mitra passed away on 16 July, a day after being hospitalized for fever and shortness of breath, his name was not included in any of the daily lists of people killed by coronoviruses. He Came.

Later test results revealed that Mitra was indeed infected with COVID-19, as his son, Abhijeet, and four other family members in Silchar in the northeastern Assam state were on India’s border with Bangladesh.

But Narayan Mitra is still not counted as a coronovirus victim. The virus was considered an “accidental” factor, and a panel of doctors decided that his death was caused by an already diagnosed neurological disorder that causes muscle weakness.

Abhijeet Mitra said, “He died due to the virus and there is no meaning.” testing.

Such findings may suggest that India, which has recorded more than 5.1 million infections – second only to the United States – has about 83,000 deaths in a country of 1.3 billion people.

Evidence of its success as a basis for India’s health ministry to fight the epidemic and reopen the economy and restart it following Prime Minister Narendra Modi’s order to shut down the entire population earlier this year. Is quoted as.

But experts say the number is misleading and India is not counting many deaths.

“We are undergoing deaths by an unknown factor,” Dr. T. Jacob John, a retired virologist.

The Ministry of Health has reduced the death toll over the past few years, but declined to comment this week on whether the states were reporting all suspected and confirmed virus deaths.

The exact number during a pandemic is difficult to determine: countries count cases and have different deaths, and testing for the virus is uneven, making direct comparisons misleading.

In India, mortality figures were poor even before the epidemic was recorded. Of the estimated 10 million deaths each year, less than a quarter are fully documented, and only a fifth of these are clinically certified according to national data.

Most Indians die at home, not in hospitals, and doctors are usually not present to explain the cause of death. It is more prevalent in rural areas, where the virus is now spreading.

An epidemiologist at the University of Toronto, Drs. Prabhat Jha, who has studied deaths in India, said that if they want to make progress in fighting the virus, countries should beat the death.

Jha said, “It is better to guess better than under estimate.”

Guidelines from the Ministry of Health echo this concern, asking states to record all suspected virus deaths, including “possible deaths” – those likely to cause COVID-19 deaths , But was not tested for.

But they are guidelines advisors, and many states do not comply. In India’s worst-affected state of Maharashtra with more than 1 million cases, suspicious deaths have not been recorded, with the state’s health director Drs. Archana Patil said.

Other states such as Assam have created panels of doctors distinguishing “deaths from the real virus” and underlying diseases. In some cities such as New Delhi or Mumbai, these panels have sometimes added deaths in tally.

But Dr. Anoop Kumar Burman, who led the panel in Assam, said the state was not involved in several fatal incidents where the virus was “accidental” and not the cause of death. In the case of Narayana Mitra, he had more symptoms of an underlying neurological disorder, Burman said.

The state of Assam was following federal guidelines and was only citing the virus in deaths due to respiratory failure, pneumonia, or blood clots, Burman said. But the guidelines exemplify these factors as to how the virus can kill and is not a restrictive checklist. Barman declined to answer any follow-up questions from The Associated Press.

The state of Assam has recorded over 147,000 infections but fewer than 500 deaths as of Wednesday.

In the state of West Bengal, a similar panel was placed in May and the state said it would follow federal guidelines later. Of the 105 deaths of those who tested positive for COVID-19 in April, the panel found that 72, or about 70%, were not caused by the virus.

PV Ramesh, who led COVID-19 management for the state of Andhra Pradesh in South India until July 8, said that coronovirus deaths “do not count while at home, in infection, or in hospitals.”

The gaps in the data also mean that India’s ability to identify spikes in deaths from natural causes over the years is clear. Problems in death counts in countries such as South Africa have raised concerns.

Courts, meanwhile, have criticized some states, such as Telangana, for having transparency in sharing data about deaths.

In addition, in May, guidelines from the Federal Ministry of Health advised hospitals to conduct autopsy in suspected COVID-19 cases to prevent exposure to the virus. Although the guidelines say that certification can be done by doctors, experts said it was also leading to reducing deaths.

Despite the increasing number of reported infections, the government’s insistence on fewer deaths led people to think that the virus was not necessarily fatal, causing a “false sense of security”, Dr. Anant Bhan, who researches public health and ethics in Bhopal city. Bhan said that people let their guards down because of not taking any precautions in wearing masks or maintaining social distance.

The director of a hospital in rural Wardha district of Maharashtra, Dr. SP Kalantri said that the regional authorities were also under pressure to show the pressure of the death under pressure. He said there were initially “subtle indications” from district officials to “reduce the number” by listing some of the deaths caused by underlying diseases.

Maharashtra’s state health director Archana Patil said it was a problem in some districts at first, but officials have been advised to report all deaths.

Meanwhile, those working in the crematorium have reported an increase in receiving the body – whether it is from the virus or not.

At a cremation ground in Lucknow, the capital of India’s most populous state, Uttar Pradesh, activist Bhupesh Soni said 30 people were being cremated every day, compared to five or six before the epidemic.

A cremation takes about 45 minutes, but Soni said many days have come when he has worked more than 20 hours.

“It’s an endless flow of bodies,” he said.

Biswajit Banerjee, author of Associated Press in Lucknow, India and Indrajit Singh in Patna, India contributed.

Follow AP Epidemic coverage at http://apnews.com/VirusOutbreak And https://apnews.com/UnderstandingtheOutbreak

The Associated Press Department of Health and Sciences has support from the Science Education Department of the Howard Hughes Medical Institute. AP is solely responsible for all content.

    .