ICMR issues new guidelines to record Covid deaths, says this will help build robust data

The new guidelines are an attempt to streamline the Covid mortality surveillance in the country.

Medics and relatives carry the body of a Covid-19 patient for cremation in New Delhi, on 10 May 2020 | Manvender Vashist | PTI

New Delhi: The Indian Council of Medical Research (ICMR) Monday released a fresh set of guidelines for medical practitioners listing cause of death for patients as an increasing number of discrepancies have been reported in Covid-19 cases across the country.

The new guidelines outline a standardised form where medical practitioners have to categorise the death’s immediate cause, antecedent cause, and other significant conditions in separate columns.

This means practitioners are expected to list Covid-19 as an “underlying cause of death” leading to Acute Respiratory Distress Syndrome (ARDS), cardiac injury, pneumonia and other primary causes of death.

The new guidelines are an attempt to streamline the disease’s mortality surveillance in the country.

India’s death toll from the infection crossed 2,000 over the weekend, with as many as 2,206 deaths being reported as of Monday morning.

The missing numbers

States including Delhi, West Bengal, Gujarat and Maharashtra reported variations in their death toll due to varying metrics determining a patient’s death as due to Covid-19. The Delhi government, while acknowledging the discrepancy, issued fresh guidelines on Sunday.

In West Bengal, the death toll due to the disease went up three times on 24 April after the central government wrote to the chief secretary asking for “case records” of all coronavirus-linked fatalities. These deaths had been attributed to other causes by an expert panel constituted by the Mamata Banerjee government.

The Centre’s panel was formed earlier this month to “audit” coronavirus fatalities reported by hospitals in the state.

Gujarat has the maximum number of cases and deaths after Maharashtra, and the second highest fatality ratio in the country after West Bengal. A large number of those dying are the young.

Under pressure from the Centre, which listed Gujarat and West Bengal as states of concern on 6 May, authorities have been changing their explanations for the deaths, from patients self-reporting too late, the Tablighi Jamaat to a different virus strain.

Explaining the significance of recording the cause of death during the Covid-19 pandemic, ICMR also noted that “COVID-19 is a new disease and a pandemic affecting all communities and countries, and a robust data is needed in India to measure the public health impact of the ailment and to plan for timely health interventions”.

Deaths with inconclusive test results but in which coronavirus symptoms are present will be recorded as “probable COVID-19” fatalities. Deaths in which tests are awaited with the presence of symptoms will be recorded as suspected deaths, while those testing negative but have symptoms will be mentioned as “clinically-epidemiologically diagnosed COVID-19″, the guideline stated.