The numbers don’t add up. TN could lose out for under-reporting its active cases

Active Covid cases (people undergoing treatment) are being grossly under reported in the state, jeopardising its share of oxygen and drugs such as antiviral Remdesivir or immunosuppressant tocilizumab. The Centre makes the allocation based on the number of active cases.

In the past one week (between April 30 and May 6), the state added 1.49 lakh fresh Covid cases. After 1,041 deaths, there should have been at least 1.48 lakh people under treatment on Thursday, but the state reported 1.31 lakh cases. Epidemiologists say the under reporting could be much more considering that several people (some estimates put the number at 20,000) infected before April 30 would still be under treatment. On Friday, when the state added 26,465 new cases, the active case number was revised to 1.35 lakh.

Most allotments – drugs, medical equipment, testing kits or vaccines — made by the Centre are based on demand and the number of people on the active registry. “There is no doubt that the Centre has miscalculated oxygen allocation to the state. But TN’s statistics could be adding to this misery,” said former director of public health Dr K Kolandaswamy.
Neighbouring Andhra Pradesh was allotted 500 tonnes of oxygen a day for the 1.8 lakh active cases and Telangana got 360 tonnes for 73,000 active cases. “We should account for people in hospitals, home isolation and those on transit in ambulances. The simplest way to do this is to ensure they don’t get out of the registry for at least two weeks after testing,” Kolandaswamy said.

Officials in the public health department said one of the main reasons for the mismatch is early discharge from hospitals. “Many hospitals now discharge patients on the second or third day if they don’t require oxygen or have any other complaints that require intense monitoring. Though many of these patients are sent for home isolation, their names inadvertently get added to the discharged list,” an official said.

Between April 30 and May 6, Chennai reported 42,727 cases. After accounting for 319 deaths, the city should have had at least 42,000 active cases. But the city reported just 33,316. Director of public health Dr T S Selvavinayagam said the state protocol permits discharge of patients ten days after symptoms. “Many people go for testing only on the third or fourth day of symptoms and by the time results arrive many of them are healthy. So, they may get discharged fast too,” he said.

Infectious diseases experts say at a time when there is increasing concern over reinfection and relapse of Covid-19, early discharges from the registry can be dangerous. “All international organisations such as WHO and CDC recommend at least 14 days isolation. There are scientific reasons for this,” said infectious disease expert Dr Subramanian Swaminathan. “These people can still transmit the virus and infect others. More than that, evidence shows that severe disease occurs in the second week. In that period, morbidity and mortality is high. Besides artificially pushing up recovery, it will increase deaths,” he said.