GEIS-新闻详情

Undercounting of Covid-19 deaths hides extent of devastation in India

2021-07-08 00:00:00.0 海峡时报-亚洲原网页

BANGALORE - India is among the worst affected countries in the pandemic, but the full extent of the impact in terms of deaths is heavily concealed by narrow definitions of Covid-19 deaths, fudged data and opaque death registries.

Officially, about 405,000 people in India have died of Covid-19 so far. But field journalists, epidemiologists and surveyors estimate that the real number is probably far higher.

Part of the problem is whether the deaths are being accurately recorded.

Official guidelines say that when a person who tested positive for Covid-19 dies, the disease should be listed as the cause of death. When a person with symptoms of Covid-19 dies - regardless of whether he had tested negative or not been tested - his death should be classified as a suspected or probable Covid-19 death.

However, many states do not follow these guidelines and record as Covid-19 deaths only those people who had tested positive for the disease and died of related causes.

Last week, India's Supreme Court again directed the authorities to ensure that any death that occurred within three months of the person testing positive for Covid-19 be classified as a Covid-19 death.

One way which experts the world over track the true impact of the pandemic is to measure excess mortality.

The World Health Organisation defines excess mortality as the difference in the total number of deaths in a crisis and that expected under normal conditions. This number captures both the deaths caused directly by Covid-19 and others resulting from indirect impact such as a weak healthcare system.

But death registration data in India can be both unreliable and hard to find.

Its countrywide Civil Registration System (CRS) tracks births and deaths, and is implemented by state governments. Different states officially register deaths with varied levels of thoroughness. For example, Tamil Nadu and Karnataka register all deaths, but Bihar registers only 52 per cent of them.

Usually, states in India release an annual report of births and deaths more than a year later - so the 2019 data would be out in December 2020. The national CRS report that collates state data is also delayed by at least 1？ years.

During the pandemic, state governments have been collecting but not releasing all CRS data about deaths. Journalists and researchers have thus been leaning on unnamed government sources to access this data. What they have found has confirmed suspicions about vast undercounting of Covid-19 deaths.

Indian news website Scroll.in found that Madhya Pradesh saw nearly three times more deaths in April and May compared with the same period in previous years. The excess deaths between January and May were 42 times the reported Covid-19 death count.

Andhra Pradesh in May recorded nearly five times the usual number of deaths for the month. The excess deaths between January and May were 34 times the official Covid-19 death toll.