Central team raises questions on Bengal audit panel’s certification of COVID deaths

Published : April 24, 2020 22:08 IST

A private building handed over to the West Bengal government for use as a quarantine centre for suspected coronavirus cases, in Kolkata. Photo: Debasish Bhaduri

The Inter-Ministerial Central Teams (IMCT) that are visiting the COVID-19 hotspots in West Bengal have raised questions regarding the system by which the cause of death of a COVID patient is determined by the State government’s “audit committee”.

In one of the two letters sent to Chief Secretary Rajiva Sinha on April 24, Apurva Chandra, Additional Secretary to the Government of India and team leader of one of the IMCTs, wrote: “The Principal Secretary (Health) in his presentation on 23 April 2020 gave some reasons for 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 IMCT did not find the reasoning convincing as there is no comparison between a road death and a death in a hospital due to disease.”

The IMCT sought several facts from the State government, including:

i) Government order constituting the Committee of Doctors to declare cause of the death for COVID patients

ii) Case records of all COVID patients where cause of death is attributed to some other cause by the Committee

iii) Time taken by the Committee in coming to its conclusion

iv) Whether such a Committee to ascertain cause of death exists for any other disease in the State of West Bengal.

v) Whether such a Committee is in line with ICMR guidelines or medical practice.

The IMCT has also sought an interaction with the “Audit Committee” to “understand their methodology.”

On April 5, the State government set up the “audit committee” to “ascertain the cause of death of a person who has tested positive for COVID-19.” The five-member committee that conducts “audits of suspected deaths due to COVID-19”, examines the BHT, treatment history, laboratory investigation reports, death certificates and other documents necessary for ascertaining the cause of death of a patient who had tested positive for COVID-19.

The Chief Secretary, during his press briefing, said that as of April 24, the audit committee had declared 18 people dead of COVID-19, and 39 cases referred to it as deaths due to other causes, even though all were COVID-positive cases. It was the first time that the total number of cases referred to the audit committee was revealed.

“Chaotic” COVID hospitals

In its second letter, the IMCT referred to reports on social media that dead bodies were lying in beds in a ward. “On inquiry, it was informed that it is possible that dead bodies are lying on bed in a ward as it takes at least 04 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 death certificate,” the letter stated.

The Central team also pointed out that there were only 12 ventilator beds available in Bangur Hospital, even though the hospital caters to 354 serious COVID patients. The IMCT also observed that the admission of patients in the hospital appeared to be “chaotic.” “There was no social distancing in the waiting area. Some of the patients appear to be in very poor health but there was no medical support available,” the second letter stated.

IMCT also wondered why test results were taking such a long time to arrive in certain hospitals. “There were a large number of patients in the isolation wards of CNCI [Chittaranjan National Cancer Institute ] as well as Bangur Hospitals awaiting COVID test results for 05 days or longer. Specifically at CNCI, there were 04 patients since 16.04.2020 awaiting test result…,” the letter stated.