Tag Archives: Private hospitals

Indian state sharply raises COVID-19 death toll prompting call for wide review

By Manas Mishra and Neha Arora

BENGALURU/ NEW DELHI (Reuters) – An Indian state has raised its COVID-19 death toll sharply higher after the discovery of thousands of unreported cases, lending weight to suspicion that India’s overall death tally is significantly more than the official figure.

Indian hospitals ran out of beds and life-saving oxygen during a devastating second wave of coronavirus in April and May and people died in parking lots outside hospitals and at their homes.

Many of those deaths were not recorded in COVID-19 tallies, doctors and health experts say.

India has the second-highest tally of COVID-19 infections in the world after the United States, with 29.2 million cases and 359,676 deaths, according to health ministry data.

But the discovery of several thousand unreported deaths in the state of Bihar has raised suspicion that many more coronavirus victims have not been included in official figures.

The health department in Bihar, one of India’s poorest states, revised its total COVID-19 related death toll to more than 9,429 from about 5,424 on Wednesday.

The newly reported deaths had occurred last month and state officials were investigating the lapse, a district health official said, blaming the oversight on private hospitals.

“These deaths occurred 15 days ago and were only uploaded now in the government portal. Action will be taken against some of the private hospitals,” said the official, who declined to be identified as he is not authorized to speak to the media.

Health experts say they believe both coronavirus infections and deaths are being significantly undercounted across the country partly because test facilities are rare in rural areas, where two-thirds of Indians live, and hospitals are few and far between.

Many people have fallen ill and died at home without being tested for the coronavirus.

‘WIDESPREAD PROBLEM’

As crematoriums struggled to handle the wave of deaths over the past two months, many families placed bodies in the holy Ganges river or buried them in shallow graves on its sandbanks.

Those people would likely not have been registered as COVID victims.

“Under-reporting is a widespread problem, not necessarily deliberate, often because of inadequacies,” Rajib Dasgupta, head of the Centre of Social Medicine and Community Health at New Delhi’s Jawaharlal Nehru University, told Reuters.

“In the rural context, whatever states may say or claim, testing is not simple, easy or accessible,” Dasgupta said.

Overall, India’s cases and deaths have fallen steadily in the past weeks after a surge from mid-March.

The official total of cases stood at 29.2 million on Thursday after rising by 94,052 in the previous 24 hours, while total fatalities were at 359,676, according to data from the health ministry.

The New York Times estimated deaths based on death counts over time and infection fatality rates and put India’s toll at 600,000 to 1.6 million.

The government dismissed those estimates as exaggerated. But the main opposition Congress party said that other states must follow Bihar’s example and conduct a review of deaths over the past two months.

“This proves beyond a doubt government has been hiding COVID deaths, ” said Shama Mohamed, a spokeswoman for Congress, adding that an audit should also be ordered in the big states of Uttar Pradesh, Madhya Pradesh and Gujarat.

(Reporting by Manas Mishra in Bengaluru and Neha Arora in New Delhi; Editing by Sanjeev Miglani)

Analysis-India’s vaccine inequity worsens as countryside languishes

By Krishna N. Das, Abhirup Roy and Rajendra Jadhav

NEW DELHI/SATARA, India (Reuters) – Urban Indians are getting COVID-19 shots much faster than the hundreds of millions of people living in the countryside, government data shows, reflecting rising inequity in the nation’s immunization drive.

In 114 of India’s least developed districts – collectively home to about 176 million people – authorities have administered just 23 million doses in total.

That’s the same number of doses as have been administered across nine major cities — New Delhi, Mumbai, Kolkata, Chennai, Bengaluru, Hyderabad, Pune, Thane and Nagpur — which combined have half the population.

The disparity was even stronger last month, after the government allowed private sales of vaccines for adults aged under 45 years, an offer which favored residents of cities with larger private hospital networks. For the first four weeks of May, those nine cities gave 16% more doses than the combined rural districts, data from the government’s Co-WIN vaccination portal shows.

“My friends from the city were vaccinated at private hospitals,” said Atul Pawar, a 38-year-old farmer from Satara, a rural western district of Maharashtra, India’s wealthiest state. “I am ready to pay, but doses are not available and district borders are sealed because of the lockdown.”

The Ministry of Health and Family Welfare did not respond to a request for comment.

India has administered more than 222 million doses since starting its campaign in mid-January – only China and the United States have administered more – but it has given the required two doses to less than 5% of its 950 million adults.

Rural India is home to more than two-thirds of the country’s 1.35 billion people. While urban areas account for a disproportionately large share of the confirmed COVID-19 cases, those concerned about the spread of the virus in the countryside say statistics undercount cases in villages, where testing is less comprehensive.

The health system in several regions in India collapsed in April and May as the country reported the world’s biggest jump in coronavirus infections, increasing pressure on the immunization program.

Prime Minister Narendra Modi’s government offers vaccines to vulnerable people, healthcare workers and those aged over 45 for free. Since last month, individual states have also been expected to procure vaccines for younger adults, or to provide them commercially through the private sector.

Poorer states say this leaves their residents more vulnerable. The eastern state of Jharkhand, where nearly all districts are categorized as poor, this week urged Modi to give it free vaccines for all age groups.

In many states the doses for those under 45 are available mostly or entirely in urban areas. Some officials say this is intentional, as the infection spreads more easily in crowded cities.

“It’s because of high-positivity” in urban areas, said Bijay Kumar Mohapatra, health director of the eastern state of Odisha, explaining the state’s decision to prioritize cities.

Major international and domestic firms such as Microsoft, Pepsi, Amazon, Reliance Industries, Adani Group and Tata Motors have organized inoculations for their employees, in many cases in partnership with private hospitals. Most of these companies and the huge private hospitals that serve them are located in urban centers.

Vaccination rates in rural areas have also been depressed because of patchier internet access to use the complex online system for signing up for shots, and possibly because of greater hesitancy among villagers than among city dwellers.

“LUCRATIVE DEALS”

India’s Supreme Court criticized the government’s handling of the vaccination program this week and ordered it to provide a breakdown of shots given in rural and urban areas.

“Private hospitals are not equally spread out” across the country and “are often limited to bigger cities with large populations”, the top court said in its order dated May 31.

“As such, a larger quantity will be available in such cities, as opposed to the rural areas,” it said. Private hospitals may prefer to sell doses “for lucrative deals directly to private corporations who wish to vaccinate their employees”.

Dr. Rajib Dasgupta, head of the Centre of Social Medicine and Community Health at New Delhi’s Jawaharlal Nehru University, said the risk of inequity was that parts of India would build up immunity disproportionately.

“It can leave the rural population relatively more vulnerable.”

(Reporting by Krishna N. Das, Abhirup Roy and Rajendra Jadhav; Additional reporting by Prasanta Kumar Dutta, Jatindra Dash, Sumit Khanna, Rupam Nair; Graphics by Tanvi Mehta; Editing by Peter Graff)