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Corona death toll in India likely of magnitude greater than official count: CGD paper

Coronavirus. Stock Photo: Pixabay

Washington/New Delhi, July 21 (MNN) A Working Paper published by US Center for Global Development has concluded that the coronavirus deaths in India are likely of the magnitude greater than the official count. Congress leader Rahul Gandhi tagged the study on his social media account.

“True deaths are likely to be in the several millions, not hundreds of thousands, making this arguably India’s worst human tragedy since partition and independence,” the authors of the Working Paper said in one of their conclusions.

The coronavirus death toll in India was around 4 lakh by June, and stood at 4,18,480 on the Indian Health Ministry website as of Wednesday.

The 27-page Working Paper entitled ‘Three New Estimates of India’s All- Cause Excess Mortality during the COVID-19 Pandemic’ dated July 20 has been authored by Abhishek Anand, Justin Sandefur and Arvind Subramanian.

In the abstract, the authors said that they report excess mortality estimates from three different data sources from the pandemic’s start through June 2021.

“First, extrapolation of state-level civil registration from seven states suggests 3.4 million excess deaths. Second, applying international estimates of age-specific infection fatality rates (IFR) to Indian sero-prevalence data implies a higher toll of around 4 million. Third, our analysis of the Consumer Pyramid Household Survey, a longitudinal panel of over 8,00,000 individuals across all states, yields an estimate of 4.9 million excess deaths.”

The authors said that each of these estimates had ‘shortcomings’ and that they also diverge in the pattern of deaths between the two waves of the pandemic.

“Estimating COVID-deaths with statistical confidence may prove elusive. But all estimates suggest that the death toll from the pandemic is likely to be an order of magnitude greater than the official count of 4,00,000; they also suggest that the first wave was more lethal than is believed.”

The three said that understanding and engaging with the data-based estimates is necessary because in this horrific tragedy the counting — and the attendant accountability — will count for now but also the future.

While Abhishek Anand’s credentials listed in the paper indicated he was from the prestigious Harvard University, Justin Sandefur is from Center for Global Development, and Arvind Subramanian associated with CGD and Brown University.

In their conclusions, the trio said that each of the three different data-based estimates for all-cause excess mortality in India had “shortcomings”.

“The CRS-based numbers are still not available for all the states; they are known to under-count deaths and whether that under-counting remained the same or changed during the pandemic is still not clear; and the CRS numbers also stop for most states in May 2021.

“The second estimate is only partly based on Indian data (on infection rates) and assumes IFRs based on other countries whose validity for India is open to question; and we cannot adjust the IFRs for wave 2 when mortality is likely to have increased as domestic health systems were overwhelmed.”

“The important caveat on the death estimates from the CPHS is that its pre-Covid mortality does not track closely estimates from other official sources. Perhaps even more important is that the CPHS shows a big and inexplicable spike in mortality in 2019 before Covid. If some of the measurement errors from the CPHS pre-Covid carry over to the Covid period, the reliability of the excess deaths estimates is not assured. The time pattern of the excess death estimates is also different across these three estimates.

“Even with all these caveats, there are three important takeaways from our findings.

“First, unsurprisingly, there is considerable uncertainty within and across estimates. They range from about 1 million to 6 million overall, with central estimates varying between 3.4 to 4.9 million. And the timing on the estimates between the two waves also varies across estimates. It is imperative, therefore, that research continue to estimate more precisely Covid-related deaths. It is equally imperative that government aid this effort by making available all the data on sero-surveys and deaths it has generated.

“Second, the first wave seems to have been more lethal than is popularly believed. Because it was spread out in time and space, unlike the sudden and concentrated surge of the second wave, mortality in the first wave appeared moderate. But even the CRS data suggest that up to 2 million might have died in that period. In fact, not grasping the scale of the tragedy in real time in the first wave may have bred the collective complacency that led to the horrors of the second wave.

“Finally, and perhaps the most critical takeaway is that regardless of source and estimate, actual deaths during the Covid pandemic are likely to have been an order of magnitude greater than the official count. True deaths are likely to be in the several millions not hundreds of thousands, making this arguably India’s worst human tragedy since partition and independence.

“Our purpose in this paper has been to report–without in any way endorsing–different data-based estimates. A collective understanding of and engagement with them and indeed with estimates from other data sources, warts and all, is now necessary.”

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