CHENNAI, Tamil Nadu — At the time of writing this, across Tamil Nadu several people are waiting for their turn to cremate someone in their family. The wait time given to some of them is around 24 hours or more.
Crematoriums across the state are overworked. Some of them have malfunctioned due to overuse. The scenes outside crematoriums are chilling. An apocalyptic pandemic, one would think. But no. Not according to the DMK-led Tamil Nadu government statistics.
There is a deathly mismatch between the number of bodies arriving at each crematorium and the number of deaths due to COVID-19 released by the State Government every day.
In Coimbatore, for example the number of COVID-19 related deaths officially reported on 19 May is 17. But in Coimbatore’s Athupalam crematorium alone scores of bodies were waiting to be cremated.
There are other crematoriums in the district where the scenes are no different.
In Dharmapuri, only one death is counted as death due to COVID-19 on 19 May. But bodies were piling across crematoriums in the district.
“Many of these deaths are not recorded as COVID-19 deaths,” says an official with the state government who did not want to be identified.
The official elaborates that patients who have died of co-morbidities without testing positive in the RT PCR test will not be counted as COVID-19 related death.
“They may have been from the susceptible population, which means they could have been COVID positive in the past but while dying, if they have not been registered as a COVID-19 positive patient the Cause of Death does not mention COVID-19. And they are not accounted for in the numbers released in the daily bulletin,” the official says.
An expert epidemiologist who did not want to be named told India Ahead that there are serious problems with the “lab bias” that Tamil Nadu has. In simple terms a lab bias is the tendency to go strictly by the lab test results alone.
“There are several RT PCR negative cases who are categorised under SARI (Severe Acute Respiratory Infections) and the numbers of fatalities are separately categorised as SARI deaths. But they may have been treated as COVID-19 under a clinical suspicion because of the classic symptoms displayed. If the treatment fails and the patient dies, it would not be counted as a COVID-19 related death because we tend to go by the lab results only,” the expert says.
“If officials go simply by the RT PCR test reports of the patients and then record deaths accordingly, there will be serious implications in the efforts to combat COVID-19,” he says, adding that there cannot be proper planning and preparing for what is to come if the actual on-ground scenario is not considered.
“This is what happened when we were faced with the Dengue epidemic in the past. Tamil Nadu went only by the NIV kit test results. This was another ‘lab bias’ displayed by the state. NIV kit test results alone were not reflecting the actual impact of dengue on ground in the state. It was because of this mismatch that handling the number of deaths became tough for the state’s health department,” the expert said. He however, added that in terms of dengue, Tamil Nadu was far better in reporting its numbers when compared to most other states.
The expert also points out that Tami Nadu used to be the pioneer of maternal death audit in the past. “We have the expertise in auditing deaths and planning accordingly for the future, but that is not what we are doing with regards to COVID-19. We need to have a thorough death audit for every life lost and then look at how the susceptible population can be saved in the near future,” the expert said.
Tamil Nadu government had recently ordered an audit of all deaths including the reconciliation of deaths. However, officials were not available to comment on the progress of the audit or to elaborate on the reconciliation of deaths which may have shown a correction in the number of COVID-19 related deaths reported earlier.