There have been some media reports based on a published research paper alleging that mortality due to COVID19 in India is much higher than the official count and actual numbers have been undercounted. The study estimates that people between 3.2 million to 3.7 million have died from COVID19 by early Nov 2021 in the country, as compared to official figures of Nov 2021 of 0.46 million (4.6 lakhs).
As has been stated earlier for similar media reports, it is again clarified that these reports are fallacious and completely inaccurate. They are not based on facts and are speculative in nature.
India has a robust system of reporting deaths including COVID-19 deaths that is compiled regularly at different levels of governance starting from the Gram Panchayat level to the District-level and State level. The reporting of deaths is regularly done in a transparent manner. All deaths are compiled by the Centre after being independently reported by States. Based on globally acceptable categorization, Government of India has a comprehensive definition to classify COVID deaths which has been shared with the States and the States are following it. Furthermore, Government of India has been urging States to update their mortality numbers in case if certain deaths are not reported in time at the field level, and hence remains completely dedicated in getting the correct picture of the pandemic related deaths. Government of India has urged States and UTs through several formal communications, multiple video conferences and through deployment of many Central teams for correct recording of deaths in accordance with the prescribed guidelines. Union Health Ministry has also regularly emphasized the need for a robust reporting mechanism for monitoring district wise cases and deaths on a daily basis. Therefore, to project that COVID deaths have been under-reported is without basis and devoid of justification.
The study quoted in the media reports has taken four distinct subpopulations — the population of Kerala, Indian Railways employees, MLAs and MPs, and school teachers in Karnataka, and uses triangulation process to estimate nationwide deaths. Any such projections based on limited data sets and certain specific assumptions must be treated with extreme care before extrapolating the numbers by putting all states and country of the size of India in a single envelope. This exercise runs the risk of mapping skewed data of outliers together and is bound to give wrong estimations thereby leading to fallacious conclusions. The sheer justification that the study has credence since its findings/estimates are in convergence with another study is baffling, defies logic and highlights the bias with which the article has been written.
The media reports further claim that “Experts believe India’s civil registration system is vulnerable to gaps. The current civil registration system has little interoperability with health information systems, there is potential for gaps in recording of deaths.” It is reiterated that the Union Government has followed a transparent approach regarding COVID data management and a robust system of recording all COVID-19 related deaths already exists. In order to avoid inconsistency in number of deaths being reported, Indian Council of Medical Research (ICMR) has issued ‘Guidance for appropriate recording of COVID-19 related deaths in India’ for correct recording of all deaths as per ICD-10 codes recommended by World Health Organisation (WHO). The date of cases and deaths due to COVID19 are being put in public domain on a daily basis since start of the pandemic, and similarly all states, including districts, are releasing regular bulletins with all details on a daily basis which is also in public domain.
It is an established fact that there shall always be differences in mortality recorded during a profound and prolonged public health crisis such as COVID19 pandemic and well conducted research studies on mortalities are usually done after the event when data on mortalities are available from reliable sources. The methodologies for such studies are well established, the data sources are defined as also the valid assumptions for computing mortality.
In the case of analysis of COVID19 mortality in India, it must be noted that there is added push in India to capture and report all COVID19 deaths due to the entitlement to monetary compensation to the next of kin of each and every COVID19 deceased person. This whole process is being continuously monitored by the Hon’ble Supreme Court of India. Therefore, likelihood of underreporting of COVID deaths in the country is significantly less. Hence, the conclusion that the “undercount” is due to reluctance or inability of families and local authorities is fallacious and far from the truth.
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