Kolkata: The central team visiting Kolkata to assess the COVID-19 situation wrote to the West Bengal government on Friday seeking a detailed report regarding the functioning of the coronavirus death audit committee and a meeting with its members.
In a letter to Chief Secretary Rajiva Sinha, the Inter Ministerial Central Team (IMCT) led by senior bureaucrat Apurba Chandra sought to know the system of approving the declaration of death of COVID-19 patients by the committee of doctors set up by the state government.
Bengal reported three virus-related deaths on Friday, taking the death toll to 18. Sinha said the audit committee has so far examined 57 deaths of which 18 are directly related to COVID-19.
"The remaining 39 people died due to severe co-morbid conditions, which were immediate causes of the deaths and coronavirus was the incidental finding,” he said.
As far as the total number of cases is concerned, the state government's figures put it at 503, while the website of the Union Ministry of Health and Family Welfare showed 514.
Meanwhile, the central team that reportedly interacted with the state principal secretary (health) and director of health services, besides visiting a number of hospitals and quarantine centres, expressed several concerns in its letter to Sinha.
"The principal health secretary on April 23 gave some reasons for the establishment of the committee of doctors and also mentioned that if a COVID patient dies in a road accident, he cannot be said to have died of COVID," the letter read.
"The IMCT did not find the reason convincing as there is no comparison between a road death and a death in a hospital due to disease," he said. The team sought the case records of all the COVID-19 patients, where the cause of death is attributed to some other cause by the committee.
"We would like to know whether such a committee is in line with ICMR guidelines or medical practice," Chandra added.
The team further pointed out multiple flaws on the government’s initiative in containing the virus spread, including a large number of patients being kept at isolation wards and hospitals facing difficulties in receiving test reports even after a week.
“There were a large number of patients in the isolation wards of Chittaranjan National Cancer Institute (CNCI) as well as MR Bangur hospitals awaiting COVID test results for five days or longer. Specifically at CNCI, there were four patients awaiting test result since April 16, 2020, two patients awaiting test result since April 17, 2020, and three since April 18, 2020. Some of the patients have tested negative. It is not clear why the test results should take such a long time and there is a danger of COVID-19 negative patient acquiring the infection in the hospital while awaiting test result,” the letter read.
Chandra said there was a chaotic scene at MR Bangur Hospital during his visit and expressed concern over no medical support being provided to two critically ill patients. He also pointed out gross violation of social distancing norms in the waiting area of the hospital.
On patients being referred to other hospitals, Chandra said if ‘referred patients’ were not escorted by health workers, then there are high chances that they may not turn up to the other hospitals where they were referred or may delay in admitting themselves.
The letter said the rate of testing in the state is in line with the rate of testing in other states at a corresponding period of time.
“Details may be furnished of those having returned to Kolkata from abroad, when the first testing protocol was introduced, till March 8, 2020, and whether all those who returned from abroad and were required to be tested were found negative till the date that the first case was detected,” it said.
The team has also sought an explanation of social media posts about bodies lying on beds in a ward. “On inquiry, it was informed that it is possible that bodies are lying on bed in a ward as it takes at least four hours to issue a death certificate, after which the body is shifted to the mortuary. It is not clear why a body should lie in a ward in full view of other patients and not shifted to the mortuary even while awaiting a death certificate. Records may be furnished for how much time it takes to issue a death certificate and shift a body to the mortuary,” the letter read.
Later, during a press conference, Chief Secretary Rajiva Sinha refuted claims on non-cooperation on the part of the state government with the central team, adding that he would look into the concerns raised by IMCT.
“As far as their findings at some of the hospitals are concerned, I will soon meet with officers of the respective hospitals to resolve the issues (if found any).”
Regarding a government medical college refusing a patient, Sinha said strict action would be initiated against those found guilty.
When asked about the IMCT seeking clarification on the audit committee formed to ascertain the actual causes of deaths, Sinha said the panel was formed to keep a track on direct COVID-19 deaths and those dying of serious co-morbid conditions.
“From April 3, the committee have examined 57 deaths so far. Of these, 18 deaths are directly related to COVID-19 and the remaining 39 people died due to severe co-morbid conditions, which were immediate causes of the deaths and coronavirus was the incidental finding.”
Releasing the audit committee report, Sinha said, “The examination was done based on bed-head ticket, treatment history, laboratory investigation reports and death certificates.”
“The co-mobidities were cardiomyopathy with chronic kidney disease, renal failure, cerebro-vascular-accident, acute lymphoblastic leukaemia, left ventricular failure in severe hypertension, multi-organ failure in type-II diabetes and hypertension, red cell aplasia in a case of severe diabetes and hypertension and severe diabetes with hypertension with hypo-natremia,” the report read.
Meanwhile, Sinha said during the last 24 hours, 51 new COVID-19 positive cases were detected in Kolkata and districts of Howrah, North 24 Parganas, Hooghly, Purba Burdwan and Purba Medinipur, he said.
"Three deaths were confirmed by the audit committee, taking the total number of deaths in West Bengal to 18," Sinha said.
He said 943 samples were tested for coronavirus during the past 24 hours and 103 patients have been discharged from hospitals till Friday. Sinha said a total of 8,933 samples have been tested for the coronavirus till now in the state.
(With inputs from PTI)