Estimating COVID-19‒ Related Mortality in India: An Epidemiological Challenge With Insufficient Data
Lauren Zimmermann, Maxwell Salvatore, Giridhara R. Babu, Bhramar Mukherjee
Abstract
According to these studies, the IFR for India is roughly 0.1 % using observed death counts and 0.4% after incorporating underreporting of deaths (Table 2). [...]during wave 1, a group of volunteers collected reported deaths from obituaries in newspapers and found the death count to be almost twice that officially reported.13 Likewise, during this recent surge, a New York Times article noted that authorities in Gujarat reported between 73 and 121 daily COVID-19-related deaths in midApril, contradicting a leading newspaper in Gujarat that cited the number as several times higher (around 610 daily deaths).10 Recently, an excess death calculation based on comparing death certificates issued in the state of Gujarat14 showed that while the state reported 4218 COVID-19-related deaths during March 1 to May 10,2021, an estimated 61 000 excess deaths remained uncounted, indicating an underreporting factor of nearly 15. [...]comparisons to past years of satellite images revealing fires emitting from burial pyres has imprinted the sheer scale of additional lives lost to the pandemic in April 2021. According to the latest global excess mortality study (January 2021), 77 countries report data on all-cause mortality, enabling experts to compute country-specific excess mortality, which is largely considered the gold standard for estimating the burden of COVID-19.16 India is a notable exception16;in our opinion, the release of these figures is sorely needed. The Indian government recently announced a pilot trial of a personal digital health identifier, which would ultimately serve as an electronic key to a health data repository for each individual nationwide.17Integrating data across health systems offers a solution to capturing all-cause mortality in a more nationally representative way.