Serosurvey reveals underreporting of Covid-19 deaths in 7 districts

Seven districts in Karnataka have shown a clear indication that cases and areas of circulation of Covid-19 are being missed, and that they are under-reporting deaths, concluded researchers of the state’s serosurvey.

The districts in question are Ballari, Belagavi, Bidar, Kalaburagi, Mandya, Raichur and Vijayapura.

The surveyed population in these districts had high antibodies indicating that they all had a past infection. The said districts had a high case-to-infection ratio which is a measure of undetected infected individuals for every RT-PCR confirmed case.

The aforementioned districts, despite having high antibodies in its surveyed population, had a low infection fatality rate that means there is under-reporting of deaths. The districts have been asked to at least prioritise verbal autopsies as currently Covid patients’ autopsies are being avoided largely. The serosurvey report has recommended strengthening death audits to ensure efficient clinical management.

Vijayapura has the highest case-to-infection ratio in the entire state (higher than the state average of 1:40) with 1:111 which means for every RT-PCR confirmed case 111 infected individuals are going undetected, which is worrisome. At the same time, it has the least infection fatality rate in the state at 0.02% (lower than the state average of 0.05%) and the highest rate of antibodies with 23.9% (higher than the state average of 16.4%) indicating a significant percentage of people with past infection.

Not surprisingly, Vijayapura till Wednesday reported only 196 deaths and 12,807 cases.

P Sunil Kumar, Deputy Commissioner, Vijayapura, told DH, “Death audit has been done for 177 Covid deaths, so far. The remaining 19 cases are pending for audit. For all deaths, verbal autopsies are being done. We have also been testing all vulnerable populations, all primary contacts, and symptomatic secondary contacts. Officials regularly visit their homes and check if they have any symptoms. We do target testing, which is why our positivity rate hovers around 4% to 5%.”

The district has 15 private hospitals, two medical colleges and one district hospital.

“It is not a case of under-reporting but a case of late reporting by private hospitals, by 20 to 30 days. From August, they started updating deaths every day, in an app. As far as deaths where the patients were not diagnosed for Covid while alive, the revenue department is tracking if there was a rise in non-Covid deaths in any village in the district. The serosurvey in Delhi and Dharavi said the Covid prevalence is 20% to 30% but that cannot be the bar, I think,” Kumar added.