Outstation patients being brought to Delhi in "very sick state" for treatment, and "time lapse" in transferring to hospital home quarantined persons whose health has deteriorated, could be among the factors behind the high number of COVID-19 fatalities recorded here in the last few days, say experts.
For our comprehensive coverage and latest updates on COVID-19 click here.
Doctors at leading government facilities and private hospitals in Delhi on September 27 also concurred that the deaths being reported now are "mostly of patients aged 60 and above with co-morbidities". The national capital reported 46 COVID-19 deaths on September 26, the highest in over 70 days, taking the toll to 5,193, while 3,372 fresh cases pushed the tally to 2,67,822. This is the highest number of coronavirus deaths reported in a day in Delhi since July 16, when the city had recorded 58 fatalities.
COVID-19 cases have shown a surge since the beginning of this month with September 16 recording 4,473 cases, the highest single-day spike here till date. From September 9-19, fresh cases were recorded in excess of 4,000 per day except on September 14 when the figure stood at 3,229 with 26 deaths being recorded that day, according to official data. However, since September 20, fresh cases have remained below the 4,000-mark.
The daily fatalities count from September 15-24 was recorded in excess of 30 on all days. Only on September 25 it stood at 24, jumping again to 46 the next day. Also, the seven-day average of daily COVID-19 cases in India has been gradually declining for nine consecutive days from September 17-26, the first time such a phase of continuous fall has been recorded since the outbreak of the pandemic, according to a report which cites data from European Centre for Disease Prevention and Control (ECDC).
Medical Director, Rajiv Gandhi Super Speciality Hospital, Dr B L Sherwal said the fall in the number of daily cases in the last one week is a "very healthy trend" and emphasised that "a lot has been learned about the behaviour of the virus" since the outbreak. "The number of deaths being reported in excess of 30 in the past few days or 46 yesterday, can be attributed to two major reasons -- most of the patients who are dying are in 60s, 70s, 80s or 90s, and the victims are mostly those who had co-morbities," he told PTI.
RGSSH is a dedicated COVID-19 facility under the Delhi government which reported four deaths on September 26. "Also, a large number of patients coming to Delhi are from neighbouring cities or states, and are being brought in a very sick condition, so again the survival rate is low," Sherwal said when asked why death cases are rising when daily cases are now falling. At RGSSH, out of the total 500 beds, 400 are for ICU and HDU patients, and 162 beds in the ICU are occupied, he said.
Previously either one or two COVID deaths were occurring daily at the Hospital but on Saturday four patients died, which was a "big number" relatively, Sherwal added. The average COVID-19 death rate in Delhi for the last 10 days stands at 0.94 percent, according to the September 26 health bulletin.
Dr Suranjit Chatterjee, Senior Consultant, Internal Medicine at Apollo Hospitals here, echoed Sherwal's view and said outstation patients from Haryana, Madhya Pradesh and other places are being brought to the facilities here in "a very sick condition". He added that patients from Delhi are also being brought in such a state. "If they are already sick, and have travelled such a long distance, despite the best efforts of doctors and standardised treatment protocols many of these patients die, especially those with co-morbities whose condition can deteriorate suddenly," he said.
Chatterjee also conjectured that "time lapse" in transferring old patients from home isolation to a hospital could be leading to deaths of many. "There has to be a very low threshold in this transition from home quarantine to a hospital, especially for patients aged 60 and above and having co-morbidities. I would say such patients with co-morbities should rather be sent to any good COVID hospital rather than put under home isolation if we have to save lives," he said.
Dr Amarinder Singh Malhi, from the Cardiovascular radiology department at AIIMS here, when asked about the daily cases, said, "it is too early to say whether we are past the peak". The cases may have plateaued or decreased a bit, but there is no significant reduction. People need to behave responsibly in the coming months and step out only if there's an emergency, he said.
Giridhar Babu of the Public Health Foundation of India said there is always a "lag time" in reporting deaths. "Generally 14-17 days after a surge in cases, one will see a high number of deaths being reported. The surge in cases in Delhi could have started two weeks earlier so because of that surge, whatever the hospitalisation-related complications happened are being seen now. If the surge in cases continues, you will have to observe the number of deaths also," he said.
