India’s Covid Death Toll: Lies, Damned Lies and Statistics | K N Ninan

by K N Ninan

Mark Twain, an American writer is credited with popularising a statement rightly or wrongly attributed to Benjamin Disraeli, British Prime Minister during 1874 to 1880 which stated that: “There are three kinds of lies: lies, damned lies and statistics†. Standard textbooks in statistics quote this to introduce students to the subject. Darrell Huff, a journalist wrote a book in 1954 titled ‘How to Lie with Statistics’ which aptly sums up how statistics can be used, misused or even doctored to support or demolish a point of view or perpetuate falsehoods.

These statements hold true while discussing India’s covid death toll. As per official statistics over 4.50 lakh people (as on October 12) have died due to covid. Over 1.57 lakh deaths occurred during the first covid wave and over 2.93 lakh deaths during the second wave. However, experts, media, civil society, and others have been questioning the data released by the Indian government regarding the number of covid deaths in the country.

A study titled: Three New Estimates of India’s All Cause Excess Mortality during the Covid-19 Pandemic by the Centre for Global Development, Washington report three excess mortality rates using three data sources from the pandemic’s start through to June 2021. The study relied on extrapolation of state-level civil registration (CRS) data on deaths; applying global estimates of age-specific covid infection fatality rates (IFR) to Indian seroprevalence data and analysing longitudinal household survey data for over 8 lakh individuals in India collected by the Centre for Monitoring Indian Economy (CMIE), Mumbai. The excess deaths were measured against the actual deaths recorded during three pre-pandemic reference periods. Based on this the study reveals that the excess deaths during the covid pandemic in India ranged between 3.4 million to 4.9 million which is 8 to 11.5 times higher than the official estimates of covid deaths in India.

The estimated excess deaths during the first wave ranged between 1.5 to 3.4 million and between 1.4 to 2.4 million during the second wave. While CMIE data suggest higher excess deaths (3.4 million) during the first covid wave, the seroprevalence and IFR procedure reveal greater fatalities (2.4 million) during the second wave. Part of the difference is because their analysis for the first wave covered 11 months (April 2020 to March 2021) and second wave covered 3 months (April to June 2021). To quote the study: “True deaths are likely to be in several millions not hundreds of thousands, making this arguably India’s worst human tragedy since partition and independence†.

The Modi government, not unexpectedly, was dismissive of the study’s findings. However, what may be embarrassing for the ruling party is that one of the authors of this study is Dr Arvind Subramanian, Professor, Brown University, USA who was the Chief Economic Adviser to the Modi government during the period 2014 to 2018. The study acknowledges some of its limitations. For instance, the CMIE data had information on mortalities reported by the households but not the cause of these deaths.

Other studies too point to gross underestimation of covid-related deaths in India. Bhramar Mukherjee, Professor of Epidemiology, University of Michigan who has been closely tracking the covid situation in India estimated the covid-19 death toll to be as high as 2.5 million i.e., five times higher than the official death toll. Based on serosurveys and epidemiological models a study by Ritwik Bhaduri of Indian Statistical Institute, Kolkata and others suggest that more than 90% of covid infections in India remains unreported and the undercounting of covid-19 deaths ranges from a factor of 1.5 to 5.

Anecdotal accounts by covid-affected families, staff of hospitals, crematoriums, burial grounds and investigative reports by journalists, media and others too point to gross underestimation of covid deaths in India. Discrepancy between death certificates issued and official covid-19 deaths were reported in many states. For instance, Gujarat which reported 4218 covid deaths during March 01 to May 10, 2021, reported 61000 uncounted deaths, indicating an under-reporting factor of nearly 15. A media report noted that while the Madhya Pradesh government reported only 26 covid deaths in Bhopal between April 21 to April 24, 2021, crematoriums recorded 537 cremations i.e., over 20 times higher. Dainik Bhaskar, a leading Hindi newspaper, which investigated reports of floating bodies in the Ganges in Uttar Pradesh and Bihar photographed over 2000 bodies along a 1140 km stretch of the river buried in shallow graves or floating in the river. Heart-rending scenes of infected patients gasping for breath awaiting admission to hospitals and dying due to lack of ICU beds, oxygen cylinders, life-saving drugs or people scrambling to source wood or space to cremate their loved ones with crematoriums unable to cope up with the long queue of dead bodies awaiting cremation, leaping flames from hundreds of burning pyres in overworked crematoriums will haunt people for generations to come.

The Modi government which has been in denial mode even proclaimed to the World Economic Forum in Davos, Switzerland held in January 2021 that not only had India beaten the corona pandemic but also assisted 150 countries with vaccines. Despite graphic and factual evidence, the Union Health Minister informed Parliament that no covid-related deaths had occurred due to lack of oxygen! This is because as per the Indian Council of Medical Research (ICMR) guidelines for appropriate recording of covid-related deaths in India, asphyxia, respiratory arrest/failure among others can’t be mentioned as cause of deaths. In other words, covid-affected patients who died due to lack of timely access to oxygen, life-saving essential drugs, ICU beds can’t be recorded as deaths occurring due to covid.

Even data relating to the number of those infected by corona virus indicate wide discrepancy. While official data suggest that over 32 million people in the country were infected by corona, ICMR’s fourth serosurvey results released in July 2021 suggests it to be over 290 million. On April 17, 2021, despite the daily corona cases rising to a peak of 2.34 lakhs our Prime Minister seemed unmoved but was more impressed by the huge crowd mobilised to hear him at an election rally in Asansol during the West Bengal assembly elections.

(The author is an economist)