India’s COVID-19 deaths higher than that reported by the government, indicate sample surveys

India’s cumulative COVID-19 deaths are 6-7 times higher than reported officially, says analysis

By Vibha Varshney
Published: Friday 07 January 2022

India’s death count for COVID-19 is a mystery for many experts. As of January 6, India reported a total of 346.76 deaths per million, which is much lower than that in rich countries such as the United States (2,505.11 deaths per million) and the United Kingdom (2,193.76 deaths per million). 

The country’s cumulative number of deaths has been reported as 483,178, according to Our World in Data. The figure is  seven times lower than that of the US. This anomaly has perplexed researchers as India has a poor health infrastructure and death rates were expected to be higher. 

While reasons such as low infection rate and higher immunity levels in the population can explain the low mortality to an extent, experts have often pointed out that India might actually be underreporting the number of deaths due to factors like incomplete certification of COVID-19 deaths and misattribution to chronic diseases.

An analysis published in Science journal on January 7, 2022 suggested that India’s cumulative COVID-19 deaths were 6-7 times higher than reported officially.

While this would put India’s monitoring system in poor light, it would also jack up the global death figures. “If our findings are confirmed, this may require substantial upward revision of the World Health Organization’s estimates of cumulative global COVID-19 mortality, which, as of January 1, 2022, stood at 5.4 million,” said Prabhat Jha and colleagues based in Canada, the US and India. 

Many model-based estimates of cumulative COVID-19 deaths through June 2021 in India put the death rate to be anywhere between a few hundred thousand to over four million. 

Now, the researchers tried to estimate the death count in India using one independent and two government data sources. They used data collected via a nationally representative telephone survey conducted by CVoter, a private polling agency in India. 

The company contacted 137,289 adults in all states and Union territories between March 2020 to July 2021 to get actual figures of deaths in families. Using this data, they estimated 3.2 million COVID-19 deaths in India from June 1, 2020 to July 1, 2021, the majority of which occurred from April 1 to July 1, 2021 (when COVID-19 doubled all-cause mortality). 

Two government data sources found that, when compared to pre-pandemic periods, all-cause mortality was 27 per cent higher in 0.2 million health facilities and 26 per cent higher in civil registration deaths in states: Both increases occurred mostly in 2021. 

The findings corroborate earlier findings by Institute for Health Metrics and Evaluation, which too indicated that excess deaths due to COVID-19 is likely to be six times that reported.  

Similarly, a study, published in Lancet journal in December 2021, looked at all-cause mortality in Chennai and found 5.18 excess deaths per 1,000 people between March 1, 2020 and June 30, 2021. 

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