The Union Health Ministry has come down heavily on the Kerala Government for the less than transparent manner in which it has been reporting COVID-19 deaths.
The ongoing COVID-19 death reconciliation exercise, which has added 8,684 deaths (October 22-November 22) in a space of one month to the State’s COVID toll, completely belies its claim that it has managed the pandemic well, a death analysis report by the Ministry of Health and Family Welfare (MoHFW) has said.
Following the death reconciliation exercise, the State’s case fatality rate has jumped from 0.3% to 0.73%.
The allegation that the State has not been declaring all COVID deaths or including all deaths of COVID-positive persons in its official list of deaths is something that was raised right from the initial days of the pandemic. The State has never offered a clear explanation for the inconsistencies in death reporting, gaps in data and the unusual disparities in COVID mortality rate between districts when these were pointed out. Many deaths that occurred in the continuum of the afflictions unleashed by the disease had been missing from the official list of COVID deaths since March 2020 when COVID deaths began to be reported first.
Ex-gratia payments
The State was forced to release the backlog of “undeclared” COVID deaths in the State, make death reporting online directly from hospitals and undertake a death reconciliation exercise only after the issue of ex-gratia payments to the families who lost their kin to COVID was raised by the Supreme Court.
The report points out that from contributing 6.2% of total cases during the month in the country but only 1.4% of total deaths reported in this period, Kerala in September ‘21, contributed to 65.7% of country’s cases but 45.2% of country’s deaths.
The report calls it “shocking” that in the one month from October 22 to November 22, apart from 1,789 new deaths, the State reported a backlog of 8,684 deaths, which constitutes 83% of the total 10,473 deaths reported during the period.
While the MoHFW has always emphasised the need for a robust, timely and transparent reporting of cases and deaths on daily basis to all the States, the huge backlog of deaths added to the State’s official COVID toll as part of the death reconciliation exercise “reveals inadequacies in the recording and reporting mechanism.” This has brought to fore the gap in the effective implementation of containment strategy of the State, the report says.
“By deliberately not declaring COVID deaths and straining to push the narrative that Kerala had the lowest case fatality rate, at no point during the pandemic did we have the true picture about COVID’s real impact. And that, when mortality reduction should have been the only goal before the Government. If the Government had been more transparent about data sharing, the collective wisdom of the State’s clinicians could have helped the State evolve more focused strategies to bring down deaths,” a public health expert opined.
As for disease transmission, Kerala continues to present a unique picture and has remained on a plateau consistently since the past few months. Testing levels have come down drastically to between 50,000-60,000 tests daily.
Breakthrough infections
Even when it has been reporting an average of 5,000 new cases daily since the past few weeks, over 40% of the new cases reported are breakthrough infections in fully vaccinated individuals. The active case pool has been declining steadily and hospitalisations and ICU occupancy too have come down sharply over the past few weeks. Only about 7% of the active cases are in hospitals, with approximately 1.6%admitted in oxygen beds and 1.4% in ICUs.
Close to 62% of those above 18 years in the State have been fully vaccinated. Official data puts the death of those who had breakthrough infections at less than 3%. Yet, the fact that there are close to 50 COVID deaths daily in the State is something that needs to be explored in detail.
