High fatality rate: Punjab conducting gap analysis of patients on ventilators

CHANDIGARH: Struggling with the low survival rate of coronavirus patients on ventilator support, the Punjab government is conducting a gap analysis for taking corrective measures to bring down the Covid-19 fatality rate.
The deaths rate among the patients on ventilators in Punjab — which has been reporting the highest mortality rate in the country from the past three months — is over 90%.

There has been a drop in the number of patients requiring oxygen, intensive care units (ICUs) and ventilator support in the last one month but their survival rate continues to be low, leaving the health experts worried. Earlier, the average number of patients whose condition became serious daily was 20, which has now dipped to around five, according to the state health department officials. Patients are put on a ventilator when their lungs fail to perform the breathing process.
To help the government identify issues impacting the efficiency of the treatment of patients on ventilators, a team of experts led by Dr K K Talwar, Punjab government’s adviser on health issues, is conducting the study. All hospitals — government and private — have been asked to provide real time details of all patients, including comorbidities in those put on ventilators.
The hospitals have been asked to submit details of reason for considering invasive ventilation, date of starting invasive mechanical ventilation, mode of oxygen therapy before invasive ventilation, Glasgow coma scale, oxygen saturation, fraction of inspired oxygen, respiratory rate, systolic blood pressure, diastolic blood pressure, vasopressors/inotropes, urine output in last 24 hours, partial pressure of oxygen, arterial blood gas analysis (ABG), c-reactive protein, trial of supportive therapies and Covid-specific drugs such as Remedisvir, steroids, anticoagulant and tocilizumab.
As per the analysis of 4,769 deaths, done by the state health department, 2,092 deaths occurred at government facilities having intensive care units, ventilators and oxygen support system for providing treatment to critically ill patients, while 2,345 people died during treatment at private level-III facilities.
Punjab health department spokesperson for Covid-19 Dr Rajesh Bhaskar said the government was working on improving the survival rate of patients on ventilator which at present was low.
The gap analysis would help in taking corrective measures. “In Punjab, the majority of the patients, who put on ventilator support were elderly and suffering from comorbidities. In many cases, there was also delay in approaching hospitals for treatment,” he said.
As by the time a patient is put on a ventilator, the infection has already done an irreversible damage in most of the case, the Punjab chapter of Indian Medical Association (IMA) laid stress on testing for timely detection and timely treatment of infected people. “The survival rate of patients on ventilators is very low everywhere. Early detection and treatment is the only way to bring down the mortality rate,” said Dr Paramjit Mann, general secretary, IMA, Punjab.
Leading the pack
Punjab has the highest mortality rate of 3.1% in the country, followed by Maharashtra and Gujarat, where 2.6% and 1.9% of the total infected people have succumbed to the virus. The national fatality rate is 1.4%.
State records 617 cases, 16 deaths
Punjab reported 617 cases of Covid-19, while 16 people succumbed to the virus on Wednesday. The state’s overall tally of cases stands at 1,57,928, while the virus has claimed the lives of 4,980 people. A total of 530 people were discharged from hospitals after recovering. Jalandhar reported six deaths, while two each died in Tarn Taran and Mohali, and one each in Barnala, Ludhiana, Pathankot, Patiala, Ropar and Sangrur.