India’s COVID Deaths May Be 6-7 Times Higher Than Reported: Study

The study estimates that about 32 lakh people died of COVID-19 in India since the onset of the pandemic in 2020.

A study found that India may have seen about 32 lakh deaths related to COVID-19 over the course of the pandemic, which is six to seven times the official reported numbers.

The study, titled 'COVID mortality in India: National survey data and health facility deaths,' published in the journal Science on Thursday, 6 January, derives its numbers from one independent data source, and two government ones.

Led by Prabhat Jha, a professor at Canada's University of Toronto, a team of international researchers used a nationally representative survey of more than 1.3 lakh adults across states and Union Territories of India.

The team found that 29 percent, or 32 lakh, of all deaths between June 2020 and July 2021 were attributed to COVID-19, of which 27 lakh happened between April and July 2021, during the grim second wave that gripped India.

A sub-survey of 57,000 adults showed similar patterns in COVID-19 and non-COVID-19 mortalities.

Increased All-Cause Mortality and Data Gaps in Recorded Deaths

According to the two government data sources used in the research, all-cause mortality during the pandemic was 27 percent higher in two lakh health facilities compared to pre-pandemic times and ten states saw a 26 percent spike in civil death registrations.

The United Nations Population Division (UNPD) estimates that more than a crore COVID-19 deaths took place in India, of which "over three million (30 lakhs) were not registered and over eight million (80 lakhs) did not undergo medical certification."

It added that attribution to chronic diseases as well as incomplete certification may have also contributed to the data deficiency, as "most deaths occur in rural India, without any medical attention."

The first study was a mortality reported in a nationally representative telephonic survey conducted by CVoter, a private polling agency that launched the survey to help track the pandemic and covered over 1.4 lakh adults.

In addition to that, it looked at the Centre's data on deaths in government hospitals — with over 90 percent of them being in rural India — and civil registration systems (CRS) data related to COVID-19 deaths recorded in ten states.

The researchers found that the increase in facility deaths in the first viral wave was primary in urban areas, but the second wave saw both urban and rural facilities reporting deaths.

"The estimates of 3.1 to 3.4 million deaths from the independent COVID Tracker survey represent a national COVID death rate per million population ranging from about 2300 to 2500, or approximately 6- to 7-fold the officially reported rate on Sept 1, 2021," said the study.

Government Yet to Release Definitive Data

Noting its strengths and limitations, the paper suggests that the actual deaths in government-run facilities may be more, as the Government of India is yet to release this data from June 2021 onward.

It also expects a "more definitive quantification of excess mortality" after the Registrar General of India relaunches it's Sample Registration System (SRS) to cover all deaths in 2020 and 2021.

Further, it underlines the need to improve medication certification and death registration systems for timelier reporting. It noted a marked difference between deaths being reported in the poorest states in central India and large gaps between reported deaths of men and women.

Calling their results "conservative", the study concludes by noting that COVID-19 related deaths in India were "substantially greater" than officially reported.