Health workers carry the body of a person, who died from complications related to COVID-19, for cremation. Photo: Reuters/Danish Siddiqui
New Delhi: The COVID-19 death toll in the two Telugu states of Telangana and Andhra Pradesh has been massively undercounted, according to two separate reports in The Hindu and Scroll.
In Hyderabad alone, the excess deaths reported between April 2020 and May 2021 are ten times the officially recorded COVID-19 death toll for the entire state of Telangana, according to The Hindu. During this period, the state reported 3,275 deaths, but excess deaths in Hyderabad alone were 32,752, according to the newspaper.
These findings, based on deaths registered with the country’s civil registration system, are the most accurate estimates yet on how many COVID-19 deaths have been ‘missed’ by official figures. Similar analysis from cities like Chennai and Kolkata, apart from states like Gujarat and Madhya Pradesh have also found varying degrees of undercounting of deaths.
To find the excess deaths in Hyderabad, The Hindu accessed data on month-wise death certificates issued for the last two years and compared with data for 2016 to 2019. For 2021, the data covers deaths until May 31.
There were 36,041 certified deaths in 2021, which meant there were 14,332 “excess deaths” compared to the average during the pre-pandemic years between 2016 and 2019. In the first five months of 2021, the excess deaths in the city’s municipal corporation limits were 8.2 times the official COVID-19 death toll of 1,740 for the entire state.
The Hindu said that excess deaths in Hyderabad could not be compared to the city’s official COVID-19 death toll because Telangana does not publish official district-wise pandemic fatalities. Even after the Telangana high court rapped the state government’s policy not to provide disaggregated data, there has been no change in policy.
However, to estimate the undercount in Hyderabad, The Hindu did a comparison with other cities in south India. “For instance, as of June 12, 27% of all deaths in Tamil Nadu occurred in the capital, Chennai, while 47% of all deaths in Karnataka occurred in Bengaluru city,” the report says.
If one assumes that Hyderabad followed the trends observed in Bengaluru the official tally of COVID-19 deaths in the city would be 820 in 2021. “The excess deaths in Hyderabad, 14,332 would be then 17.5 times more than the estimated reported deaths. Correspondingly if the trends in Chennai held, the undercount factor would be 30.5 times. If these trends are extrapolated to the entire State, the actual death toll could range from 57,000 to 1,00,000,” the report adds.
Between April-December 2020, Telangana’s official COVID-19 toll 1,535. But since there were 18,420 excess deaths in Hyderabad alone during this period, COVID-19 deaths could have been undercounted by a factor of 12, if this data is extrapolated for the entire state. This is higher than the undercount factor in the second wave, The Hindu said.
The estimation comes with the caveat that not all excess deaths can be attributed to COVID-19 alone. Several other factors could have led to a higher death toll, including that during the second wave, the fact that the healthcare system was clogged could have meant that people with other illness also could not avail treatment and died.
“However, most of these excess deaths in a pandemic peak should largely represent COVID-19 related deaths,” The Hindu says.
Since GHMC only registers 79% of all deaths, even before the pandemic, the actual number of deaths could be even higher, the newspaper warns.
Andhra Pradesh
According to Scroll, the excess mortality reported in Andhra pradesh from January-May 2021 was 34 times the official COVID-19 toll. Stunningly, in May 2021 alone, the state reported over 130,000 deaths, which is nearly five times the average number of deaths in the month.
This report also uses data from the country’s civil registration system. The data shows that in May 2018 and 2019, the average number of deaths reported in Andhra Pradesh is 27,100. In May 2021, this rose to saw over 130,000.
“In all, between January 1 and May 31 this year, Andhra Pradesh saw 130,000 ‘excess deaths’ – deaths over and above the 2018-19 average. This was nearly 34 times the official Covid death toll for the same period, although not all of the excess deaths would be from Covid alone,” Scroll says.
According to the report, there was a substantial increase in mortality in Andhra Pradesh in August and September 2020, towards the end of India’s first wave. This also indicates that the actual COVID-19 death toll was several times higher than the official figure.
The report adds that in Tamil Nadu, the data shows that nearly 400,000 deaths were registered between January 1 and June 13 this year. The state only provides annual totals of registered deaths, which averages to 593,000 in the whole of 2018-19.
“Assuming that deaths are distributed uniformly through the year, Tamil Nadu registered an estimated 129,000 excess deaths in the first 164 days of this year, which is 7.5 times the official Covid death toll for the same time period,” Scroll says.
The problem of undercounting deaths
Across the country, reports have found that many COVID-19 deaths are being ‘missed‘ due to various factors. Several states have now begun ‘reconciling’ fatalities, with Maharashtra the latest to do so. Over the past month, the state has added nearly 20,000 deaths to its official figure. Bihar also nearly doubled its official tally recently.
As of Monday, the country has officially reported more than 3.74 lakh fatalities due to COVID-19. Though this tally is the third highest in the world – behind the US and Brazil, experts believe that the actual toll could be four times higher.