He adds that almost every country undercounts COVID-19 mortality. He notes SRS data haven’t been released since 2018, before the pandemic, so that suspension may just reflect a disorganized system. Ramanan Laxminarayan, a Princeton University epidemiologist and economist, doesn’t see the undercount as entirely deliberate. “I think the political pressures were such that they said, ‘Anything that’s going to come out is going to be embarrassing.’” He and others also fault the government for not releasing data from what’s known as the Sample Registration System (SRS), which routinely surveys 1% of India’s population to track births and deaths. “The Indian government very much is trying to suppress the numbers in the way that they coded the COVID deaths,” Jha says. One, he says, is politics: He thinks the administration of Indian Prime Minister Narendra Modi has clouded the true picture of the pandemic. “There must be other things that we still don’t understand.” But those factors can’t be the whole story, he says. And death registration in the country had been spotty even before the pandemic. He also focused on the large cities, where death rates may have been lower than in the countryside. Jha says his early, low estimate was based on the first wave of infections in the fall of 2020, which may have been less deadly than the Delta variant that drove India’s massive surge in spring of 2021. The result: a much higher estimate-between 23 deaths per million by September 2021, comparable to the rate in the United States, which has one-third as many people. They also analyzed government reports from hospitals and similar facilities and looked at officially registered deaths. They tapped data from an independent polling agency that surveyed nearly 140,000 people across the vast country by telephone, asking whether anyone in each household had died from COVID-19. Jha’s own early analysis supported the assertion that India had an unusually low mortality rate from COVID-19, but he and his colleagues have now probed more deeply. That’s 340 COVID-19 deaths per million-about one-seventh the per capita COVID-19 mortality tallied in the United States. And India’s suffering could be far from over-the Omicron variant of the coronavirus has begun to surge there.Īt the end of 2021, India reported about 480,000 deaths from SARS-CoV-2 infections. “I think it does call for a recalibration of the global numbers plus saying, ‘What the heck is going on in India?’” says Jha, whose team published the new India analysis today in Science. If true, the finding could prompt scrutiny of other countries with anomalously low death rates and push up the current worldwide pandemic total, estimated by the World Health Organization (WHO) at some 5.45 million people. Now, a prominent epidemiologist who contended the country really had been spared the worst of COVID-19 has led a rigorous new analysis of available mortality data and concluded he “got it wrong.” India has “substantially greater” COVID-19 deaths than official reports suggest, says Prabhat Jha of the University of Toronto- close to 3 million, which is more than six times higher than the government has acknowledged and the largest number of any country. India, from the earliest days of the pandemic, has reported far fewer COVID-19 deaths than expected given the toll elsewhere-an apparent death “paradox” that some believed was real and others thought would prove illusory.
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