As Goa fatalities cross 200, doctors call for death audit

PANAJI: Over a month after testing positive for Covid-19, a woman battling cancer and diabetes succumbed on Monday. Deprived of insulin and a proper diet, her health deteriorated and her family had to shift her to a private hospital. But the damage was already done.
The death, relegated to another statistic, found no mention in the state government’s daily bulletin on Covid-19.But medical professionals say it presents yet another reason why the state government needs to conduct an authoritative and thorough audit of Goa’s Covid strategy and deaths.
Perturbed over the sharp increase in Covid-19 cases and the deaths, now 204, doctors and researchers recommend the state government needs to assess and analyse the spread of the pandemic in the state and prepare a death audit.
“Detailed data on deaths should be released, so that doctors and researchers can learn. It will also help other doctors treat patients and save further lives,” said pulmonologist and former president of the Indian Medical Association – Goa, Dr Anil Mehndiratta. As of now, the government dismisses most deaths as “comorbidities”.
Doctors, both from the public and private sector, said that a detailed audit can identify gaps in treatment strategies for different comorbidities, and help improve the directorate of health service’s protocol for treatment of Covid-19 patients. An audit will also assist policymakers in managing the pandemic, which has already infected 1% of the state’s population.
IMA-Goa is currently assisting the state government by monitoring and treating asymptomatic Covid-19 patients who have opted for home isolation. Assisted by the Indian Dental Association, doctors call patients twice a day and use tele-medicine to track the patients for 10 days.
“Because of Goa’s sedentary lifestyle, our eating habits, Goans are more prone to lifestyle diseases such as diabetes, hypertension, and cancer, which in turn lead to low immunity,” said IMA-Goa president Dr Samuel Arawattigi.
Doctors, speaking on condition of anonymity, questioned why the government is being secretive about the pandemic. The way a healthy person reacts to Covid-19 drugs such as Remdesivir, FabiFlu or steroids is significantly different from the way a diabetic patient or someone with hypertension will react to the same drugs, and this information can help the medical fraternity, they say.
“I agree that there is a need for a study. I think a lot of the issues surrounding Covid cases and awareness can be resolved through a study,” said former dean of Goa Medical College (GMC), Dr Vinay Jindal.
Sources also pointed out that quite a few healthcare professionals have tested positive for Covid-19, which is a cause of worry. The state government and the daily bulletin are silent about this figure. “It is very important to find out why healthcare workers are testing positive,” a senior doctor said. “Is it that the PPE is of bad quality, are they not being used, or are the protocols for donning and doffing improper?”
A few days earlier, the Kerala government released its death audit report that identified early symptoms of Covid-19 and also highlighted the role of hospital-acquired infections. Kerala’s Covid death report also suggested that proper awareness about early indicators of the infection can help patients seek treatment in time.
GMC dean Dr Shivanand Bandekar has confirmed that quite a few of the patients who lost their lives to the pandemic were brought to the hospital at least 10 days after they contracted the virus.
Goa’s case fatality ratio for Covid-19 has touched 1.1%, with the state witnessing a spurt in deaths over the past two weeks.
Data from asymptomatic cases, said epidemiologists and researchers, needs to be studied along with the treatment given to moderate to severe cases, so that a focused approach among people with comorbidities could be developed.
“A death audit that brings out how and why people died, the co-morbidities that they had, and the treatment that was given, can help improve the way we handle cases. The way the daily Covid bulletin is prepared, it does not give a proper picture,” a DHS doctor said.