Data discrepancy amid virus crisis could spell disasterDifferent figures on Covid-19 death toll, which have puzzled many, raise concerns if there are more virus fatalities than what the government is reporting.
Last year, when the country was in the grip of the first wave of the pandemic, there were concerns if the government was failing to provide the actual information. Officials in November told the Post that the number of Covid-19 deaths could be far higher than what the Health Ministry was reporting.
And on February 24, the government released new data, adding 619 deaths attributed to Covid-19 infections. Thereafter, there was a dramatic decline in new cases of the coronavirus, surprising even the experts.
Now the country’s second wave is sliding into a devastating crisis, with hospitals forced to turn away patients for lack of beds and oxygen and daily new infections inching closer to the 10,000 mark, and concerns are growing if the death toll is being underreported.
It was also evident from the discrepancy in the numbers released by the Health Ministry and the Nepal Army, which is tasked with managing the bodies of those succumbing to Covid-19.
The difference was 598—15 percent higher than the government claim.
Almost none to minimal communication has been the hallmark of the KP Sharma Oli administration ever since it took office. Misinformation starting right from Oli since the coronavirus first hit the country has continued even when a second wave has engulfed the country.
Even as the country’s healthcare system was cracking, with over 50 deaths a day and hospitals overwhelmed, Oli boastfully said in an interview with CNN that “the situation is under control”.
The statement came exactly a week after the Health Ministry said things had become unmanageable.
Public health experts and doctors who have been constantly saying that the contagion has already spiralled out of control say the government, which made a spectacular bungling in handling the pandemic, now appears to be hiding the data.
“There is discrepancy in the data,” Brigadier General Shantosh Ballave Poudyal, the Nepal Army spokesperson, told the Post. “It needs to be reconciled which I believe has already begun.”
The Health Ministry, which updates the coronavirus situation in the country, three days ago suddenly stopped giving the number of deaths reported “in the last 24 hours”.
On Sunday, the ministry’s situation report said the death toll of 88 was based on the compilation of bodies managed by the Army and figures prepared by the Covid-19 Crisis Management Centre, a government task force formed to fight the pandemic. That created confusion, as many thought those were deaths of a single day (24 hours).
On Wednesday, the Health Ministry said the death toll reached 4,252, adding 168, the number of fatalities based on the data provided by the Army.
Officials at the Health Ministry, however, deny there is any discrepancy. According to them, data from the Army could have been higher because they “might have” managed also the bodies of those who didn’t succumb to the coronavirus.
That reasoning sounds exactly like what Oli said last year that no one is dying from the coronavirus in Nepal. Oli from the Parliament’s lectern had even made a claim that Nepalis have immunity strong enough to fight the virus.
Dr Jageshwar Gautam, spokesperson for the Health Ministry, argued that there could be a “slight” difference due to “some errors” in counting.
“But I don’t see any reason for a huge difference,” Gautam told the Post. “We can tally the number case by case if necessary.”
The Army, however, refused to buy the claim that it has managed also the bodies of those people who died without testing positive for the coronavirus.
The mechanism to manage the bodies of people dying of Covid-19 is under the Covid-19 Crisis Management Centre, called CCMC, led by Deputy Prime Minister Ishwar Pokhrel.
Respective hospitals report to Covid-19 Crisis Management Centre about the casualties, and it then reports the respective divisions of the national defence force. The Army’s respective divisions are responsible to mobilise the dead body management squad to the respective hospitals.
The Nepal Army has eight divisions, one each in the seven provinces and the Kathmandu Valley.
Poudyal, the Army spokesperson, said the national defence force’s squads take custody of the dead bodies only after the death certificates are produced before them, and such documents must mention if the person had Covid-19.
Sources at the Army say that there is a problem in record keeping at the Health Ministry.
Officials say there is a lack of coordination among various levels of government agencies, which could be leading to the under-reporting of Covid-19 deaths. Since contact tracing has not been effective, there is no data on the people who are in isolation and anyone dying without reaching hospitals.
According to Army sources, the Health Ministry’s update includes reports received until 1pm of the day. Those who die after 1 pm aren’t included in the earlier day's briefing and that needs to be adjusted in the next day’s figures, which according to the Army sources, might have been missing.
Officials at CCMC said that the Army has raised the issue at the CCMC meetings for a while, as a result the ministry started adjusting the toll.
On Tuesday, the Army’s record showed the death toll was 186, while the ministry’s data put it at 225.
However, Monday's situation update of the ministry put the figure at 139 while the actual toll was 165.
The Army believes the higher figure on Tuesday than the actual number could have been the result of the ministry’s attempt to adjust the data.
Officials at CCMC refused to comment.
In a text reply to the Post, Khag Raj Baral, a secretary at the Prime Minister’s Office who is also a member of CCMC, said the officials at the Epidemiology and Disease Control Division can speak on the matter.
Officials at the division were not available for comments.
Experts say the coronavirus situation has turned into a grave crisis, with many believing the insidious double mutant variant from India as the cause, and a lack of proper communication from government officials and attempts to hide the figures could lead to catastrophe.
Statistics can help experts analyse the exact situation and suggest measures to control the pandemic.
Just as the number of active cases crossed the 100,000 mark, Nepal also overtook India in terms of daily infections per million. Similarly, Nepal’s daily deaths per million too surged past India.
India, with which Nepal shares a long porous border, is currently the worst hit country in the world, reporting over 300,000 new infections a day for the past few weeks, at times crossing the 400,000 mark. India’s infection tally has already surged past 20 million. Daily death count is averaging over 3,000.
Experts say some important issues are attached when the government deals with situations like the current pandemic. While deaths should not be treated merely as numbers, authorities must maintain the figures carefully so as to assess the actual situation and to make the fight against the disease strong and more effective, according to them.
“The under-reporting by the Health Ministry is basically the result of a lack of coordination in data sharing,” said Dr Praveen Mishra, former secretary at the Ministry of Health. “The government's data sharing, from the local level to the central level, is very bureaucratic. There should be a single window. The government should be mindful, as fudging data could not only ruin its credibility but also put citizens’ lives at risk.”
The Oli administration which is not tired of thumping its chest for “controlling” the virus with minimal loss of lives has been too slow to recognise that the pandemic has shaken the country’s health system.
Hospitals have already stopped taking in new patients, while many are treating people outside–on the ground, in chairs and tables.
Oli on Saturday even went on to blame the people for spreading the virus, saying they became negligent, ignoring the fact that his own party organised a huge demonstration in the heart of Kathmandu in February.
Two days later, in an opinion piece in The Guardian, he conceded that the country is burdened by the Covid-19 pandemic and sought support from the international community.
But many say Oli’s appeal is too little, too late, as the global focus is currently on India, whose deepening virus crisis has emerged as a threat to the world. Nepal currently does not have vaccines and there are concerns if the country would run out of other medical supplies very soon as there are no international flights. With the rising number of Covid-19 cases, the demand for oxygen in hospitals has gone up and there is neither enough production nor enough cylinders.
Apart from his appeal on Monday through the UK newspaper and his May 2 address to the nation to the international community, the Oli administration has not activated diplomatic channels to seek support.
Human Rights Watch on Monday said that Nepal government must act urgently to avoid a looming Covid-19 catastrophe.
The rights watchdog also wondered if the Oli administration is indeed paying attention to the Covid-19 crisis.
“The government’s willingness to devote its attention to the crisis remains unclear,” it said. “International NGOs have been unable to transfer funds to the government because the bureaucracy is unable to complete paperwork due to Covid-19 cases among ministers and officials.”
“In discussions among development agencies in the final week of April, seen by Human Rights Watch, international officials spoke of a lack of clarity from the government as to its priority needs, and also a lack of information among themselves about such basic matters as the country’s medical oxygen infrastructure,” it added.
Amid such a crisis, underreporting of cases, deaths, stock of oxygen and beds by the government could spell a disaster, experts say.
“I believe the Army’s data is accurate, as it is working in the field,” Dr GD Thakur, former director at the Epidemiology and Disease Control Division, told the Post. “There are serious lapses of coordination among government agencies. Lower death figure by the government also makes it claim that it has managed to keep the fatality rate down, which actually is not the case.”