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Health

How and Why the Gujarat Government Is Hiding the State’s COVID-19 Death Toll

The government’s daily bulletin of novel coronavirus statistics provides a death tally that appears to be considerably lower than the numbers observed at several crematoria in the state.

Ahmedabad/Surat: Three days after the Gujarati new year’s day on November 20, Jyotiben Joshi, 71, breathed her last on a ventilator bed in the 1,200-bed COVID-19 ward at the New Civil Hospital in Ahmedabad. Her 50-something brother, Pradip Joshi, and her 30-something nephew, Nitin Joshi (names changed to protect their identities), had a difficult time retrieving her body from the hospital the next morning and ferrying it to a crematorium in the Wadaj area.

After her death, Jyotiben’s story spoke volumes about allegations that the Gujarat government is hiding the actual death toll due to COVID-19.

Jyotiben had passed away at around 8 pm on November 20. The hospital staff told the Joshis to take away her body immediately, since beds were needed given the rising number of COVID-19 cases after Diwali.

But the Joshis didn’t immediately have PPE kits and puja material and they would have had no time to organise these things since there would be a night curfew from 9 pm. Also, they were reluctant to cremate Jyotiben in the dark.

Night curfew at Ahmedabad. Photo: Hanif Sindhi/DNN/Ahmedabad

At the hospital the next morning, the Joshis had to wait for nearly an hour and a half from 7 am for the hearse to arrive. Earlier, Jyotiben’s body had been moved to a sprawling hall filled with other bodies.

“There must have been quite a few bodies, maybe 20-25. It seemed the majority of them were of COVID-19 patients since the bodies were properly wrapped in body bags, unlike the others,” Nitin Joshi told The Wire. “The hearse took time to reach us since it was dropping off other bodies at various crematoria (mostly the five leading ones in Ahmedabad). We told the authorities we would call a private hearse, but there was some rule that only the Civil Hospital’s hearse could go,” Nitin added.

By the time the Joshis reached the Wadaj crematorium, it was around 9 am. They joined the “cremation queue” of two bodies placed near the CNG furnace. Another body was already in the furnace. Another van drew up behind the Joshis’ hearse.

It usually takes 90 minutes to two hours for a body to burn completely in a CNG-fired machine, so the Joshis had to wait nearly four hours for their turn. “It must have been around 4.30 pm when we reached home,” Nitin said. 

The Wadaj crematorium has two CNG furnaces, but one of them had been out of service. According to Nitin Joshi, the crematorium staff apparently said this was “due to overheating by over-use because of continuous flow of bodies through the night”.

So that morning of November 21, 2020, Jyotiben’s body had been one of five COVID-19 infected bodies at the Wadaj crematorium. Since it is mandatory for victims of the novel coronavirus to be cremated in a CNG furnace, it is highly like that these five deaths were all due to the coronavirus. Ahmedabad has five big crematoria, including the one at Wadaj. Each has seen similar “cremation queues” ever since the second wave of the dreaded virus hit, soon after Diwali.

Municipality workers and family members wearing PPE kits cremate persons who died of COVID-19. Photo: PTI

Five plus x equals five

According to the Gujarat government’s daily bulletin on November 21, 2020, there had been five COVID-19 deaths and 354 new cases in the last 24 hours in the Ahmedabad Municipal Corporation areas. To judge by this bulletin, those five bodies must all have been cremated at the Wadaj crematorium, with the Joshis as witness. So what happened to the other bodies Nitin had seen in the hall at the hospital where Jyotiben’s body had been placed? And what accounted for the similar or longer queues at the other cremation grounds that day?

Other than the five deaths in Ahmedabad, Gujarat reported four other deaths on November 21: two in Surat and one each in Rajkot city and Gir-Somnath. But the local Gujarati media was replete with stories and pictures of packed crematoria in cities like Vadodara, Surat and Rajkot, as well as in smaller towns. The state government is yet to deny any of this.

Against the total of nine reported deaths on November 21, 2020, Gujarat reported 1,515 fresh cases of COVID-19 infection; the highest number of new cases on a single day since March. The state government attributed this “second spike” to the crowds that had shopped for Diwali and ignored the government’s pleas to wear masks and maintain social distancing. In fact, chief minister Vijay Rupani’s voice had been recorded on cellphone caller tunes earlier, during Navratri, appealing to people to keep indoors during the Garba festival.

What the Joshis had seen at the crematorium on November 21 was not an isolated case and not restricted only to that date. Consider the case of veteran journalist Thakorebhai Patel, 88, who died on December 2 of natural causes. About 10 people went with his body to the Thaltej crematorium – another major one in Ahmedabad – and waited for nearly five hours for Thakorebhai’s turn in the CNG furnace. 

Among these people was senior journalist Dhimant Purohit, who described what he saw there in a column in the reputable Gujarati daily, Jai Hind. He said they had waited for two hours for three bodies to be cremated at the CNG furnaces, while three others waited. Two among the three bodies in the furnaces were of COVID-19 victims and two of the other three bodies waiting to be cremated were also of COVID-19 victims. 

Also Read: Ahmedabad – 19 Official COVID-19 Deaths But Snaking Queues at Crematoria

“I had heard about the severity of the pandemic in Ahmedabad but I was shaken to see for myself so many bodies there,” he wrote. 

Purohit saw at least four victims of COVID-19 during those few morning hours at the Thaltej crematorium on December 2. However, on December 3, 2020, the state government’s daily bulletin said that Ahmedabad had reported nine deaths during the last 24 hours. The four bodies Purohit had seen at Thaltej must have been included in these statistics. In all, on December 3, the whole of Gujarat reported 13 deaths, including two in Surat and one each in Rajkot and Vadodara cities besides the nine in Ahmedabad.

Healthcare workers wearing PPE shift a coronavirus patient to another part of the CIMS hospital, in Ahmedabad, October 1, 2020. Photo: PTI

Counting, not counting

In Surat on December 6, Dr Chandresh Jardosh, president of the Gujarat chapter of the Indian Medical Association, told The Wire: “There is no doubt that the numbers are being underplayed. There seems to be an unwritten policy of not counting deaths of COVID-19 patients with co-morbidities as deaths due to COVID-19.”

But when asked about the discrepancy between the number of deaths reported and the number of deaths observed in the city, Ahmedabad municipal commissioner Mukesh Kumar told The Wire: “We don’t react to unconfirmed reports like this.”

Asked if the deaths of patients with co-morbidities were not being counted in the daily bulletin, Mukesh Kumar said: “We go by the guidelines of the ICMR (Indian Council of Medical Research).”

Specifically asked if the ICMR guidelines say such cases should not be counted among COVID-19 deaths, he said: “I am not saying if ICMR states this or not. We go by what the state health department says. At AMC (Ahmedabad Municipal Corporation) level, we won’t know this.”

The Wire then reached out to the additional chief secretary (environment) Rajiv Gupta, who is the officer on special duty overseeing efforts to control COVID-19 in Ahmedabad. At first, he said he was on leave and said urgent questions could be sent via text message.

After reading The Wire‘s questions sent via text message, he maintained that since he was on leave it was better to contact AMC officials.

Dr Jardosh also claimed that people who have tested positive through rapid antigen tests are also not being tallied in the daily bulletin, though the treatment protocol remains the same. “But, ironically, if they recover, they are counted among COVID-19 recoveries,” he said.

Rapid test kiosks have been set up in all the major cities of Gujarat and the authorities continuously appeal to the people to get themselves tested if there have symptoms of the viral infection.

There are “crematorium queues” in Surat, just as in Ahmedabad, said Dr Jardosh. “We don’t need any evidence for something we can see. It is difficult to get the latest numbers now, but I had found that against 1,500 registered deaths in Surat in May 2019, the number was actually 4,000 in May 2020,” Dr Jardosh said. “There have been several instances of people rushing from one crematorium to another, looking for an available slot at the furnaces. Imagine running from pillar to post with the bodies of your near and dear ones.”

Dr Mona Desai, national chairperson of the Women Doctors’ Wing of the IMA and immediate past president of IMA’s Ahmedabad branch, told The Wire: “Besides those with co-morbidity, there is an unwritten instruction to record deaths of people over 65 years as ‘death due to old age.’ I fail to understand this!” She added: “There is no evidence [of this directive] and nobody will tell you [that] this [is the case] officially.”

The severity of the second wave of cases in Gujarat can be understood from the fact that besides the 1,200-bed COVID-19 ward in Ahmedabad civil Hospital, 400 beds at the Institute of Kidney Diseases and Research Centre have been redeployed for patients of the coronavirus and arrangements have been made for more municipal corporation reserved-beds at private hospitals.

Official sources said that over 90% of these beds were occupied, while Dr Bharat Gadhavi, president of the Ahmedabad (Private) Hospitals and Nursing Homes Association, told The Wire that some 80% of private hospital beds were also occupied.

“This is slightly better than a few days ago, when about 93% of the beds were full,” Dr Gadhavi said. Asked about fudging numbers, he said: “I am not in a position to comment on the government’s numbers, but as far as we (private hospitals) are concerned, we give all the data.”

Besides arranging for hospital beds, the state government has extended the night curfew in the four major cities of Ahmedabad, Vadodara, Rajkot and Surat indefinitely in view of the rising cases.

Night curfew in Ahmedabad. Photo: Hanif Sindhi/DNN/Ahmedabad

As on Monday, December 7, Gujarat officially had 2,20,168 positive cases. There have been 4,095 deaths due to the virus, the fifth highest in the country after Maharashtra, Karnataka, Delhi and Uttar Pradesh. Interestingly, Rajasthan, has had 60,000 more cases than Gujarat, but it death toll of 2,448 is only half of its neighbour’s.

Campaigns of doom

“At every stage, the Gujarat government has tended to play down the situation and today here we are,” said an independent public health expert who requested anonymity since he works in close association with the state health department. “You ask just anyone on the street and she would know of at least five coronavirus patients, if not more. Almost every housing society in Ahmedabad and many in Surat, Vadodara and Rajkot, have COVID-19 patients either in the hospitals or at their homes.” 

Citing the post-Diwali surge of fresh cases, he pointed out that the government for the earlier three months had been conducting itself as though the pandemic “had almost ended and that Diwali would be like a good omen”. It was this ‘all is over now’ attitude of the government that encouraged the Diwali shopping crowds to ignore wearing masks and follow social distancing rules.

“The reason the government let an all’s-well situation prevail during the past few months was that it was preparing for the (November 3) by-elections to (eight) assembly seats,” said Dr Jardosh. 

Also Read: India: Many MBBS Students Are Being Put on COVID Duty in Improper Conditions

The state government had given a favourable opinion to the Election Commission to hold the by-elections even as the latter assured the Gujarat high court in a public interest litigation (PIL) on August 31 that the polls would be held after proper consultations about the COVID-19 situation. The PIL had opposed holding the by-polls during the pandemic

This was around the same time that the newly appointed Gujarat BJP president, C.R. Paatil, had organised huge public rallies across the state, especially in the Saurashtra region, where there was no sign of social distancing or masks. 

Paatil himself contracted the infection, while over 110 party workers and leaders, including newly elected Rajya Sabha MP Abhay Bhardwaj also tested positive for the virus. Abhay Bhardwaj recently passed away at a Chennai hospital after several lung complications. 

Incidentally, all this occurred during the state government’s drive to catch people without masks at public places. 

In fact, the Gujarat high court had taken a serious view of political rallies. In a suo moto petition on the state’s handling of the COVID-19 situation, Chief Justice Vikram Nath and Justice J.B. Pardiwala had in September observed:

“The political leaders of the state are expected to lead their masses and not by themselves flout the norms or the rules and regulations prescribed to combat the pandemic. The flouting of the norms at the end of the political leaders would set a bad example for the people at large, and the same may prompt the people to defy the norms.”

It did prompt the masses. Gujarat now inches towards 2021 with more and more fresh cases every day.

Ironically, the State Election Commission in October had decided to postpone by at least three months the elections to local bodies, including six municipal corporations, 55 municipalities, 31 district panchayats and 231 taluka panchayats, which were scheduled to be held in November-December, 2020.    

Darshan Desai is editor, Development News Network, Gujarat. Email: info@dnnonline.in