According to a report released by the World Health Organisation on 5 May, the actual number of COVID-19 related deaths in India was around 4.7 million, and not 520,000 as reported by the Central Government.
This estimate by the WHO was first reported in an article in the New York Times, nearly a month before its official release.
According to the article titled 'India Is Stalling the W.H.O.’s Efforts to Make Global COVID Death Toll Public,' around one third of the nine million excess deaths calculated by the WHO globally occurred in India.
The report now officially released by the WHO corroborates these estimates.
The Union Health Ministry has questioned the WHO's use of a mathematical model to calculate the number of COVID-19 deaths, saying that the "figure is totally removed from reality."
The health ministry also said that India has an "extremely robust" system of births and deaths registration. The government called the WHO's system of data collection "statistically unsound and scientifically questionable".
What the WHO Estimates Say
As per the WHO's estimates, approximately 14.9 million died of COVID related issues between 1 January 2020 and 31 December 2021.
The report also says India had 830,000 excess deaths in 2020, and 3.9 million excess deaths in 2021, making it the country with the highest COVID death toll in the world.
Accoring to the report, around 2.3 Million of these deaths occurred in just the span of 2 months (April and May 2021) at the peak of the second COVID wave in the country.
It adds that the WHO arrived at their estimated numbers by combining the national records with deaths that were previously unaccounted for, with the help of surveys and statistical models used to estimate the true COVID death toll of countries with uncertain data.
The new numbers also include indirect COVID deaths which were previously not considered COVID deaths in India, it said.
'Flawed Methodology': India Responds
The Indian Government, responded to the article back in April, standing by its official numbers, and criticized the WHO's "one size fit all approach".
In their statement, the MoHFW dismissed the WHO's methodology used to arrive at their estimated data, pointing out that the WHO has not yet shared the confidence interval for the present statistical model across various countries.
Addressing the Indian government's dissatisfaction with WHO's methodology, Dr Bhramar Mukherjee, a professor of epidemiology and biostatistics, had said India should refute it with scientifically backed data of their own.
"If you have an alternative estimate, which is through rigorous science, you should just produce it. You cannot just say, ‘I am not going to accept it."Dr Bhramar Mukherjee, professor of epidemiology and biostatistics, quoted by the New York Times
Speaking to FIT at the time, renowned virologist Dr Shahid Jameel echoed this thought, saying that although the government has criticized independent studies, it hasn't put out its own estimates of actual COVID deaths.
The central health authority "continues to stonewall data available with MoHFW by not making it available to independent researchers," he further added.
Estimating Actual COVID Deaths
This isn't the first time that the gap between the reported and the actual COVID death toll in India has been brought up.
Other independent studies, of which there are at least 5 across the world, have come up with similar numbers in the ballpark of 4 million COVID-19 related deaths in India in the 2 years of the pandemic.
A paper published in the medical journal Lancet in March 2022 also estimated that India's actual COVID death toll between January 2020 and December 2021 is around 40 lakhs more than the official numbers.
Furthermore, the authors of the Lancet study found that of the 191 countries they looked at, India had the highest number of excess mortalities.
According to his own basic calculations too, Dr Jameel tells FIT, the reported numbers turn out to be underestimates.
Breaking down the broad estimation, Dr Jameel says, "The CDR (crude death rate) reported by India for 2018-19 was 7.2 per 1000 people. For a 1.38 billion population, this translates to about 27,200 deaths per day."
"The government estimates for COVID-19 deaths at the peak of the 2nd wave were about 4000 per day, which is only about 15 percent more than normal daily deaths. This would not have caused the scenes we witnessed at crematoria and burial grounds."Dr Shahid Jameel, Virologist
So, even if the WHO's methodology requires more scrutiny, other studies available in the public domain throw up similar figures of estimated COVID deaths in India.
'There Will Always Be More Actual Deaths Than Estimates'
... And there is no way of knowing the actual number accurately. This is true for all countries.
"It is not possible to count every death during a pandemic for various reasons. In the end, the best estimates will come from multiple types of surveys that give an excess mortality figure."Dr Shahid Jameel, Virologist
However, the robustness of a country's data collecting system will determine how small the gap will be, say experts.
Speaking to FIT for a different article back in March, Dr Murad Banaji, a mathematician at Middlesex University in the UK, who has been closely watching India's COVID-19 data said, "unfortunately, instead of trying to get to the bottom of what went wrong, the government has engaged in amateurish attempts to discredit the research papers and pre-prints estimating India's pandemic mortality."
Why Does It Matter?
To put it simply, lack of transparency breeds mistrust.
We say this in the initial months of 2021 when COVID vaccines were first rolled out, and how a lack of clear data from the central health bodies on deaths and serious adverse events following the administration of COVID-19 vaccine spurred widespread misinformation and vaccine hesitancy.
Apart from this, accurate data of COVID-19 related deaths is critical to knowing how well the vaccines are working in the real world in preventing mortality, a piece of information that is essential to planning and preparing for any future waves.
(Written with inputs from the New York Times.)
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