Following criticism over the alleged “less-than-honest” manner in which Kerala was reporting its COVID-19 deaths, the Health Department is now rolling out an online, real-time reporting system, which will ensure transparency, accountability and completeness in COVID-19 death reporting henceforth.
The system, developed by e-health division, is being rolled out on a trial basis on Tuesday.
The COVID-19 death reporting in the State has been mired in controversies right from the time of the first wave and inconsistencies in reporting, gaps in data and the unusual disparities in mortality rate between districts have led to allegations of data manipulation by the State. Even though the importance of accurate death reporting and data sanctity for the purposes of pandemic-impact assessment and policy formulation for the future had been pointed out time and again by health experts, the State did nothing to set right its systems or to undo the damage that had been done.
With the State and the Central governments deciding to offer compensation to the victims of COVID-19, especially children who had been left orphaned by the pandemic, inconsistencies in death reporting was no longer something that the government could sweep under the carpet.
Entries by doctors
Under the new online reporting system being made accessible to all public and private hospitals, doctors can enter the details of COVID-19 deaths — whether COVID-19 is the direct or underlying cause — directly on to the World Health Organisation’s reporting format. This will be approved by the head of the institution and sent to the District Medical Officer, who will compile the data and release the report. The software will auto generate several other data sets too, apart from electronic medical records.
“Till now, there has been so much variance in the COVID-19 death data reported from panchayats, health vigilance, hospitals and the districts and the gap was beginning to be yawning. It is not necessarily due to ‘hiding’, but more so because of incomplete hand-written medical bulletins from hospitals, which get shelved, so that the deaths go ‘undeclared’. The backlog of three to four weeks was being cleared slowly, which was why 200-250 deaths a day were being released during the past two weeks,” a senior Health official said.
Mandatory fields
“In the new online reporting system, one cannot report a death to the district without completing many mandatory fields, including date of COVID-19 testing, the SRF ID (specimen referral form ID) and cause of death. Every death has to be reported within 24 hours. The system detects process delays and will keep prompting, ‘task pending’. In all, the new system ensures transparency, real-time reporting and most importantly, completeness of data,” he said
Kerala’s case reporting has always been sound and the State’s case fatality rate (CFR), which is a proportion of deaths to the total COVID-19 cases detected, has been naturally low. But at some point, the need to maintain a low CFR overtook other considerations. It was this very conscious exercise to project the CFR at a low which eroded the State’s credibility in COVID-19 death reporting.
Commendable
“It is commendable that the State has taken the demand for accurate COVID-19 death reporting seriously. It should now undertake a COVID-19 death data reconciliation exercise, as is being done in other States so that the COVID-19 death data so far can be recalibrated and data gaps filled,” a public health expert said.
