Case fatality rate punches hole in govt. claim

A stable case fatality rate (CFR) at 0.48%, despite the steep increase in the number of COVID-19 cases in the second wave is a claim that Kerala always held on to; something which set it apart from the rest of the country.

However, the latest data shows that the claim was built on the cumulative CFR figures till date. The COVID CFR in the State since April tells a different story, with the current fatality rate crossing 1% .

If one were to take a closer look at the State’s CFR since April 15, when the second wave began, the COVID death rate has been steadily increasing every 15 days. From the fortnight from April 15 till June 30, there has been a steady, five-fold increase in case fatality rate.

Why is the likelihood of COVID deaths rising when the State is past the peak of the second wave and when the pressure on hospitals and ICUs have supposedly eased? With a highly transmissible virus variant like Delta in circulation, the efficiency of COVID protocols or testing/ isolation strategy is extremely limited when it comes to preventing disease transmission. Hence, the focus now has to be entirely on COVID mortality reduction.

But with the administrators going after test positivity rate (TPR) reduction, issues on the patient care front are being ignored.

The outcome of hospitalised patients in the State seems to be becoming worse as each week passes.

District-wise data

“The government’s own district-wise data shows that the current CFR in many districts is over 1% (Thiruvananthapuram 1.6, Ernakulam 1.26, Palakkad 1.06, Kollam 1.03, Kannur 1.02, Kozhikode and Pathanamthitta 0.8) and that the risk of mortality has been going up even when the case graph has come down.

Is it the poor quality of care in ICUs? Or is it because COVID-positive patients continue to present late in hospitals, by which time too many complications have set in? It could also be the variation of care in institutions or issues in transportation. “The first step in discerning this would be looking inwards and admitting that we are losing too many patients,” a public health expert said.

The government’s data over the last 14 days shows that the current CFR is 0.91%. But what is projected is only the cumulative CFR (proportion of deaths amongst those who have tested COVID-positive so far) of .48%, which will be low as the denominator has now crossed 32 lakh.

Two-week lag

He points out that as there is a two-week lag between hospitalisation and death, current CFR should be calculated as death in the fortnight/cases in the previous fortnight x 100. Going by this, Kerala’s CFR has been steadily rising every fortnight, from 0.2% since April 15-30 to 1.02% in the fortnight from June 16-30. In other words the likelihood of death in COVID-positive persons has increased five times in this period.

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Printable version | Sep 23, 2021 12:21:46 AM |

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