New Delhi: India’s death rate in 2020 — the first year of the Covid pandemic — remained constant at 6 per cent, the same as the last pre-pandemic year, 2019, an analysis of the Civil Registration System (CRS) data released earlier this week shows.
Death rate is defined as the number of deaths per thousand population in a given region and time period.
An estimated death rate normally finds mention in Sample Registration System (SRS) data. However, top government officials have made these estimates based on provisional population estimates available for 2020.
The CRS data does not imply that there were no excess deaths in India in 2020. It simply suggests that compared to 2019, India did not witness a sharp spike in the number of deaths registered across the country in the first year of the Covid-19 pandemic.
To assess the number of excess deaths in the country, a reasonable estimate of death registration levels would be needed. The CRS data made public Wednesday does not provide such an estimate, unlike data released earlier.
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WHO ‘conveniently ignored’ CRS data
The Ministry of Health and Family Welfare (MoHFW) Thursday issued a fresh rebuttal to the World Health Organization’s (WHO) estimate of 4.7 million (47 lakh) excess deaths due to Covid in India till 2021.
While questioning the WHO’s methodology and claiming that CRS data has a death registration level of 99.9 per cent, the health ministry Thursday accused the WHO of “conveniently ignoring” the CRS data despite having access to it.
“The CRS data of 2020 published by RGI [Registrar General and Census Commissioner of India] on 3 May 2022 clearly reveals that the narrative sought to be created based on various modelling estimates of India’s Covid-19 deaths being many times the reported figure is totally removed from reality. We now have actual figures of deaths (i.e. all-cause mortality) for 2020. The historical figures of all-cause mortality for the years 2018 and 2019 are also available in public domain. Since RGI figures capture ‘all-cause mortality’ for a particular year, mortality figures of COVID-19 could at best be considered a subset of the ‘all-cause mortality’ in that year.”
“Therefore, reliable figures released by the statutory authority captured through a rigorous process across the country are presently available for analysis and support in policy planning. It is a known fact that modelling, more often than not, can lead to overestimation and on few occasions, these estimates may stretch to the limits of absurdity,” read a statement by the Ministry of Health and Family Welfare (MoHFW).
Crude death rate
According to the CRS data, the number of deaths registered in India touched 81.2 lakh in 2020. Officials in the office of the RGI say the provisional population estimate for 2020 stands at about 135 crore, which is in line with estimates shared by the Ministry of Health. This means that India’s crude death rate was steady at 6 per cent in 2020.
Crude death rate is the ratio of deaths recorded over a period of one year and the average population that same year.
The latest crude death rate estimate signals a disruption in trends from preceding years — it had dipped steadily from 8.5 deaths per thousand population in 2000 to 6 in 2019. This was a sharp departure from trends reported by many countries, including the US, which saw an increase in death rate during the pandemic.
The CRS data does not estimate what percentage of deaths in India were actually reported in 2020. It has also been pointed out that the same data shows a decline in year-on-year increase in deaths that year.
The number of deaths registered in India in 2020 saw a jump of 4.75 lakh from the previous year, from 76.4 lakh in 2019 to 81.2 lakh in 2020. This difference was lower than that the 7 lakh jump between 2018 (69.5 lakh) and 2019 (76.4 lakh).
Death registration levels
While the actual increase in the number of deaths between 2019 and 2020 may have declined, the 2020 CRS report, unlike the one released in 2019, is silent on one crucial detail — level of registration.
The 2019 CRS report clearly said that the level of registration — deaths registered for every 100 that occurred -—stood at 92.6. It further provided an estimate of the actual deaths that may have occurred in the country — 83,01,769 against the 76,41,076 that were registered.
Sources in the office of the RGI say the omission was deliberate.
“Covid caused many disruptions in our work. So, it was not possible to conclusively write what percentage of deaths had been reported. That is why that number is not there,” a senior functionary told ThePrint.
However, a senior official in the health ministry said a figure of 99.9 per cent death registration level had been “internally shared” with the ministry.
Though the all-India death registration level is missing from the 2020 CRS report, there have been estimates about what percentage of deaths were registered within 21 days of them occurring in various states across the country, which is the criterion for registration of deaths according to the CRS.
Many of these estimates show a sharp decline in the death registration level between 2019 and 2020. In Assam, for example, this figure dipped from 74 per cent in 2019 to 20.5 per cent in 2020.
Officials familiar with the issue say death registration happens over a longer duration, adding that about 5-6 per cent of deaths registered in a given year actually date back to the earlier year, which is why the two figures cannot be compared.
“Deaths are registered when there is a compelling reason for it, for example, if there is property involved. During Covid, there was the question of compensation, so there may have been more registrations,” an central government official told ThePrint.
“If we go by the 2019 death rate and the provisional population estimate for 2020, we reach a registration level of 99.9 per cent, but that may not be entirely correct because there are too many assumptions in that number. That is why we have not given the level [of registrations],” added the official.
(Edited by Amrtansh Arora)
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