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Are states quietly adding ‘backlog’ to Covid death toll? Modi govt wants audit & analysis

Modi govt's apprehensions stem from the fact that while daily cases have nearly halved in the last 2 weeks, there has not been a proportionate decrease in daily deaths. 

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New Delhi: The Modi government may be quick to counter any “speculation” in the international media about India’s death toll but it is concerned that the daily Covid fatalities have not reduced in proportion to the cases. 

The central government is now pushing states to conduct death audits, in order to arrive at a more realistic estimate, and has asked the director general of health services (DGHS) to look at the latest deaths data from the civil registration system (CRS), which accounts for all deaths. 

In the two-week period between 1 June and 15 June, daily positives have more than halved (53 per cent) from 1,32,788 to 62,224, but there has not been a proportionate decrease in the daily deaths — daily Covid fatalities have reduced from 3,207 to 2542, a decrease of about 20 per cent.

But while the CRS data may give an estimate of extra deaths in the course of the second Covid-19 wave, linking them to the pandemic may be impossible unless states undertake a meticulous and detailed death audit. 

Sources in the office of the Registrar General of India (RGI) say that even before the pandemic, the medical cause of only 22 per cent of deaths were known.

“We are currently in the process of compiling reports for 2019. We do not have data for 2021 yet; that is still with the state governments. However, to make a presumption that any additional deaths would be because of Covid-19 may not be correct because recording of medical causes of deaths had been poor even before the pandemic,” said a senior official in the RGI office, speaking on condition of anonymity.

“For just 22 per cent of the deaths, we have information about the medical causes. And this is the pre-pandemic statistic.” 


Also read: Safety is key, health ministry says but doesn’t know Bengaluru lab still studying Nagaland bats


‘Backlog’ deaths suspected to be reason behind high numbers

So far only two states, Bihar and Maharashtra, have officially added backlog deaths — those that happened in the past but had not been linked to Covid-19 — to their pandemic toll. 

Officials, however, said there are apprehensions that many states are adding backlog death numbers to the daily total without expressly saying so. 

“You have to understand that our daily toll has not come down in proportion to the rate of change of daily cases. Even if one accounts for a 15-day lag period (which is the average time between diagnosis and death) these numbers do not add up,” said a senior health ministry official who did not want to be named.

“That is why we have written to states asking them to undertake death audits. To Maharashtra and Bihar also, we have said that deaths should be added with details about date and district. This will help us understand the behaviour of the disease better and analyse and plan for the future.” 

Health ministry sources said six states whose death numbers are a particular cause for worry, and in serious need of a systematic audit, are West Bengal, Tamil Nadu, Kerala, Karnataka, Bihar and Maharashtra. 

“We are not saying that they are fudging numbers. Our limited point is that the reporting and auditing has to improve if we are to correctly assess the impact of the pandemic,” the official added.

Govt responds to The Economist

Meanwhile, in a rebuttal to an article in The Economist, which said that India’s Covid-19 deaths could be several times the official estimates, the Modi government has termed the piece as being “speculative”, “without any basis and seems to be misinformed”.

In a press note, the health ministry said that the union government has been transparent in its approach. 

“The Union Health Ministry has also regularly emphasised the need for a robust reporting mechanism for monitoring district-wise cases and deaths on a daily basis. States consistently reporting lower numbers of daily deaths were told to re-check their data,” the press release said.

“A case in point is the union government writing to the State of Bihar to provide a detailed date and district wise break-up of the reconciled number of deaths to the Union Health Ministry. It’s a well-known fact that there shall always be difference in mortality recorded during a profound and prolonged public health crisis such as COVID pandemic and well conducted research studies on excess mortalities, usually done after the event when data on mortalities are available from reliable sources.”

(Edited by Arun Prashanth)


Also read: Lab leak or natural? How the evidence stacks up in the coronavirus origin investigation


 

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