Count the dead: Important to get near-accurate estimates of Covid deaths

By: |
August 19, 2021 5:30 AM

To be sure, the excess deaths with unspecified causes will definitely not be all Covid-deaths, but given the concurrence with the pandemic, a large number can be attributed to the disease.

Bear in mind, India may have not counted first-wave deaths and incidence correctly, which could have led to the complacency that ushered in the tragic second wave. Bear in mind, India may have not counted first-wave deaths and incidence correctly, which could have led to the complacency that ushered in the tragic second wave.

According to an analysis by Reporters’ Collective (RC), Gujarat has been under-counting deaths due to Covid-19, between March 2020 and April 2021 in 68 of 170 municipalities in the state. The death data from the 68 municipalities account for a mere 6% of the state’s population, and a conservative projection based on simple proportionality would peg the excess death in the state 27 times higher than the Gujarat government’s official Covid-death toll on the morning of August 16.

The analysis notes that the excess deaths in the state in May 2021 have not been included—the Gujarat government’s own numbers show Covid deaths that month numbered much higher than April’s. This, and the fact that rural areas of the state, where healthcare-access is not as strong, have also been left out of the analysis would suggest the RC projection is conservative.

To be sure, the excess deaths with unspecified causes will definitely not be all Covid-deaths, but given the concurrence with the pandemic, a large number can be attributed to the disease. So, even if the Covid-death number in the state isn’t actually 27 times higher than reported, it is very likely a significant multiple. That said, governments, whether it is the Centre or the states or the local governments, owe it to Indians to record the Covid data correctly, and for several reasons. It may not entirely be deliberate under-counting—Covid deaths occurring at home, especially without a diagnosis of the disease, simply may not enter the records. But, the records must be corrected to the maximum extent possible.

Accurate attribution not only has statistical import, but also epidemiological import. For instance, there is a lot, in terms of Covid pathology including predisposition to fatality, that is still not clear to science. Proper identification of the disease and related deaths, thus, are key to global efforts to control the disease’s severe outcomes. Also, the second wave showed how short India’s overall healthcare ecosystem is on critical Covid-19-management infrastructure; near-accurate case fatality data—including granular data such as deaths because of oxygen shortages—will help us in successive waves, if any. Bear in mind, India may have not counted first-wave deaths and incidence correctly, which could have led to the complacency that ushered in the tragic second wave.

Such under-reporting is a chronic ailment for India. So, the government has its task cut out. The need isn’t to pat one or the other state on the back—both Gujarat and Uttar Pradesh received praise for “good Covid management” from the highest echelons of power—even as a troll-army targets others for presenting better data. Acclaimed researcher Chandrakant Lahariya’s, based on his analysis of ICMR sero-survey data and vaccination read together with reported cases from states, believes Uttar Pradesh under-reported the cases the most (reporting one for every 98 cases missed). The corresponding under-reporting factor was 61 for Gujarat, against India’s 30 and Kerala’s six (the lowest in the country). The need is to remedy this state of affairs—even when it is, very likely, not deliberate in many cases.

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