MUMBAI: A steady decline in Mumbai’s Covid-19 case fatality rate (CFR) has found a mention in a report by the central team that recently visited some of the worst affected wards. It noted that the CFR dipped from 6.35% on April 11 to 3.92% on April 26, even as cases multiplied 3.7 times in the same period—from 1,036 to 3,917.
CFR is the ratio of Covid-19 deaths to the number of patients who have tested positive. The report also underlined that the city’s CFR was better than the state’s average of 4.3% at the later date; in fact, Mumbai was closer to the national CFR of 3.1%. However, with 51 deaths in the last two days, the city’s CFR marginally rose to 4.06% on Wednesday.
At the beginning of April, the CFR touched 7% for the city, following which a task force was formed to evaluate why the death rate was so high. Soon after, the deaths dropped to a single digit, but double digit mortalities have again been seen in nine out of the past 10 days. Incidentally, the city recorded its highest deaths in a single day (26) on Wednesday.
BMC’s additional municipal commissioner Suresh Kakani said while deaths were a cause for concern, many preventive measures have been put in place. “We found many came and died in the hospitals within hours, mainly because of extremely low oxygen levels. So we have started screening senior citizens with low oxygen saturation levels and putting them under treatment,” he said.
Experts, however, raised questions on whether CFR alone can give a true picture of the situation. Dr Subhash Salunkhe, member of the state’s Covid-19 task force, said denominator (the number of people testing positive) plays a big role here. “In places where testing is high, CFR will automatically go down,” he said. In evaluation of deaths, it has emerged that people with co-morbid conditions are predisposed to suffer from a more critical form of the disease or die of it.
Bhopal-based Dr Anant Bhan, a researcher in bioethics and global health and policy, said: “Currently, tests are mostly focusing on people coming to hospitals and their contacts. A better picture could emerge if tests were happening at the community level too.”
Several Mumbai doctors, however, raised questions over the magical dip in CFR. “Home deaths could be falling between the cracks as they are neither hospitalised not tested for Covid-19,” said a senior physician, adding that as soon as such cases are brought to hospitals, they are sent back to be certified by community doctors.
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