Despite the drastic decline in the number of COVID-19 deaths in the State, the Case Fatality Rate (CFR) continues to be highest in the 90-99 age group. From 11.4% on July 13, the CFR in this age group rose to 12.1% on August 13 and has remained the same since then.

While the fatality rate has remained constant among senior citizens of three groups — above 60 years, above 70, and above 80 — for the last three months, it has seen an increase in the centenarians group, from 4.8% on July 13 to 5.75% on September 12.

Despite their vulnerability, the rate of infection is not very high among senior citizens. Senior citizens have accounted for a mere 14.5% of the total 29,61,735 positive cases (as of September 12). However, nearly 57% of the 37,504 COVID-19 deaths in the State reported till September 12 were from this susceptible group.

A look at the absolute numbers shows that the highest number of deaths (10,765) have been reported in the 60-69 age group, while the highest number of infections (6,79,510) have been reported in the 30-39 age group. As many as 64 of the 92,630 infected children in the 0-9 age group and 93 of the 2,29,355 infected children in the 10-19 age group have succumbed to the disease so far.

Anoop Amarnath, member of Karnataka’s COVID critical care support unit, who heads the Department of Geriatric Medicine at Manipal Hospitals, said the high CFR in the nonagenarian group was because of the low absolute numbers. While this age group comprising the very elderly population is highly susceptible because of comorbidities, the pattern of infection during the second wave was different from last year’s outbreak, he said. “During the second wave, both the ascent and descent were rapid. Moreover, certain complications such as mucormycosis, stroke, and cardiac issues that patients developed post-COVID during the first wave were reported during the active phase of the infection in the second wave,” he said.

C.N. Manjunath, nodal officer for labs and testing in the State’s COVID-19 task force, attributed the high CFR in this age group to multiple age-related advanced comorbidities and geriatric issues. “While one of the potential reasons for the high mortality in the 90-99 age group is the high rate of disease progression, we have noticed many patients as well as their families refusing hospital admission for treatment,” he said. Dr. Manjunath added that case severity and mortality were considerably low among the vaccinated.

Late presentation

State Health Commissioner K.V. Trilok Chandra said the death audit committee had found that 70% of those who have succumbed to COVID-19 had comorbidities, and most of them reported late. He said that the rate of decline in the condition of the elderly was rapid once they landed with moderate/severe infection. “The high CFR in this group is because of the low absolute numbers,” he added.