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Deaths due to COVID-19 understated?

India’s official COVID-19 death figures are already tragic, rising rapidly throughout the second wave. However, there are many that now believe these death figures are being severely underreported.


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A Twitter thread in early May by Dr Ashish K. Jha, Dean of the Brown University School of Public Health, suggests that the fact that crematoriums across the country were overburdened at the height of the second wave was indicative that COVID-19 deaths were  far higher than were being reported at the time. 

“India reports another 400,000+ cases, 4000+ [deaths per] day. A sustained level of horribleness,” Dr Jha wrote. “And [it’s] not correct. True number surely closer to 25,000 deaths, 2-5 million infections today” reads the Tweet. “During [the] non-pandemic year 2019. About 27,000 Indians died on [a] typical day. Crematoriums handle that level of deaths every day. Additional 4,000 deaths won’t knock them off their feet. Crematoriums across the country reporting 2-4X normal business.”

Health Issues India noted that the basis of the theory is that India, even before the COVID-19 pandemic, counted roughly 27,000 daily deaths on average. An additional 4,000 deaths, therefore, would not have caused the catastrophic disruptions to both the health system and the crematoriums. The additional 4,000 deaths has only occurred during the previously globally unheard of heights of the second wave, and even this figure may fall within the normal range of the 27,000 average deaths.

This speculation via Twitter is now being corroborated by other experts. According to Dr Bhramar Mukherjee, a Professor of Public Health and Epidemiology at the University of Michigan, who has been tracking India’s pandemic, approximately 1.2 million Indians had already died by May 15th.

Data seems to confirm this theory. However, officially the higher figures are at this point speculative. Data from Andhra Pradesh, for example, shows over 130,000 deaths in May, nearly five times the number of fatalities for the same month in 2018 and 2019. A similar situation has been observed in Madhya Pradesh, in which three times the average monthly death rate had been reported across April and May this year.

The increase in deaths has not yet been attributed to COVID-19 by the state governments, instead, remaining silent on the issue. The fact that these deaths may be linked to COVID-19 is therefore unconfirmed, however, given the overburdening of hospital systems with COVID-19 cases, it is not an unfounded speculation. Regardless of whether the deaths are indeed related to COVID-19, a five-fold increase in deaths is an alarming situation that warrants urgent investigation.

The Telegraph has brought forward allegations that misreporting of cases is being used as a political measure

“Politically, India is governed via a federal system and this has encouraged state governments to underreport COVID-19 fatalities in political point-scoring and to reduce panic among citizens. In many states, COVID-19 fatalities were often only reported if the victim had no other comorbidities, and instead fatalities were marked as being related to a variety of other causes, including heart attacks or diabetes.”

This manner of accusation is also not an isolated case, with previous extreme examples of news alleging that some state governments have attempted to crack down on both hospitals and individuals posting online regarding the need for oxygen. Investigations into true figures have already resulted in revised death toll numbers. An investigation by the Bihar Health Department resulted in close to 4,000 additional deaths being added to their records, revising its death toll from 5,424 to 9,429. The investigation occurred due to numerous partially decomposed and previously unregistered bodies washing up on the shores of the River Ganga. 

Some have gone as far as to suggest even these revised figures to be an underestimate. It has been postulated that as many people are refraining from visiting the already overburdened hospitals for fear of contracting COVID-19 themselves, many deaths are being left unrecorded in their entirety. 

This theory reinforces the opinions put forward by Dr Ashish K. Jha, as the number of bodies being cremated would be considerably raised. While the official figures would only support a marginal increase in the activity of crematoria, based on previous year averages, the fact that many individuals have lost their lives but as of yet been unregistered officially could support the near 24-hour activity of crematoriums during the height of the second wave.

While the overall toll that COVID-19 has taken on India is yet debatable, what is not is the tragedy of the situation. More must be done to ensure that should another pandemic — or even a third wave of COVID-19 — to occur, the health system is adequately prepared.

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