Why are COVID-19 deaths rising despite fall in cases? Here’s what doctors have to say


After an unprecedented high, the trajectory of COVID-19 cases seem to be finally falling down in India. With cases peaking across states, the positivity rate going down, experts believe that the deadly second wave of coronavirus, attributed to the mutant virus variant, seems to be finally coming closer to declining.

Yet, there’s one factor that continues to be concerning- staggering fatalities.
Despite the second wave of coronavirus showing signs of ebbing since the second week of May, across India, hospitalizations continue to be on the higher side, and COVID-19 deaths are rising.

If numbers are to go by, not only did the rising numbers engulf the country starting February end, the number of fatalities have been continuously on the rise. A study conducted by John Hopkins University points out that the number of new deaths rose by a whopping 143% in the recent three months.

Places like Delhi, Uttar Pradesh, Maharashtra, amongst the worst-hit ones have also recorded sharp losses in a consistent, concerning manner.

The rising fatality rate is also in stark contrast to the first wave of the virus, where we saw high recovery rates and lower fatalities, in comparison to the global average.

Could the rise in fatalities be simply linked to the virulent virus wreaking havoc? Or are there other factors that seem to be fueling high death rates this time around? Here’s what two doctors battling on the COVID frontlines have to say about the rising death numbers

Delayed hospital admissions contributing to poor outcomes?

The severity induced by the second wave forced hospitals to fill up sooner and postpone critical admissions. Many sent out SOS messages, and unwillingly, were forced to shut doors.

While experts do stress the need to ramp up medical infrastructure big time, frontline doctors also assert that any undue delay in seeking medical care can also raise the fatality and severity rate at a juncture like this, which they have been seeing of late.

Dr Om Srivastava, Director Infectious Disease, Jaslok Hospital & Research Centre, he is also a member of Mumbai’s COVID-19 taskforce adds that there’s a very high need for patients, especially those facing high risk to recognize severe symptoms in time and seek help as and when they can:

“Yes, there’s been increased awareness, but people are still approaching help late. Many are troubled, or simply not aware of recognizing warning signs, often only coming to us when it is too late. This is one of the reasons why we tell patients to watch out for Days 1, 3, 5 and 7 during their infection and keep a lookout for any progression. Despite the medical care crunch, help sought in time can actually bring the risk of complications down.”

Dr Vasunethra Kasaragod, Consultant Chest Physician, Vikram Hospital, Bengaluru also opines that the fatality rate is also highly dependent on the condition of a patient. He says,

“The mutant virus is actually devastating. We see patients coming in on their 4th day with severe patients, and we see some patients who come in during their 10th, 11th-day post infection. The recovery timelines and the progression actually matter and we start to decipher the odds of who’s going to make it and who may not be so lucky. Hence, diagnosis and consultations should be done in time.”

Why are so many younger patients succumbing to fatalities?

The second wave seems to be deadlier for the younger age groups. Higher severity risk, hospitalizations and unfortunate deaths seem to be affecting the ones in their 20s and 30s who were once deemed to be ‘safer’ and milder casualties.

While the outcomes and fatalities soar for young people, experts believe that there’s more than one reason behind the trend. One, that vaccination seems to be showing results on the elderlies, while the unvaccinated, younger people succumb to severe dangers, and suffer from terrible outcomes.

Dr Srivastava asserts that now, the younger people are more at risk for fatality, “Seniors who have been vaccinated indeed have a low fatality rate in comparison to before, and are more likely brought in for medical care in time.”

Secondly, the doctor also adds that with younger patients, there’s also a rise in the cases that he is witnessing wherein hypoxia (sudden low oxygen levels which cause no physical distress or symptoms), high lung involvement seem to be adding to poorer outcomes.

Pressing comorbidities, and some undiagnosed conditions are also making younger people susceptible to dangers. “We see so many people in their mid-20s and 30s suffering from undiagnosed diabetes and suffer from complications,” adds Dr Kasaragod.

Obesity, high cholesterol, rising stress levels could also be comorbidities that can add to the fear of uncertain outcomes.

More complications, more fatalities

Not only is the virulent strain of the virus much more infectious this time around, but there are also other endemics healthcare workers are finding hard to get rid of. The precedence of black fungus infections, which were once deemed ‘rare’, is now the most threatening COVID complication with a mortality rate of 50%.

Treating doctors also add that patients, no matter what age, are taking a long time to recover from the viral damage. It could be the complications, the profound attack launched by the virus, but doctors see patients trying hard to recover, and ultimately succumbing to the ills.

Need to prioritize vaccination drives

Vaccination drives have been thrown open for those over the age of 18. Yet, shortage and unavailability of slots hinder access for those who may need it the most right now, warn doctors.

Urging authorities to vaccinate masses at the earliest, both doctors agree that the risk of COVID induced severity and complications greatly minimize post vaccination and in times like this, can actually bring fatality rates down. “We have seen it work on a lot of seniors, and this is what we need to do if we want to avoid the pitfalls of the third wave”, adds Dr Kasaragod.


So, when can we expect death rates to actually fall? When will the tide turn?

As is with the growth of the pandemic and the fall in the positivity rates, doctors feel that by nature, fatalities may continue to slow down 15-20 days after the peak of the pandemic and hopefully more infections being brought under control.

Doctors, however, warn that with the virus shifting gears and now encompassing rural cities, there’s a critical need for ramping up medical infrastructure, more awareness amongst the masses and of course, vaccination drives to pick pace. Not only is vaccination crucial for curbing the spread of mutant viruses, but timely inoculation can also save many from the pitfalls of severity and mortality risk, right now.



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