60-69 age group worst-hit in both Covid waves: Mumbai civic body data

An analysis of mortality data has shown that senior citizens in the 60-69 age group were the worst hit by Covid-19 during both the waves in Mumbai

An analysis of mortality data has shown that senior citizens in the 60-69 age group were the worst hit by Covid-19 during both the waves in Mumbai.

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Most experts consider the period between March and December 2020 broadly as the first wave, even as the number of cases sharply declined by November. Mumbai recorded over 293,436 cases and over 11,116 deaths during this period. The city is currently experiencing a receding second wave. During the period between January and July 15 this year, the city has recorded 48% more cases (436,359), however, the number of deaths dropped to 4,551.

Of the 11,159 deaths analysed by the civic body between March and December last year, nearly 3,177 or 28% deaths were in the 60-69 age group. Even as the absolute number of deaths decline this year, the trend has remained the same. Of the 4,490 deaths analysed between January and July 15 (the second wave), 1,142 or 25% were among the 60-69 age group.

This age group falls under the high-risk category. Medical experts say age and presence of co-morbid conditions such as diabetes, hypertension and obesity, among others, have been linked to severe forms of Covid-19.

“The high mortality is the result of high risks carried by senior citizens or those with underlying ailments,” said Dr Rahul Pandit, member of Maharashtra’s Covid-19 task force.

“A lot of thought is being given to reducing deaths in this category. The push to speed up vaccinations and introduction of monoclonal antibody cocktail drug are some of the measures aimed at reducing the mortality in the high-risk category,” he said.

Mumbai’s death numbers indicate the second wave was handled in a better way by the civic administration. Mumbai’s Case Fatality Ratio (CFR) – the proportion of deaths among identified confirmed cases – stood at around 1% in the second wave, while Maharashtra’s CFR was at 1.8%.

“Mumbai saw a lot of deaths during the April-May period last year, when the medical fraternity knew little about the infection and its management,” said Dr Avinash Supe, head of the Covid-19 death audit committee. “The average of city’s deaths is definitely better during the second wave, despite more cases,” he said.

Another important trend seen in BMC’s age-wise death analysis is the drop in the number of deaths among children. The civic body recorded 18 deaths in the 0-9 age group and 35 deaths in the 10-19 age group between March and December 2020. Between January and July 15, these numbers dropped to zero and five, respectively.

One must note the civic data is constantly under reconciliation and there is often a mismatch between the BMC and state government’s numbers. For example, even as the 0-9 age group shows zero deaths, some hospitals have recorded deaths in this group, which may be under review and yet to be reconciled. The civic-run BYL Nair Hospital has recorded three infant deaths and the SRCC Children’s hospital has recorded one death this year.

The BMC’s mortality data may present a positive picture, but the true impact of the pandemic can be analysed only by considering the all-cause mortality and the excess deaths in the city.

In 2018, the city recorded 88,892 deaths due to all causes, according to the statistics updated on the BMC website. The number rose by 2.6% to 91,223 in 2019.

In 2020, the year when the pandemic hit Mumbai, its all-cause death toll jumped by 23% to 111,942. Taking into account an average of 3% yearly rise in deaths and adding the Covid-19 toll (11,116 deaths) to it, Mumbai has recorded at least 5,000 excess deaths in 2020.

“It is hard to say that all excess deaths are due to Covid-19, but one must not simply attribute these deaths as non-Covid,” said Soumitra Ghosh, associate professor at the Centre for Health Policy, Planning and Management, Tata Institute of Social Sciences.

“A deeper analysis of this data is needed. Ideally, the government authorities should commission an institution to study this,” he said.

The stringent lockdown, mainly during the first wave, made it difficult for many to access hospitals. Elective procedures and treatment for existing ailments were delayed which led to severe health implications in patients. Experts also point that accident-related deaths came down substantially during the lockdown. “It is important to analyse the cause of excess deaths to come closer to reality. These deaths cannot be ignored,” said Ghosh.

The stringent lockdown, mainly during the first wave, made it difficult for many to access hospitals. Elective procedures and treatment for existing ailments were delayed which led to severe health implications in patients. Experts also point that accident-related deaths came down substantially during the lockdown. “It is important to analyse the cause of excess deaths to come closer to reality. These deaths cannot be ignored,” said Ghosh.