COVID-19 in Tamil Nadu: Data discrepancy and flaws in protocols mar the State’s battle against coronavirus

Tamil Nadu’s anti-pandemic strategy is marred by flawed protocols and alleged manipulation of numbers.

Devotees gathered at Vadapalani temple in Chennai on September 17. COVID infection numbers were expected to go up in the State because of gatherings at “auspicious” occasions till mid-September.

The Tamil Nadu government seems to be following a two-pronged strategy to create the impression that the number of COVID-19 deaths is on the decline—one, fudge figures and, two, declare some of those who have underlying diseases and die of COVID as having died because of non-COVID reasons.

Allegations of data fudging have been there from the time the pandemic began to spread rapidly in the State around June. At one point, the government was even forced to correct a major discrepancy in the number of patients who had died. September saw a similar discrepancy in numbers.

At a recent meeting, a top Health Department official told representatives of private medical institutions that they should conduct the COVID test on the dead bodies of every critically ill patient. Apparently, they were to record any death as having happened because of COVID only if the test was positive. This is against the government of India guidelines or international norms which state that comorbid conditions should not be considered as the underlying cause of death in patients who die of COVID.

However, Health Minister C. Vijayabhaskar makes it a point to differentiate between a COVID death and comorbidity-related death. The daily press releases from the Health Department list all the comorbidities of a patient who die of COVID in an attempt to make it seem as if those illnesses killed the patient and not the virus. The government is yet to give a coherent explanation of the discrepancy between the number of deaths of doctors from COVID and the figure put out by the Indian Medical Association.

The number of deaths in the State in September is as follows: 57 (September 16), 68 (September 15), 53 (September 14), 74 (September 13), 76 (September 12), 77 (September 11), 64 (September 10), 78 (September 9), 87 (September 8), 89 (September 7), 88 (September 6), 61 (September 5), 79 (September 4), 92 (September 3), 98 (September 2) and 96 (September 1).

With many more sectors of the economy opening up in September and with the discontinuation of the e-pass system for inter-district travel, infection rates and fatalities were expected to rise after a two-week period. But with the government’s moves to record the number of deaths technically in a different way, it is difficult to say whether the pandemic is under control in Tamil Nadu or not.

Anecdotal evidence from both public and private hospitals suggests that COVID-related deaths have not decreased over time. “I used to see about five deaths earlier in a week [during May-June]. Now it is at least 10,” said a doctor who is on the death audit committee of a hospital. Two government doctors said that the higher death numbers in State medical college hospitals was because the patients turned up at a very late stage. This is also because private hospitals discharge patients when they find their conditions worsening. From the early days of the pandemic, the number of deaths in government hospitals has been much higher than the number in private institutions.

Hospital death audit committees are struggling to conduct a thorough inquiry into the deaths because of the large number of patients involved. Given the fact that the committee members are also practising doctors, most of them find it difficult to spare time for an elaborate inquiry into each of the deaths.

In a rather strange case, H. Vasantha Kumar, a Member of Parliament who died of COVID, had tested negative before his death, a top official told this correspondent. This case was recorded as a COVID death. But the body was handed over to relatives against COVID protocols. A senior doctor explained that in the case of the MP, there was no risk of transmission as he had tested negative and hence there was no problem in handing over the body to relatives. The doctor said that earlier, hospitals had not been testing for COVID in the end stages of a patient. With the new instructions, all critically ill patients would be tested.

Erratic cases

The progress of COVID in many patients in Tamil Nadu is extremely baffling. An MLA who was admitted to a hospital after he tested positive for COVID, tested negative only after 71 days. The doctors are perplexed as available scientific evidence points to the fact that recovery begins after two weeks in the case of most patients. This patient now has breathing difficulty.

A senior doctor recalled the case of a patient who remained positive for 35 days. No research is being conducted on these erratic cases because doctors say they are stretched thin. “It is not possible to study any of these cases. You should visit a hospital to find for yourself how difficult it is for the doctors and paramedics to work with all the additional precautions,” said a doctor, adding that he was “plainly exhausted” by the end of the day because he feels he does not get enough oxygen.

COVID infection numbers were expected to go up in the State because of gatherings at “auspicious” occasions till mid-September. People packed into halls for weddings and other ceremonies used to be a common sight across the State.

Functions such as marriages are usually not held in the Tamil month of Purattasi, which began on September 17. This reduces the chances of communal gatherings and may be a sign of hope in the State.