Death won’t be counted as Covid death after patient tests negative: Tamil Nadu health minister

CHENNAI: Covid-19 patients who die of complications such as lung diseases will not be included in the Covid death registry if they test negative for the viral infection during their hospitalisation, Tamil Nadu health minister Ma Subramanian said.
In response to the allegation by opposition leader Edappadi K Palaniswami that people were losing financial benefits/compensations from the Centre and state because of underreporting, Subramaniam said the state diligently follows the “Guidance for appropriate recording of Covid-19 related deaths in India” issued by the ICMR- National Centre for Disease Informatics and Research.
“Patients come to the hospital nearly two weeks after the onset of symptoms when they are breathless. They are positive on admission and later die of a cardiac arrest or lung failure. When they die, they are tested negative for the viral infection. This is how the state declared deaths in the first wave,” he said, citing examples of playback singer SP Balasubrahmanyam and MP H Vasanth Kumar.
“Both of them were admitted for Covid treatment. SPB’s last rites took place amidst state honours after he was declared negative. Vasanth Kumar also died after he tested negative,” he said.
But senior doctors and ICMR officials say not reporting such deaths accurately could lead to gross underreporting. The ICMR guidelines detail how Covid-19 deaths should be recorded and reported along with example scenarios. Forms 4 and 4a ask the treating doctors to write down the underlying cause, contributing/antecedent factors and immediate cause. “While a cardiac arrest may be the mode of death, lung failure would have caused it. If the underlying cause for lung failure is Covid-19, then death should be recorded as due to Covid” said ICMR-National Centre for Disease Informatics and Research Director Dr Prashant Mathur.
"Also, the National Covid treatment guidelines do not recommend repeating Covid RT-PCR tests during Covid treatment," he said.
The World Health Organisation has provided codes for Covid-19 deaths -- U07.1 for all Covid deaths and U07.2 for probable Covid deaths. In the second case, Covid-19 virus is not identified through tests, but doctors have clinically or epidemiologically diagnosed and suspected the virus, he said. Inaccurate and incomplete death recording hampered disease profiling and public health response, he said. Accurate death recording would strengthen policy and programme development, he added.