Death Demographics: What about Cancer and Heart Diseases?

Ever since the world woke up to the new paradigms imposed by the Corona virus on the world, the death of an individual has not only been shorn of the celebration and rituals surrounding it, but has also been reduced to a number. They have become the reference point to ascertain the virulence of the pandemic and also to predict how many people will die before society acquires herd immunity. So many draw comfort from low death rates of Covid19 in some countries like Iceland, or, even China, for instance, when it is lower than 1 per cent and wonder whether they will escape death. What happens when it is 3 per cent, for instance?

What will happen in our country? Is the pandemic growing or flagging — how many people are really dying?

These figures hide everything and not just the demographics of people dying, their names and station in life. In Italy, the average age of those who died was 78 plus and in the US it is not just similar, but largely impacting the coloured people. Here, again, burying the dead has become a lonely activity. People grieve in isolation unable to even perform last rites for the departed.

In one of the Indian cities, a 65-year-old patient was just called ‘Number 252’ and not a single relative or associate was present when the authorities quietly disposed off his body so that they don’t incur the ire of those who do not want the burial or cremation ground to be infected by the victims of the pandemic.

Death used to be a personal thing where families and friends lived in sorrow reminiscing the life of the dead. They may still do it, but the body of the infected may be disposed in stealth – and, perhaps, in fear.

Questions about life and death are gnawing in Indian minds, like that of other societies, as it struggles to make sense of this pandemic. What will happen in our country? Is the pandemic growing or flagging — how many people are really dying?

Many of these questions allow people from different disciplines to chip in with their own views. So one has epidemiologists and mathematicians using Artificial Intelligence, engineers and others lending their wisdom and weight to this issue, but it has not made anyone really wiser. Is Corona virus the biggest killer in our contemporary society?

What about the others that have been bloating our death rates — cancer, road accidents, diabetes, co-morbidities like hypertension, among other fatal diseases? Are they killing as many as they were when the world had no Corona virus?

In short when our skies were dark, the air was polluted and the traffic was insane, and when the people did not mind  — “taking one for the road”.

A REUTERS REPPORT report corroborates this view that there has been a fall in deaths in Ahmedabad by 67 per cent and in Mumbai by 20 odd per cent. The western world is displaying contrary trends, as is some other parts of the world. There are enough reasons why it may be happening here.

As people cannot move on the streets, expressways and highways, there are no accidents except some of the migrants getting killed on the road while escaping the wrath of the lockdown and the police. There was another report from Punjab of a cop dying in a ‘freak’ accident when a speeding vehicle hit his motorcycle. Except such bizarre happenings, the accidents have nosedived.

Even if they had not, there was no way to find out as the hospitals have largely shuttered down for such patients. The ones that are still functioning have no Emergency or OPDs and most of the space is now reserved to treat Covid19 patients. Even serious cancer patients, who had been given chemotherapy, have been sent home. Some of those struggling on the streets of Delhi and elsewhere are those patients who have been thrown out of these hospitals.

Would it mean that while preparing for Covid19 patients, the world is seeing a fall in the number of deaths?

An official in the US, when asked about hospitals not entertaining any other ailment, stated in a matter-of-fact manner that, really, what was the need to cater to them when there was no reason to fall sick except the Coronavirus?

It will take a while for people to collate, but is the world really experiencing a fall in deaths due to lockdown?

A crematorium in Lucknow saw the number of deaths fall significantly from 1,100 plus to about 800 odd in the last 30 days. Delhi’s crematoriums also present a deserted picture — accentuated by the bar on the number of people who can accompany a dead body.

What conclusions can one draw from this fall in the number of deaths?

Death used to be a personal thing where families and friends lived in sorrow reminiscing the life of the dead. They may still do it, but the body of the infected may be disposed in stealth – and, perhaps, in fear.

THE BIGGEST KILLERS in India are heart attacks or cardio-vascular diseases as they are called followed by respiratory disorders like Chronic Pulmonary Obstructive Disorder (CPOD), TB and accidents. One expects that other ailments should continue to impact the lives of the people, irrespective of government protocols on how hospitals should countenance them.

There is an element of truth that hospitals hasten deliverance. This is the reason why patients are being discouraged to visit the hospital if they have minor ailments. The advise is that stay at home and let the recuperative powers of the body cure you. Only when the body is not able to recover from the virus, the patient should go for testing and subsequent treatment at the hospital.

There may be some wisdom in keeping patients — not terminally ill — to keep them at home. A study was conducted in the US which showed that the doctors’ strike brought down the mortality of patients. These findings were not just from one strike, but seven, in different parts of the world, and have serious implications for public health, if put into practice.

The first big conclusion would be that deaths could be lessened if the patients are only brought when critically ill. In many cases they become critically ill when in hospitals.  Second, the testing of disease protocols need to be made transparent and should not be left at the mercy of the doctors, who believe in testing everything and many times — even if it is not required. Testing is a bit of a racket; many public health experts have misgivings about the wild clamour for increasing testing. Others, cognizant of how random sampling could get equally good conclusions, want testing to be analysed better.

It is this group of people with a better feel for figures who are arguing that the Corona virus will kill far less than other conventional ailments like heart diseases, road accidents, etc – and, hence, authorities need to find a way to get on with life. It is indeed possible that in the new order when dead bodies could infect, the rituals of passage will change forever.