Kolkata, May 8 () Social stigma and low testing arethe key reasons for the high mortality rate among COVID-19patients in West Bengal, where the disease, like elsewhere inthe country, is still an urban phenomenon, experts say.
The state's TMC government has been drawing consistentcriticism from the Centre and opposition parties over the wayit has tackled the pandemic, and has been accused of under-reporting data about the number of COVID-19 cases and deaths.
As of May 7, the state has reported 1,548 COVID-19cases and 151 deaths of people infected with the deadly virus.
However, the state's public health authorities haveattributed only 79 fatalities to the contagion and the rest toconcurrent illnesses called comorbidities in medical jargon.
The centre recently rapped the state government overits COVID-19 management which, it said, was characterised by avery low rate of testing in proportion to the population, anda very high rate of mortality of 13.2 per cent, the highest inthe country.
West Bengal, which had tested just about 4,400 samplesby April 18 at a rate of 400 samples per day, is now testingmore than 2,500 samples a day. The aggregate now stands atmore than 30,000, according to state officials.
Experts in the field say given the fact that mostcases were reported from Kolkata, Howrah, Hooghly, North 24Parganas and South 24 Parganas, the disease is still an urbanphenomenon" but will spread to rural areas also sooner orlater.
According to public health experts and medicalpractitioners in the frontline of the fight against thedisease, not just the low number of tests but the socialstigma and ostracism faced by patients and their families areacting as a deterrent to effective tackling of the pandemic.
Social stigma is a major issue in identifying a COVIDpatient. Since the spurt in the number of cases, people havestopped coming to hospital fearing social stigma and publicshaming in their locality and instead prefer to stay home. Andwhen they do turn up, its too late, professor and seniorsurgeon at SSKM hospital Diptendra Sarkar told .
"The stigma associated with this disease needs to beaddressed so that more people come forward for tests, hesaid.
Manas Gumta, a senior surgeon and general secretary ofAssociation of Health Service Doctors, shared Sarkar's viewand said it is the responsibility of the state government tochalk out a roadmap to remove the social slur associated withthe disease.
"The government needs to engage social groups and NGOsto address the problem of social stigma. It is indeed a reasonbehind fewer people coming forward for tests," he said.
Gumta said the number of tests being performed now arestill less than what has been recommended by ICMR. The numbersneed to be increased substantially and also the testingfacilities, he said.
While decoding the arithmetic behind the highermortality rate, he said the mortality rate of COVID-19patients in most countries was 2-3 per cent, but in Bengal itwas so high due to fewer tests being conducted since the onsetof the disease.
For example, if you test 20 people and 10 are foundpositive while two of those who test positive pass away thenyour mortality rate is 20 per cent. But, if you test 50 peopleand 40 are found positive and two of them die, your mortalityrate is 5 per cent.
"So the answer to decreasing the mortality rate liesin conducting more tests, random tests of asymptomaticpatients and ramping up life support infrastructure athospitals, he said.
West Bengal, despite the increase in the number oftests, lags far behind states like Maharashtra and Gujaratwhere the number of tests has crossed two lakh and one lakhrespectively.
In most of the death cases, the patients arrived whenit was too late. But if intensive and critical care facilitiescan be ramped up, many lives can be saved. We are a bit latebut we are trying to catch up with other states in terms oftesting and treatment, said another senior doctor of a COVIDhospital who did not wish to be named.
West Bengal Home Secretary Alapan Bandopadhyay hadrecently attributed the low tests and high mortality rate toinitial lack of testing laboratories. Only one COVID-19testing laboratory was functioning in the initial days of theoutbreak of the disease.
Today, we have 16 testing laboratories and a fewothers are in the pipeline. The more testing you do, the morepeople you treat and then the mortality rate will also be low.
"The mortality rate appeared high not because Bengalwas failing but because (adequate) infrastructural facilitieswere not present, Bandopadhyay said.
The West Bengal government had alleged last month thatthe COVID-19 testing kits supplied by the Centre were far lessin number as compared to other states and many were defective.
Meanwhile, some experts feel that though the diseasehas so far been limited to urban areas, it will spread torural Bengal in the coming months.
It is true that the contagion is still an urbanphenomenon but in months to come it will spread to other ruralareas. In urban areas, the intensity of the spread is highbecause of high population density which is not the case inrural areas, senior doctor and internal medicine specialistRahul Jain said.
Out of the 23 districts of the state sevenpredominantly rural districts have not reported a singleCOVID-19 case so far, according to state government data.
At least 80 per cent of the cases have been reportedfrom the four red zones districts of Howrah, North 24Parganas, East Medinipur and Kolkata, with the state capitalhaving the highest number of containment zones and cases.
South 24 Parganas and Hooghly districts have alsoreported quite a few cases. PNT SKSK SK