Sindh Chief Minister Murad Ali Shah on Wednesday expressed the fear that the actual number of deaths from the coronavirus in the province is probably much higher than what is currently being reported.

Shah said his suspicion was that many infections are simply going undetected. "Known deaths, where the patient tests positive and they die, are so far 41 in Sindh. However, you may have also seen reports about dead bodies being brought to hospitals, which experts say cannot be tested for the coronavirus," he told a press conference.

He may have been alluding to reports like that published in the daily The News, which cited claims that more than 300 patients who were either dead on arrival (DOA) or extremely sick with “pneumonia-like symptoms” and died within hours of their arrival were brought to various public and private hospitals in Karachi during the past 15 days.

But are such fears well-founded?

Impact of the lockdown

Dr Amir Raza, former deputy medical superintendent of the Trauma Centre at the Dr Ruth Pfau Civil Hospital Karachi, says there may be a simpler explanation to the rise in reported deaths at hospitals.

"The fact of the matter is that the city’s private hospitals are not entertaining patients; the primary healthcare apparatus, that is the smaller private clinics in neighbourhoods, is shut. So every person, if they feel sick for any reason, would either rush to JPMC [Jinnah Postgraduate Medical Centre], Civil Hospital or Abbasi Shaheed Hospital. Hence, the patient volume has increased and so has the death toll at these facilities," he said.

He noted that a similar phenomenon is observed during Eid holidays, when the volume of patients increases manifold at these three hospitals because private clinics and healthcare facilities are closed or operating at low capacity.

"There is no scientific evidence to support this theory that more Covid-19 patients are dying [now]," he told Dawn.

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Edhi foundation sees increase in deaths

For its part, Edhi Foundation, the city's most noted social welfare organisation, has seen an "unusual increase" in deaths in Karachi during the last two weeks, the charity's head told Dawn.com, adding that a proper medical investigation should be carried out to ascertain the cause behind these deaths amid the coronavirus contagion in the metropolis.

Faisal Edhi said they shifted a total of 387 bodies from different areas and hospitals for burial at various graveyards between April 1 and April 13 as compared to 230 during the same period last year.

"There is an increase of 60-70 per cent deaths this year in such a short period of time," Edhi said, adding, however, that they were not in a position to pinpoint the exact cause of the deaths.

He revealed that most of the deceased persons attended to by the Edhi Foundation were of an older age and faced a variety of health complications.

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On the suspicion that some of these deaths may have been due to Covid-19, Edhi said their volunteers were following the advised procedures for transporting and burying such bodies to avoid being infected.

Why the jump in numbers?

Edhi pointed out that hospitals' OPDs were closed and people were facing difficulties in getting treatment or reaching the health facilities on time due to shortage of transport services because of lockdown measures imposed by the provincial government to prevent the spread of the virus.

Fear of contracting the virus could be another reason.

Asked about the spike in the number of bodies picked up by Edhi, Dr Raza said that in normal circumstances when there is a death in a family, the body would not be picked as the family would perform the final rites themselves.

But "now everyone is paranoid. If someone hears of a death in the neighbourhood, they fear it's from Covid-19. So naturally more people are turning to Edhi to perform ghusl (bathing of a body) and then they take the deceased to be buried from there," he remarked.

Meanwhile, the government-funded Sindh Rescue and Medical Services, operated under Aman Health Care Services, said while they have not seen an increase in deaths on arrival and are still reporting 2-3 such deaths a day, the number of suspected Covid-19 patients has increased.

Abid Naveed, executive director of Aman Health Care Services, shared that ambulances have been responding to between 30-40 calls per day of people complaining of breathing problems and chest issues, compared to 10-15 calls before the lockdown period. They have transferred 1,200 cases to hospitals since February, of whom 190 were confirmed to be positive for Covid-19, he added.

With additional reporting by Imtiaz Ali in Karachi.