A mystery: Figures in Delhi govt’s health bulletins on COVID-19 just don’t add up

The daily COVID-19 health bulletin put out by the Delhi government, it seems, aims to conceal more than reveal: The numbers in the bulletin just don’t add up – neither the active cases, nor the deaths. But what is of primary concern currently are the active cases.

An analysis of the health bulletins put out by the government shows that there are ‘missing’ active cases. According to the health bulletin of May 27, there were 7,690 active COVID-19 cases in Delhi.

The bulletin goes on to list where all COVID-19 positive cases are located. It states that as of May 27, there were a total of 2,118 positive cases in dedicated COVID-19 hospitals (DCH), 124 positive cases at dedicated COVID-19 health centres (DCHC), 482 COVID-19 positive cases at dedicated COVID-19 care centres (DCCC) and 3,878 COVID-19 positive persons were at home or in isolation.

The sum of all these Covid-19 cases is 6,608. That is a difference of 1,088 cases from number of cases of May 27 (7,690). This anomaly runs through all their daily health bulletins.

The total active cases should be the sum of all the COVID-19 cases at all locations. But, it doesn’t add up.

As of May 26, there were 7,223 active COVID-19 cases in the national Capital. At DCHs, there were 2,092 COVID-19 positive cases, 132 positive cases at DCHCs, 506 cases at DCCCs and 3,770 cases were at home or in isolation. The difference between the two figures comes to 723 cases.

In the bulletin issued on May 25, this difference was 933 cases; on May 24, it was 717; on May 23, it was 851; on May 22, it was 888; on May 21, 727, and on May 20, 968. The numbers did not add up even in April when the bulletin did not mention the number of people under home isolation.

The ‘missing cases’ could be the cases in various other hospitals in the state or it could be the patients who died, but haven’t been added in the death numbers. These could be cases in containment zones.

It is not immediately clear why there is a difference between these numbers. Repeated calls and messages by National Herald to Shaleen Mitra, who works with health minister Satyendar Jain, elicited no response. Phone calls to Padmini Singla, secretary in Delhi Government’s health and family welfare department, too went unanswered.

But this is not the only data that the Delhi government seems to be fudging. The Delhi Government has been mentioning that the deaths being mentioned in the reports are the ones where COVID-19 is the ‘primary cause of death’. The government has not explained what this means as there is no mention of ‘primary cause of death’ in guidelines issued either by the Indian Council of Medical Research or the World Health Organisation.

The ICMR guidelines state that all COVID-19 deaths have to follow certain standardised norms. According to these guidelines, a COVID-19 positive patient’s death certificate has to state immediate cause, underlying/antecedent cause, and other significant conditions causing the death.

But, this is not the only data that the Delhi government has been fudging. The Delhi government has been mentioning that the deaths being mentioned in the reports are the ones where Covid-19 is the primary cause of death.

The government has not explained what this means as there is no mention of primary cause of death in either the Indian Council of Medical Research or the World Health Organisation guidelines.

The ICMR guidelines state that all COVID-19 deaths have to follow certain standardised norms. According to these guidelines, a COVID-19 positive patient’s death certificate has to state immediate cause, underlying/antecedent cause, and other significant conditions causes death.

This means that COVID-19 would be recorded as "underlying cause of death" when it lead to death in patients suffering from chronic bronchitis, cancer, pneumonia, cardiac arrest, hypertension and Acute Respiratory Distress Syndrome (ARDS), among other conditions.

The WHO guidelines also state this clearly. In case a COVID-19 positive patient has pneumonia and ARDS, both these need to be included as causes of death, and COVID-19 would be the underlying cause of death.

The Delhi government has also vastly underreported the deaths in the state. As per figures, there have been at least 800 deaths due to COVID-19 at hospitals and cremations/burials conducted at various designated spots in the state. The government has also stopped giving the daily death numbers from May 12 onwards. It gives only the cumulative death number, which has been audited by the Death Audit Committee.

The test numbers are also a cause for concern, and the percentage of those testing positive has been increasing. As of May 27, there were 792 new cases in the city, even though only 5,783 people were tested. On May 26, there were 412 positive cases, when 4,110 persons were tested. On May 25, there were 635 positive cases, when 4,596 persons were tested. Delhi has been testing less than 6,000 persons a day for almost a month.

This under-reporting has led to a false sense of security within the citizens even as the cases continue to rise with minimal testing.