‘Primary cause key to determine Covid death’

Bhubaneswar: At least 91 Covid-19 patients have died in the state till Monday morning. However, the government claimed that 21 of them died due to diseases other than Covid.

According to state government’s data, five coronavirus patients died due to non-Covid reasons in Khurda district while the number is three for Cuttack, two each for Balasore, Mayurbhanj, Bhadrak & Ganjam and one each for Kendrapara, Keonjhar, Nabarangpur, Puri and Sundargarh districts.

The Indian Council of Medical Research (ICMR) has issued detailed guidelines for physicians to detect the cause of death in a Covid patient. “The cause of death (COD) is defined as all those diseases, morbid conditions or abnormalities, injuries which either resulted in or contributed to death and the circumstances of the accident or violence which produced any such injuries,” ICMR defined in its guidelines.

In its guidance for the appropriate recording of Covid-19 deaths in India, the ICMR said deaths with inconclusive test results, but in which coronavirus symptoms are present will be recorded as “probable Covid-19” fatalities.

Covid-19 would be recorded as an “underlying cause of death” when leading to pneumonia, cardiac injury and clotting in the bloodstream, among others, it said.

Patients may have other pre-existing comorbid conditions such as chronic obstructive pulmonary disease (COPD) or asthma, chronic bronchitis, ischemic heart disease, cancer and diabetes mellitus. These conditions increase the risk of developing respiratory infections and may lead to complications and severe disease in a Covid-19 positive individual. These conditions are not considered as an underlying cause of death as they have directly not caused death due to Covid-19, the ICMR mentioned.

Director of Regional Medical Research Centre (RMRC) Sanghamitra Pati said, “When death of a Covid-19 patient occurs, we see the primary cause of the death. For example, if a cancer patient dies and the death is not due to pneumonia or acute respiratory distress syndrome, then it will be treated as non-Covid death.”

Senior doctor and director of medical education & training CBK Mohanty said it is a technical thing and the treating doctor decides the cause of death of Covid positive patient. “As per ICMR guidelines, they decide the reason behind death. The primary reason for the death will be treated as cause of death. There might be secondary and tertiary reason.”

In one case, a truck driver from Nagpur in Maharashtra was killed in a road mishap in Sambalpur recently. When, his sample was sent for test, he was found Covid positive, he said, adding, “In this case, we cannot say he died due to the coronavirus.”     Asked about whether the government is trying to hide the Covid death, Mohanty said, “No one can hide the data. Whenever a person is found Covid positive, his/her details including health status is being uploaded in the national dashboard.”

Biswa Bhusan Mohapatra, OP

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