At 10 percent, Why is West Bengal’s COVID mortality rate so high?

Mangalore Today News Network

Kolkata, May 09, 2020: The state of West Bengal, at about 10 percent, has the highest COVID-19 mortality rate or Case Fatality Ratio (CFR) among all the states of India. The case fatality ratio, according to the World Health Organisation (WHO), is the number of deaths divided by the number of confirmed cases of a particular disease.

As of 6 May, the West Bengal government had announced 1,456 confirmed COVID-19 cases. The death toll of the state stood at 144, of which the government classified 72 as ‘COVID-19 deaths’ and 72 others as “deaths due to co-morbidities where COVID-19 was incidental”, Yahoo reported.

 

The state’s high mortality rate has also been flagged by the Ministry of Home Affairs recently, in a letter to the state government.

To put this in context, Maharashtra, which has the highest number of COVID positive cases so far, has a mortality rate of 3.97 percent. Slightly more than the national average of 3.42 percent.

What Leads To High Mortality Rates?

According to John Hopkins University, the mortality rate or CFR can vary from place to place depending on the following factors:

Rate of testing: If testing rates are low, CFR tends to be higher. If more people are tested, then more people with milder or asymptomatic cases are tested positive. This brings down the CFR.

Healthcare infrastructure: CFR increases if the healthcare system is under more pressure. For example, if hospitals are overwhelmed and are unable to treat as many patients as is the requirement, CFR will rise.

Demographic composition: CFR tends to be higher in regions where the average population is more aged.

In the case of West Bengal, a combination of all three factors come into play.

Low Rates Of Testing In West Bengal

As of 6 May, the West Bengal state government was doing 334 sample tests per million. The state reported its first COVID case on 18 March.

Before 21 April, when the Home Ministry’s Inter Ministerial team sent a letter to the state government complaining about low testing, the state was testing 68 samples per million.

At the same juncture, Maharashtra was testing 742 per million, while Gujarat, another state with a large number of positive cases, was testing 614 per million. This number had increased to 1,519 and 1,235 per million, respectively, on May 3, when West Bengal was testing only 252 per million, reports IndiaSpend.

The number of positive cases in the state have also been increasing exponentially since the MHA’s letter on 21 April, at an average of 62 per day.

In an interview to India Today on 11 April, the Director of the National Institute of Cholera and Enteric Diseases (NICED), which is ICMR’s nodal body in Kolkata, said that they hadn’t even received 20 samples the week before.

“There is a big drop. Last week we didn’t even have 20 samples per day. Number of samples being sent is determined by the state government, so if they send more samples, we are able to test more. I think sample collection has not been as per the recommendation. So number tests being done in Bengal is also less”, NICED Director, Santa Dutta, said in the interview.

In an interview to The Quint of 22 April, spokesperson of the Trinamool Congress, that runs the Bengal government, Derek O’Brien blamed the stunted testing in the state on faulty testing kits sent by the ICMR.

The NICED, on 19 April, said that the testing kits being sent to West Bengal by the ICMR were faulty as they had not been pre-standardised.

Epidemiologists in Kolkata, that The Quint spoke to, suggest, however, that with the testing numbers in the state increasing, the CFR will come down. They also note that initially West Bengal was testing only critical cases which then resulted in a higher death toll.