MUMBAI: Daily average Covid-19 deaths in the city dropped by 58% in November over the previous month- from 43 fatalities every day in October, it fell to 18. Besides the drastic drop in deaths, there has been another significant shift in the mortality trend. Almost 60% deaths were seen after 7-10 days of hospitalisation, unlike the initial months of the pandemic when majority deaths occurred within 24-48 hours of admission or within five days.
In November, 560 deaths were reported in Mumbai, a 58% drop from 1,322 in October and 56% less from 1,271 in September. Over 73% of November deaths were of those above 60 years of age, while 80% had co-morbidities. While the ratio of deaths in people with co-morbidities remains consistent at 80%, deaths among elderly are rising. For instance, 71% deaths in September were of those above 60, which rose to 73% in November.
The team that analyses Covid-19 deaths evaluated 60-80 deaths in randomly selected hospitals. Former KEM dean Dr Avinash Supe, who heads the audit committee, said maximum deaths were among seniors with co-morbidities who spent more than 7-15 days in a hospital without improvement. "This is a major shift we have seen now. Earlier, up to 40% deaths were within 24-48 hours, but that number has drastically shrunk," he said. Importantly, there are hardly any 'brought dead' cases now, he said. Deaths in 24-48 hours are indicative of poor understanding of Covid symptoms.
Mumbai saw the highest number of Covid deaths in June: 3,277 lives were lost and case fatality rate was 8.6%, which civic officials said was partly because of reconciliation of previous unrecorded deaths. The toll began to decline in August. Though the city saw the highest number of Covid cases in September (60,400), deaths (1,271) were fewer than in June, July (1,797) and August (1,305), even though the positive cases in these months were almost half the number in September.
Intensivist Dr Rahul Pandit concurred that not many deaths are being seen in younger patients. "Most deaths are in the second and third week of hospitalisation among elderly with comorbidities. They come to us when they are very sick and have 100% lung involvement or multi-organ dysfunction," he said. Factors that have helped to bring down the city's mortality, he said, include timely consultation with a doctor, fewer late presentations and adherence to treatment protocols across hospitals.
Dr Trupti Trivedi, who heads the medical ICU at Sion Hospital, said the limited deaths in young patients are mainly due to stroke and heart attacks. "Many of them test positive for Covid but there is always the question whether it was an incidental infection," she said, adding that even the public hospital is seeing deaths after long hospitalisation. Dr Pandit said often when an elderly contracts Covid, relatives don't realise it as the person would not have stepped out of the house. "People living with elderly members need to be very cautious," he said.