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Degenerated Hospital Infrastructures Likely to be Behind Phenomenon of Most Covid-19 Deaths in Hospitals Concentrating Within First 24-Hour of Admission

According to an analysis carried out by the Manipur Health Services Department, maximum number of COVID-19 patients died within 24 hours of admission in the hospitals. However, the analysis does not explain explicitly why this is so.

As of December 4, the number of deaths in Manipur due to Covid-19 has reached 295 while the total number of positive cases is 25,691 of which 20,119 are locals without significant travel history and the number of recovered persons are 22,445 and 2,951 remain as Covid-19 active cases.

It may be mentioned that Manipur’s Covid-19 data recorded 10 fatalities on November 29, making it the highest single-day spike.

The Health Services Department of Manipur Government has told the media on December 4 that the maximum number of Covid-19 related deaths reported in the state were of male patients. Of the 295 total deaths, 210 are male and 85 are female.

Further, the analysis found that out of total 295 people that succumbed to Covid-19, maximum cases that arrived at hospitals were reported dead within 24 hours of admission in the hospitals. In all 77 patients died within 24 hours of admission in the hospitals, 52 people died within 48 hours and 33 within 72 hours. Of the total who succumbed to Covid-19, 290 were suffering from co-morbidities. Only five Covid-19 patients were not co-morbidities. Though the analysis does not explicitly say, the figures seem to show that maximum deaths of Covid-19 patients, i.e. 290 out of 295, are due to comorbidities.

It may be mentioned that Manipur still has the highest ever Covid-19 cases of 8,942 per one million people as of December 3 while India has only 7,035 and the worldwide figure stands at 8,457, according to JHU CSSE Covid-19 data.

Meanwhile, Director of Health Services Department of Manipur Government, Dr. K Rajo explained about the analysis. He said that the department had carried out some analysis in view of the increasing number of death cases in the last week of November and during the past few days in December. The analysis was based on the collected death records from Regional Institute of Medical Sciences (RIMS), Jawaharlal Nehru Institute of Medical Sciences (JNIMS), Raj Medicity and Shija Hospital, he said.

According to the analysis, the death rate is highest between those aged 61 to 70 years. The least number of fatalities were recorded for patients under 15 years old, while the number of deaths of people between 16 years to 30 years is eight, and the number for people between 31 years to 45 years is 38. For the age between 46 years to 60 years, it is 93. For the age 76 years to 90 years, the number of deaths remained the same at 93 and between 91 years to 105 years it is three.

Further, the analysis found that the death rate is highest in Imphal West at 104 fatalities, 65 people died in Imphal East, 27 each in Thoubal and Churachandpur, 17 in Bishnupur and 12 in Kangpokpi, according to district wise data.

Though the analysis does not explain much about the reasons for the surge in deaths, the director of the Health Services Department Dr. K. Rajo observed that the rising death cases are also associated with festivals and frequent marriage ceremonies being held in Manipur.

Meanwhile the analysis, after a survey conducted by a group of medical experts of Manipur, revealed that the main reason for most of the Covid-19 related casualties in the state is late hospitalisation. The expert team headed by Dr. K. Rajo, stressed the need for raising awareness among the general public to visit a hospital as soon as the Covid-19 patient becomes symptomatic.

The survey was conducted at four major Covid-19 hospitals in Imphal including the Regional Institute of Medical Sciences (RIMS) and Jawaharlal Nehru Institute of Medical Sciences (JNIMS), the main Covid-19 hospitals of the state government.

However, the analysis does not detail the causes or reasons of late hospitalisation of the Covid-19 patients. Therefore the question why maximum of the deaths are within 24 hours of hospital admission, and why the Covid-19 patients are admitted late at the hospitals, remain unanswered.

Meanwhile, Manipur Chief Minister Nongthombam Biren has announced on December 1 that the state government would open a new 100-bedded dedicated Covid hospital at Jawaharlal Nehru Institute of Medical Sciences (JNIMS), Imphal within a week.

The RIMS hospital currently has 170 isolation beds including 17 in the ICU; JNIMS has 145 beds including 15 in the ICU, Shija Hospitals has 57 beds including 15 in the ICU and Raj Medicity has 21 beds including 4 in the ICU.

It may be mentioned that Manipur Chief Minister Nongthombam Biren reviewed the prevailing situation in the state in a meeting held on December 1. Before that the Chief Minister himself was under home isolation and tested negative for Covid-19 only on November 30.

Reports said that the Chief Minister emphasised the need for timely diagnosis and hospitalisation for effective treatment and prevention of casualties. He reportedly directed the concerned officials to regularly monitor the availability of oxygen in all the districts. The chief minister also instructed the officials to create a WhatsApp Group for the medical superintendents of all the government and private hospitals for better coordination.

However, a Covid-19 patient who recovered recently expressed to Imphal Review that the lack of infrastructures including insufficient beds, ICUs at the hospitals and bureaucratic procedures are factors of major concern in the deaths of Covid-19 patients. The procedures of Covid-19 test and hospitalisation have delayed the patient admissions into the hospitals and the present procedures have been said to be not patient friendly. The lack of Covid-19 infrastructures at the hospitals also seem to have sadly discouraged the patients from early and timely admission to the hospitals.

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