COVID-19: Why Mumbai's death count is higher than other cities in state

While Mumbai's daily count of fresh COVID-19 cases and fatalities due to the disease have been on a steady decline over the past couple of weeks, the city continues to report the highest number of deaths in the state. Experts, including members of the COVID task force, attribute the reason to delay in seeking treatment as they have found that many patients self-medicate before approaching a hospital. 

In the first week of October, the city was reporting more than 2,000 fresh cases daily and the numbers continued to dip until the daily count dropped below 1,000 by the end of the month. Similarly, after reporting 40-50 deaths per day for a while, over the past one week, the number has dropped to around 25. Barring Pune, all the other districts in the state, however, report around or less than 10 deaths daily.

When asked why Mumbai continues to have the highest number of COVID-related fatalities in the state, endocrinologist and member of the COVID task force, Dr Shashank Joshi pointed out that the city had a higher number of senior citizens. "We have a relatively higher prevalence of hypertension and diabetes among senior citizens here and that has contributed to the overall case fatality. While we have taken proactive steps, people are self-medicating which is causing problems," he said.

Similar symptoms

Since the symptoms are similar to that of common cold, doctors said that people were waiting before getting tested. Infectious diseases specialist and another member of the task force, Dr. Om Srivastava said, "People think of it as a common cold and delay the process of seeking treatment. By the time they come to us, one or more organs have already been affected."

A BMC health worker conducts a COVID-19 test at Nehru Nagar, Kurla East. FILE PIC

He added that sale of medicines used for treating COVID-19 patients needed to be regulated to prevent people from self-medicating. "Medicines like Doxycycline and steroids can be purchased. If there is a regulated sale of medicines then a lot of misuse can be avoided," he said.

Critical patients

Dr Kedar Toraskar, another member of the task force, who has been treating COVID-19 patients at Wockhardt Hospital, pointed out that while there were fewer fresh admissions in the past week, the number of critical patients continues to be high. "We have seen that the critical patients are in the range of 45-65 years of age and while the general ward is only half full now, the ICU continues to have 80 per cent occupancy," he said.

Referring to the fear of the pandemic, he added that it was a human tendency to avoid hospitals. "People neglect their symptoms thinking that it may be a flu and don't realise the gravity of the situation. COVID-19 is not going away. Like H1N1, there will be a lesser percentage and people may get COVID-19 every year. Ideally, anyone with symptoms shouldn't wait at all and should get tested. The costs of the RT-PCR tests have come down and there are free testing clinics as well," he said.

Changing opinions

Dr Jalil Parkar, pulmonologist at Lilavati Hospital, said that there were various factors that contributed to Mumbai's high death count ranging from unavailability of medicines to changing opinions about the use of Remdesevir, Tociluzumab and plasma therapy. "Unfortunately, senior citizens who were earlier protected at home slowly got exposed. They would come to hospital in a critical condition and turning them around became difficult. But we have been fine-tuning the treatment protocol and patients now stay in hospital for a shorter duration," he said, adding that while patients were earlier admitted for 10-12 days, even those with severe symptoms are now discharged within six days.

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