The Supreme Court’s rap on Wednesday for the Centre’s failure to recommend ex gratia to all families who lost their loved ones to COVID-19 is likely to open a Pandora’s box as all States, including Kerala, may now have to take a relook at their declared COVID death data and come clean on the actual number of deaths so that no family is denied this financial assistance.
A COVID death data reconciliation exercise is thus definitely in order in Kerala, where the Health Department stands accused of data manipulation or undercounting of COVID deaths.
The excess death mortality analysis of the State done by The Hindu had revealed that the State had an overall excess death count of 13,868 between April 2020 and May 31, 2021. This was 1.6 times the official COVID count of 8,816 during the period. The undercount factor for 2021 alone, though much lower than other States, was 2.7.
Now that the court has brought up the issue of ex gratia relief to the families who lost their kin to COVID, drawing up an accurate list of COVID deaths by accounting for a more rational and simplified definition of COVID deaths and issuing proper death certificates to all will be imperative.
Simplifying process
The court has asked the Centre to make the death certification process as simple as possible and issue certificates with cause of death as “death due to COVID-19” in all cases where a person has died within two to three months after he/she tested COVID -positive. (as the patient might have died due to the complications precipitated by COVID).
Following much criticism, the State has now put in place a decentralised online system for reporting COVID deaths wherein death data are uploaded directly from hospitals. The new system has done away with the time lag in death declaration, ensuring currency and completeness of data. But COVID-related deaths that occur at home after discharge might be captured only much later.
However, Kerala still needs to account for some 3,000-5,000 “missing” deaths in its COVID death list, public health experts reckon. Even if the State had included all these deaths, Kerala’s case fatality rate would still be below 1%. Unfortunately, the obsession to showcase low case fatality rate as Kerala’s singular achievement has cast a shadow on the State’s otherwise excellent record in pandemic control.
“Kerala will have to set up an expert committee to go over the backlog of undeclared COVID deaths. It will also need to set up a grievances redressal mechanism so that families who lost kin to COVID can put up their claim for verification. If compensation is on offer, there could be a multitude of claims which will all have to be scrutinised,” says a senior public health expert.
He says that the easiest way to do a data reconciliation exercise will be by using the Lab Data Management System portal, which has the records of all persons who tested COVID-positive in the State.
The outcome of all positive cases can be cross-checked and in the case of deaths, the cause of death can be verified from the death certificate.