Three days after National Herald published a report highlighting the under reporting of COVID-19 deaths, the Delhi government has sent an order to both private and government hospitals directing them to report all death cases to a Death Audit Committee (DAC). Its mandate is to audit each and every death in case of COVID-19 patients.
National Herald had reported that though the Delhi government has been insisting that there have been only 73 deaths, an investigation of COVID-19 deaths in all the hospitals shows that there have been more than 170 deaths. In the report, NH highlighted that though the government records show that there have been only five deaths at Lok Nayak Hospital, in reality there had been at least 47 COVID-19 deaths.
Another report in a Hindi newspaper alleged that there were close to 300 COVID-19 deaths based on investigations at cremation grounds and burial sites in the national capital.
In the order, the chief secretary Vijay Dev stated, “It has come to notice that both public and private hospitals (both COVID-19 dedicated and non-COVID hospitals) are not reporting the deaths of positive cases of COVID-19 occurring in their hospitals in a timely and regular manner.”
Squarely blaming the hospitals, the order mentioned that the government has observed that despite repeated reminders, the death summaries of the deceased patients were not being provided to the Death Audit Committee, resulting in incorrect and delayed reports being submitted.
The management of several hospitals, including LNJP Hospital, Ram Manohar Lohia Hospital and Max Hospitals, insist that they have been giving death reports to the government daily.
The order goes on to direct the reporting of COVID-19 death cases from health facilities (government and private) in Delhi should be as per the Standard Operating Procedures (SOPs).
According to the SOPs for reporting COVID-19 deaths, every hospital has to report COVID-19 deaths by email by 5 pm to the district surveillance unit and also to the state surveillance unit of the Delhi government along with the scanned copies of the case summary, medical files and other relevant data required by the Death Audit Committee.
Every COVID hospital is required to appoint a nodal officer who has to ensure that all deaths in their hospitals are communicated daily to the government. In case there are no deaths on a particular day, the nodal officer has to send a ‘NIL’ report to the committee.
The order states that the Death Audit Committee (DAC) will meet every day at 5.30 pm to examine the COVID-19 death reports to declare ‘Death due to Covid-19 or otherwise’. The senior medical officer at Directorate General of Health Services (DGHS) Dr Monalisa Borah has been directed to coordinate the activities of the DAC.
If hospitals do not send their death reports by 5 pm, the state surveillance officer has to send a reminder to the nodal officer and medical director of the hospital. If, in spite of the intervention, a hospital has not sent the death or NIL report, then the matter has to be reported to the DGHS immediately.
The Delhi government has warned that if these guidelines were not followed, strict action would be taken in accordance with the provisions of the Disaster Management Act, 2005.
On Sunday, it was widely reported that the Centre had ordered the removal of LN Hospital medical director Dr JC Passey owing to his age. However, the hospital authorities, on Monday, insisted that they had got no such orders. Passey was still on duty.
The Ministry of Health and Family Welfare has sought a clarification on the matter from the Delhi government within 10 days. Passey was appointed as the medical director of LN hospital on March 26. He had turned 62 years on June 26, 2018. A ministry order passed on October 9, 2018, states that officers who have reached the age of 62 years will not be assigned the charge of administrative posts, and they will be retained in non-administrative posts till their retirement/superannuation.