A day after the Centre told the Parliament that no Covid-19 deaths due to lack of Oxygen were specifically reported, The Organised Medicine Academic Guild (OMAG) on Wednesday dubbed Minister of State for Health Dr Bharti Pawar's statement in this regard was akin to the film `No One Killed Jessica’ template.
“The statement by the Minister is factually not incorrect. But her statement is akin to the movie `No One Killed Jessica’,” OMAG secretary general Dr I S Gilada and president Dr Suneela Garg said in a joint press statement here.
They said that the global medical community was disillusioned by the minister's statement.
The OMAG, which is the federation of medical organisations, has appealed to the Indian Council for Medical Research (ICMR), which has been at the helm of the affair since the pandemic began, “to clear the air so that the blame game stops and ensure that the blame is not shifted to the medical community”.
Dr Gilada said that there was no denying that “Detailed guidelines for reporting of deaths have been issued by the Union Health Ministry to all states/UTs” but what has been actually sent, was an eye-opener.
The ICMR)-National Centre for Disease Informatics and Research (NCDIR) document "Guidance for appropriate recording of Covid-19 related deaths in India” at page 6 categorically mentions that Asphyxia, Respiratory arrest/Failure and Respiratory Failure among others cannot be mentioned as cause of death.
“The minister’s statement that, “...no deaths due to lack of oxygen have been specifically reported by states/UTs” isn’t incorrect either,” Dr Gilada said.Following the national guidelines and state SOPs, no doctor will or can mention ‘Hypoxia’ or ‘Respiratory Arrest’ or ‘Respiratory Failure’ as cause of death. As doctors, we have been always told to avoid mentioning Mode of Dying as Cause of Death. Mode of dying merely tells you that death has occurred and is not specifically related to the disease process.
“Doctors have to record the underlying cause of death in the Medical Certification of Cause of Death (MCCD) Form 4 (institutional deaths) / 4A (non-institutional deaths) which is submitted to the Office of Registrar General, India (ORGI). The ORGI records and collates data but cannot change it,” he said.
“In any case, cause of death is never given as the patient died of ‘fever due to lack of paracetamol’ or ‘respiratory failure due to lack of steroid’ and similarly ‘patient died due to lack of oxygen’!,” Dr Gilada said.
The International Classification of Diseases (ICD) doesn't have code for lack of Oxygen or Hypoxia.
“Autopsy or post-mortem can help in cases when cause of death cannot be ascertained. However in Covid-19 hardly any autopsies are done due to the fear instilled since the pandemic began, once again due to ICMR guidelines on how dead bodies of Covid-19 patients should be disposed of,” Dr Gilada averred.