Dr Banerjee, who is also part of this group, said despite it being early days, the point to be noted was that mortality was not commensurate with the rise in cases. (Express photo by Rajesh Stephen) A state analysis of Covid-19 infections shows that case fatality rate (CFR) between February 15 and 21 was 0.67 per cent. State surveillance experts said an additional two to three weeks will provide an accurate picture on the severity of the disease due to new infections. “While there is a definite rise in cases, we cannot say the virulence has increased,” Dr Pradeep Awate, state surveillance officer, told The Indian Express.
The CFR measures severity of the disease by defining total number of deaths as a proportion of reported cases of a specific disease at a specific time. From February 15 to 21, 33,241 fresh Covid-19 cases were reported. During the same period, there were 226 deaths due to the viral infection and the CFR was estimated at 0.67 per cent. For Amravati district, which has witnessed a rise in cases, the total number of fresh cases reported from Feb 15 to 21 are 4,486. During this period, 20 deaths were reported indicating a CFR of 0.44 per cent.
Maharashtra has reported over 21 lakh cases and 51,788 deaths till February 21. Overall cumulative CFR in the state is 2.47 per cent. “While the next few weeks will provide more information on the patient’s clinical course, as of now, the CFR is less than one per cent,” Dr Awate added.
Pune district has reported 3.98 lakh cases with a CFR of 2.28 per cent. Assessment of data from hospitals across the city, however, indicates that Covid-19 mortality rate has reduced from 20 per cent in August to 5 per cent in December 2020. The report is based on a database of 13,311 patients admitted to different hospitals from July 25, 2020, to January 26 this year. Of them, 68 per cent were male, 14.4 per cent had diabetes and 16 per cent had hypertension. A total 1,515 out of 10,985 died during their hospital stay, as per the report prepared under the aegis of the Pune platform for Covid response.
According to the report, patients needing oxygen on admission to hospital are increasing whereas those requiring ICU on admission have decreased.
The report has been prepared by a volunteer group of prominent doctors, scientists, epidemiologists, heads of business and industrial establishments and start-up leaders, which is also backed by the district administration. Sudhir Mehta, coordinator of this group and president of Mahratta Chamber of Commerce, Industries and Agriculture, told The Indian Express that this new data was extremely relevant, especially as there was a rise in new infections over the past two weeks. “It just shows that early patient management is important to prevent disease severity.”
“We are interested in saving lives and a better analysis can help improve clinical practices,” Mehta said, adding that the aim was to use cross-functional power of academics, data scientists and educationists for a better analysis of the Covid situation.
While a database of serious patients admitted to hospitals has been generated, the effort was also supported by Indo-Health Software Solutions Private Ltd. “We developed the ‘I-HEALWELL’ application to understand trends, CFR rate and to get a clinical granular insight,” said Tushar Kamble, co-founder of Indo-Health Software Solutions Pvt Ltd.
Col (Retd) Dr Amitav Banerjee, head of department of community medicine at DY Patil Medical College, said after opening up there was bound to be episodic spikes.
Dr Banerjee, who is also part of this group, said despite it being early days, the point to be noted was that mortality was not commensurate with the rise in cases. “If after 15 days, mortality does not rise we can conclude that the virus is becoming less virulent. However, it will be of concern if there is a rise in Covid mortality,” Dr Banerjee said.
According to doctors, it is a “wait-and-watch” situation. For instance, at Bharati hospital, 51 patients have been admitted in the last two weeks and 12 are in the ICU “All are from Pune and 75 per cent in the ward are on oxygen support,” said Dr Jitendra Oswal, deputy medical superintendent at Bharati hospital. At Ruby Hall Clinic, Dr Kapil Zirpe, head of neuro-critical care unit, said the number of patients was on the rise. “It is too early to say, but if one is infected in the family then all six get the disease. Physical examination is being done as per ICMR guidelines and treatment protocol is being followed,” Dr Zirpe added.
Dr Atul Mulay, consulting nephrologist at Deenanath Mangeshkar hospital, said early management was crucial and the message was not to panic or shy away from testing. “Compared to six months ago, there is better knowledge available regarding diagnostics and Covid treatment,” Dr Mulay said.