More than 60% of coronavirus disease (COVID) fatalities in Bengaluru had sought treatment three or more days after the first symptoms of illness emerged. The data of deaths across key hospitals in the city indicate this is happening because doctors urge high-risk patients to reach out for treatment after the first signs of illness, which may be their panic or precautionary reaction.
Treatment protocols at hospitals are now tuned to consider all patients arriving with severe respiratory illness and influenza-like illness as COVID cases. The Karnataka government pushed efforts to reduce the number of fatalities from that in July.
Bengaluru recorded 1,029 deaths till 31 July, with 932 deaths recorded in July alone. Nearly 65% of deaths in July occurred within 24 hours of hospitalisation of the patients. Or the patients died before reaching a hospital, according to the data given by the Karnataka health department.
At the government-run Bowring and Lady Curzon Hospital, a key COVID treatment hospital with 165 beds and 15 ICU ventilator beds, 42 patients who died had got admitted three or more days after the first symptoms showed up. Twenty other patients reported their illness within one to three days of the first symptoms. The remaining six patients reported within a day of the first symptoms, the hospital data shows.
“We lost 22 patients (over 30 percent) within 14 hours of admission, 30 patients within one to five days of admission, and 16 patients over five days after admission. All the patients had comorbidities, with 48 of them reporting diabetes mellitus as an existing co-morbidity. All came after the development of complications,” Dr Manoj Kumar, the director in-charge of the Bowring Hospital, said.
At the Rajiv Gandhi Institute of Chest Diseases, a total of 68 deaths were recorded till 31 July. According to the mortality analysis data from the hospital, at least 49 of the deceased patients (72%) reported their illness between three to seven days of first symptoms.
“Nearly 40% of the patients died within 24 hours of admission. Almost 70 to 80% died within three days of admission,” Dr C Nagaraja, the director of the RGICD Hospital, said.
At the private St John’s Medical College Hospital — the largest COVID treatment facility in the private sector — there have been 99 deaths till 31 July out of 416 patients admitted with severe breathing distress since the first cases emerged in Bengaluru. Dr Sanjiv Lewin, chief of medical services at St John’s said, “My understanding is that patients not getting to ICU in time, co-morbidities, and lack of critical care teams are the three reasons for high mortality in hospitals.”
“They usually come within three to five days to the hospital. It is when breathing difficulties emerge that a person is likely to seek medical help. It is a combination of fever, cough, and breathing difficulties that prompts a hospital visit,” Dr Lewin added. “It is logical that they will reach a hospital in three to five days. But the disease is so fast in older people with comorbidities that it gives you no time,” he said.
These hospitals are looking at all SARI cases as suspected COVID cases as well, to improve treatment outcomes. “When we call cases as SARI, nine out of 10 are confirmed COVID cases. Even if not confirmed, some are highly suspicious because the CT scan looks exactly like a COVID case,” Dr Lewin said.