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Govt asks states to focus on elderly to reduce fatalities

Hindustan Times, New Delhi | By
Aug 29, 2020 06:35 AM IST

The states that are reporting higher deaths are Maharashtra, Tamil Nadu, Karnataka, Telangana, Gujarat, West Bengal, Uttar Pradesh, Punjab, Andhra Pradesh, and Jammu & Kashmir.

In an attempt to bring down the number of Covid-19-related deaths in the country, the Union health ministry has asked states to focus on vulnerable population, such as patients with underlying health conditions and those with above 60 years of age.

A health worker in personal protective equipment (PPE) collects a sample using a swab from a person at a local health centre to conduct tests for the coronavirus disease (COVID-19), amid the spread of the disease, in the old quarters of Delhi.(REUTERS)
A health worker in personal protective equipment (PPE) collects a sample using a swab from a person at a local health centre to conduct tests for the coronavirus disease (COVID-19), amid the spread of the disease, in the old quarters of Delhi.(REUTERS)

In a review meeting with states reporting higher number of deaths on Thursday, the ministry directed them to particularly pay attention to the vulnerable population. “There are about 10 such states that account for almost 90% of the Covid-19 deaths over the past couple of weeks. If we manage to control deaths in these states, then the national case fatality rate will automatically come down. These intensified measures will particularly be for implementation in these states. In some states, it is certain districts that are reporting high case load. So, the focus is being broken further down to the district level,” said a health ministry official, requesting anonymity.

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The states that are reporting higher deaths are Maharashtra, Tamil Nadu, Karnataka, Telangana, Gujarat, West Bengal, Uttar Pradesh, Punjab, Andhra Pradesh, and Jammu & Kashmir.

“Since a majority of those we are losing to Covid-19 belong to a particular population group, like those with underlying medical conditions or the aged population with less reserves in body to fight off the disease, more focus needs to be put on this population group and states have been directed accordingly,” the official added.

The states have been asked to maintain a weekly database of Covid-19 deaths for each health facility managing patients, with particular focus on the vulnerable population. “They will have to document all information related to deaths in each of their Covid hospitals, especially the cause of death, to examine what could have been done to avoid these deaths,” the official said.

The age-wise Covid-19 mortality data released by the health ministry earlier this week shows that more than half (51%) of the 61,690 Covid-19 patients who succumbed to the viral infection in India are 60 years and above.

The findings about the age-wise distribution of deaths in India appear to be in line with what scientists have observed about global trends of the disease — it disproportionally infects younger people, while it severely affects those who are older.

Doctors treating Covid-19 patients agreed.

“Normally we see patients are recovering well. Comorbidities and old age both are contributing factors in patients turning serious. This category needs special care,” said Dr Sandeep Nayar, director, respiratory medicine department, BLK super speciality hospital.

Clinical management is one of the key components of disease containment strategy.

“How we treat our sick patients is what is crucial in saving their lives. We will be able to save more lives if we have a sense of what is killing them. There is a need to systematically and scientifically not just collect data but to also analyse it. We have managed quite well so far, and the gains need to be consolidated further for us to win this battle,” the official quoted above added.

While national CFR (case fatality ratio) has dropped to under 2% and is currently at 1.83%, the health ministry has set a target of bringing it down to 1% or below.

“The surveillance system will also put special focus on vulnerable population as they are currently most susceptible to contracting infection because they have had been largely indoors so far,” said another senior official from the integrated disease surveillance programme who did not wish to be identified.

Other focus areas that states will have to work on include making available to masses real-time information on availability of beds and ambulances across Covid-19 facilities, while significantly reducing ambulance response time.

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  • ABOUT THE AUTHOR
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    Rhythma Kaul works as an assistant editor at Hindustan Times. She covers health and related topics, including ministry of health and family welfare, government of India.

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