Editorial: Covid, where did the dead go?

There are no easy and credible answers as to how many people died in India due to the Covid-19 pandemic. India’s official death toll for the period between January 1, 2020 and December 31, 2021 stands at 4,81,000 while the latest report from the World Health Organisation (WHO) puts the figure at ten times as many. Wrapped in mystery, the issue has popped up in public debates repeatedly during the last one year and refuses to die down.

Data released by WHO suggests that India accounts for almost a third of the Covid deaths that occurred globally and points out that India is one among the ten countries where Covid-led mortalities have been undercounted with Pakistan, Russia, Egypt and Bangladesh also figuring among them.

The report mentions that at least 14.9 million deaths associated with Covid-19 in 2020 and 2021 were not counted globally. Government of India has refuted the charge of underassessment and termed the report fallacious, ill-informed and mischievous and held the WHO’s methodology for assessment flawed.

For a country of India’s size, diversity and wildly varying level of healthcare infrastructure across States, discrepancies should not be unexpected in any kind of data. But the yawning chasm between official statistics and the WHO’s assessment gives room for suspicion if the Union Government is out to suppress data which may fly in the face of triumphalist drumbeating for its Covid management. Even earlier, news reports from several states have pointed out a mismatch between Covid deaths being reported by hospitals and burials plus cremations being reported from graveyards and crematoria. There were also instances of compensation claims for Covid deaths exceeding the official mortalities due to the infectious ailment. Then a scientist, Ariel Karlinsky, a scientist from the World Mortality Dataset, a global repository providing updated data on deaths from all causes, is on record to have said that Covid-related mortality data was unavailable with India’s main statistical office, when he asked for it in November 2020.

Counting dead in India has never been systematic. Most deaths occur at home, more so in rural areas. Successive National Family Health Surveys (NFHS) have pointed out that most births in poorer states like Uttar Pradesh, Bihar and Assam remain unregistered in any kind of civil registry system.

The UN estimates say, of the 10 million annual deaths in India, seven million do not have a medically certified cause of death and three million fatalities are simply not registered.

A sound medical information system and comprehensive healthcare metrics hold the key to effective check against vulnerabilities and help ramp up operations during outbreaks of pandemics.

It is for the authorities to ensure that medical data does not suffer from paucity and opacity data, as it has happened in the current case. India can ignore it only at its own peril.