India’s Covid death toll could be 6 times higher than reported: Study

“India’s official cumulative Covid death count of 0.48 million implies a Covid death rate of approximately 345/ million population, about one-seventh of the US death rate. India’s reported Covid death totals are widely believed to be under-reports because of incomplete certification of Covid deaths and misattribution to chronic diseases and because most deaths occur in rural areas, often without medical attention,” the study states.

The study was conducted by researchers from India, Canada, and the US, including Dr Prabhat Jha from the Centre for Global Health Research at the University of Toronto and Dr Paul Novosad from the department of economics at Dartmouth College.

The study used data from a nationally representative telephonic survey of 140,000 people, reported deaths across 200,000 public hospitals through the government’s Health Management Information System, and the deaths recorded in the Civil Registration System of 10 states that accounted for nearly half the official Covid-19 toll.

This data was then overlaid on the United Nations Population Division (UNPD) estimates of deaths due to various causes that must have happened in 2020 to calculate the excess deaths.

“Excess deaths close to 3 million. 1. Far higher than official totals. 2. Implies global COVID death count off by >2 million (and more given undercounting elsewhere) Multiple data sources and different analytical approaches all agree: there were more than 2 million COVID deaths in India thru summer 2021. India alone accounts for a huge share of global COVID deaths. WHO should be updating their global numbers taking this into account,” tweeted Dr Novosad.

“The conclusion from our paper was that there were seven to eight times more deaths than reported. It is in the same ballpark as other studies all of which suggest vast undercounting and that is important to get an estimate of what the third wave would be like. So far, the third wave in other countries has been bigger than the second. Who gets tested might change over time (thereby changing the number of reported cases), but the number of deaths are consistent,” Dr Prabhat Jha had told The Indian Express when the pre-print study was released.

Dr Jayprakash Muliyil, chairperson of the Scientific Advisory Committee of the National Institute of Epidemiology, said, “Before the pandemic reached India, I calculated the expected mortality based on the age-specific death rate from Europe; we have a younger population so I had adjusted for it. Based on my calculations, India was to report 2.2 million deaths as per the infection dynamics at the time. When the deaths were reported in just thousands, it was embarrassing.”

“All I am saying is, a toll of 3 million is reasonable.”

There have, in fact, been studies that have estimated higher mortality in India, including an analysis co-authored by former economic advisor Arvind Subramanian that estimated a mortality between 3.4 million and 4.9 million.