Bengaluru: Late deaths after long period of hospitalisation more common during second wave of Covid crisis

Out of the 1,855 Covid-related deaths reports in the city in the week between May 28 and June 3, as many as 734 (nearly 40 per cent) patients died 10 or more days after hospitalisation or at home, shows official data from the state health department.

Unlike the first wave of the pandemic when many patients in Bengaluru died on the way to hospitals or soon after being admitted, a significant portion of deaths in the city during the second wave have occurred nearly 10 days after patients were hospitalised. Also, many have died at home during the current wave.

Out of the 1,855 Covid-related deaths reports in the city in the week between May 28 and June 3, as many as 734 (nearly 40 per cent) patients died 10 or more days after hospitalisation or at home, shows official data from the state health department.

Delayed deaths are a significant departure from the pattern witnessed during the first wave when nearly 60 per cent of the fatalities occurred within one to three days after patients were hospitalised. Moreover, many patients during the second wave developed complications when they were on the mend after 10 days of treatment.

“Many deaths are dying due to post-Covid complications. Many Covid patients died when they were in the recovery phase,” said Dr Shiva Kumar who works at the emergency unit at the Victoria Hospital — a tertiary Covid care facility attached to the Bangalore Medical College.

“If a proper retrospective study of the death cases is done, then you will find that many patients had to be admitted to ICUs after they had been released from hospitals earlier. One to two per cent of these patients have died. Many patients who were not treated properly are reporting complications later on — this would be around 10% of the case. And 5% of them are admitted to ICUs later. So post-Covid complications and deaths have been fairly common during his wave,” headed.

The medical superintendent of a Covid treatment facility in the city said though cases where patients deteriorated after discharge from hospitals were high during April and May, that seemed to be no longer the case now.

“In many cases, deaths have occurred after patients who had been hospitalised for 10 days or more were released due to absence of fever,” said an associate professor at a private medical college which is treating Covid patients.

Out of a total of 860 Covid-related deaths that occurred in Bengaluru between July 1 and July 28 last year, 565 fatalities were within 24 hours of people being hospitalised or patients being pronounced dead on arrival at hospitals, shows the data for date of admission and date of deaths provided in the state health bulletins.

The number of daily Covid deaths in Bengaluru is still high — according to official figures, the number of fatalities reported was 307 on June 2 and 347 on June 3 —-despite a significant drop in the number of daily cases (3,533 on June 3, 5,736 on May 28 and 23,000 on May 5) because of the longer periods of hospitalization of patients.

“A large number of deaths continue to be reported because of a lag in reporting numbers and also because patients are staying in hospitals longer now,” said Dr M K Sudarshan, public health expert and chairman of the technical advisory committee of the Karnataka government on Covid-19.

“One unique feature of the second wave in Karnataka in particular is the high case fatality rate. The reasons are the sudden surge and we were not fully prepared to meet the huge demand for clinical facilities. It took a fortnight — till about the middle of May — before things got sorted out. But by then the wave was plateauing,” added Dr Sudarshan.

Rajiv Gandhi University of Health Sciences vice-chancellor Dr S Sachidanand said, “We cannot compare the total cases and deaths together. They are occurring in different timelines. The deaths being reported now are of patients who were infected 15 to 21 days earlier. At that point of time, the number of positive cases was more. The death rate is proportionate to the case rate that was prevailing around 14 to 21 days earlier. Also, there are more post-Covid deaths due to complications like diabetes and thromboembolic (clotting) phenomena.”

Going by the state health department data, another key features that emerges is out of the 1855 deaths that were reported from May 28 to June 3 actually occurred between April and May 15.

An official of the state technical advisory committee admitted that there were some lapses in reporting the number of deaths in the city at the peak of the crisis.

The number of cremations were in the range of 50 to 85 during some days in the 13 electric crematoriums and three open crematoriums in Bengaluru at the peak of the crisis in late April and early May. This has now fallen to single digits, highlighting that there is a clear disconnect between the official data of daily deaths and the actual number of fatalities occurring now.

In the first wave, the highest number of deaths that were recorded in Bengaluru in a single month was 971 in September while there were large numbers of deaths in July (962), August (950) and October (897) as well. In the four months of the first wave when cases were at a peak, a total of 3,780 Covid deaths were officially reported in the city.

In the second wave, the number of deaths in Bengaluru reached 1907 in April and increased three-fold to 7,085 in May. There have been 860 deaths reported from June 1 to June 3.

Karnataka recorded a total of 29,554 deaths Covid deaths between March 2020 and May 2021, with 57 per cent of the deaths (16,969) occurring in the last two months. Bengaluru has seen a total of 13,622 deaths in the period, with 66 per cent of the deaths (8,992) occurring in April and May 2021.

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