New Delhi: Fifty-four municipalities of Gujarat saw about 16,000 excess deaths between March 2020 and April 2021 as compared to the January 2019-February 2020 data, showed an analysis by US researchers of death registration data. This excess death figure is around 60 per cent higher than Gujarat’s total official Covid death toll of 10,080.
In a pre-print uploaded on the website medRxiv, researchers from Harvard TH Chan School of Public Health and the University of California, Berkeley said they used data from civil death registers for 54 of the 162 municipalities of Gujarat, located across 24 of its 33 districts, to estimate the impact of the pandemic on all-cause mortality.
The total population of these municipalities is about 32 lakh, or 5 per cent of the state’s total population, according to the 2011 Census.
“Using a model fit to monthly data from January 2019 to February 2020, we estimate excess mortality over the course of the pandemic from March 2020 to April 2021,” the researchers said.
“We estimated 16,000 excess deaths across these municipalities since March 2020. The sharpest increase in deaths was observed in April 2021, with an estimated 480% increase in mortality from expected counts for the same period,” the paper said.
The scientists used publicly available data uploaded on the website ‘Wall of Grief’ by The Reporters’ Collective — “an online memorial to document the lives lost in India during the Covid-19 pandemic”, and de-identified data from civil death registers, the official death registers of gram panchayats in rural India and of municipalities and municipal corporations in urban India.
The researchers found a greater increase in mortality from the baseline (2019) levels in females and among people in the 40-60 age group during the pandemic.
“Our excess mortality estimate for these 54 municipalities, representing approximately 5% of the state population, exceeds the official COVID-19 death count for the entire state of Gujarat,” they wrote.
ThePrint reached Satchit Balsari, one of the authors of the paper, for a comment via email but didn’t receive a response until the publishing of this report.
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93% deaths in Gujarat are registered
According to the National Family Health Survey (NFHS) 2019-20, 93 per cent of all deaths in the state are recorded in the civil registers. During the period under study, 44,568 deaths were recorded across the 54 municipalities.
“While deaths were higher in both 2020 (31,477) and 2021 (17,882 up to April) compared to 2019 (25,590), the sharpest increase in deaths was observed during the second wave of the pandemic in 2021,” the researchers reported.
“Between January and April of 2021, 17,882 deaths were observed, reflecting a 102% increase over the average of the previous two years for the same months. The observed increase in all-cause mortality between January and April 2021 differed by age and sex. The largest percentage change compared to the same months in the previous two years was in the 50 to 60 years age group (164%) followed by the 40 to 50 years age group (152%),” they said.
They also pointed out the fact that this estimate is from just 54 municipalities — all of them urban — is a convenience sample rather than a random sample.
Additionally, they said the baseline period is short and may not be sufficient to capture yearly mortality variations. It was not possible to calculate mortality rates as population figures by municipality were not available.
“We estimated a 480% increase in deaths in April 2021, in the municipalities studied. This is the highest percentage increase in deaths recorded in a single month anywhere in the world. In April 2020, Ecuador recorded a 411% increase; in April 2021, Peru recorded a 345% increase,” they said.
“This large discrepancy between official COVID-19 death counts and excess mortality underscores the need to rectify how official death counts are collated. Reliance on death certificates as the single source of truth is sub-optimal when access to health systems, testing availability, and death certification accuracy and completeness are all weak,” the researchers added.
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