India’s excess deaths during the pandemic could be a staggering 10 times the official Covid-19 toll, likely making it modern India’s worst human tragedy, according to the most comprehensive research yet on the ravages of the virus in the south Asian country.
Most experts believe India’s official toll of more than 414,000 dead is a vast undercount, but the government has dismissed those concerns as exaggerated and misleading.
The report released on Tuesday estimated excess deaths, the gap between those recorded and those that would have been expected, to be between three million to 4.7 million between January 2020 and June 2021.
It said an accurate figure may “prove elusive” but the true death toll “is likely to be an order of magnitude greater than the official count”.
The report, published by Arvind Subramanian, the Indian government's former chief economic adviser, and two other researchers at the Centre for Global Development and Harvard University, said the count could have missed deaths occurring in overwhelmed hospitals or while health care was delayed or disrupted, especially during the devastating peak surge earlier this year.
“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 report said.
The partition of the British-ruled Indian subcontinent into independent India and Pakistan in 1947 led to the killing of up to one million people as gangs of Hindus and Muslims slaughtered each other.
The report on India’s virus toll used three calculation methods: data from the civil registration system that records births and deaths across seven states, blood tests showing the prevalence of the virus in India alongside global Covid-19 fatality rates, and an economic survey of nearly 900,000 people done thrice a year.
Researchers cautioned that each method had weaknesses, such as the economic survey omitting the causes of death.
Instead, researchers looked at deaths from all causes and compared that data to mortality in previous years, a method widely considered an accurate metric.
Researchers also cautioned that virus prevalence and Covid-19 deaths in the seven states they studied may not translate to all of India, since the virus could have spread worse in urban versus rural states and since health care quality varies greatly around India.
And while other nations are believed to have undercounted deaths in the pandemic, India is believed to have a greater gap due to it having the world’s second highest population of 1.4 billion and its situation is complicated because not all deaths were recorded even before the pandemic.
Dr Jacob John, who studies viruses at the Christian Medical College at Vellore in southern India, reviewed the report for The Associated Press and said it underscores the devastating impact Covid-19 had on the country's under-prepared health system.
“This analysis reiterates the observations of other fearless investigative journalists that have highlighted the massive undercounting of deaths,” the doctor said.
The report also estimated that nearly two million Indians died during the first surge in infections last year and said not “grasping the scale of the tragedy in real time” may have “bred collective complacency that led to the horrors” of the surge earlier this year.
Over the last few months, some Indian states have increased their Covid-19 death toll after finding thousands of previously unreported cases, raising concerns that many more fatalities were not officially recorded.
Several Indian journalists have also published higher numbers from some states using government data.
Scientists say this new information is helping them better understand how Covid-19 spread in India.
Murad Banaji, who studies mathematics at Middlesex University and has been looking at India's Covid-19 mortality figures, said the recent data has confirmed some of the suspicions about undercounting.
Mr Banaji said the new data also shows the virus was not restricted to urban centres, as contemporary reports had indicated, but that India’s villages were also badly impacted.
“A question we should ask is if some of those deaths were avoidable,” he said.
Australia
More than half of Australia’s 25 million people were under lockdown on Tuesday after a third state adopted movement curbs to rein in the highly contagious Delta variant of coronavirus.
Australia’s infections and deaths are well below other developed nations, but its use of lockdowns, prompted by a sluggish vaccination campaign, is putting pressure on the national government, with polls at their lowest in a year and just months before elections are due to be held.
South Australia, a state of 1.8 million, imposed a seven-day lockdown after detecting five infections linked to a returned traveller, just as the neighbouring state of Victoria extended by a week a five-day lockdown that had failed to stop new cases.
"We hate putting these restrictions in place but we believe we have one chance to get this right," South Australia premier Steven Marshall told reporters.
The largest city of Sydney, where the latest Delta outbreak started before spreading elsewhere, is in the fourth week of a five-week lockdown. Three regional centres were added to areas 250km inland after a positive test there.
Sydney is the capital of New South Wales, the state that recorded 78 new cases on Tuesday, down from 98 a day earlier, for its biggest daily dip since Sydney went into lockdown.
At least 21 of the new cases were infectious in the community before being diagnosed. Authorities have said that figure should be near zero if Sydney’s lockdown is to be lifted by a target date of July 30.
"We are seeing more hospitalisations, more admissions to ICU, more people on ventilators – we have to stop the spread of Covid," Kerry Chant, the state's chief health officer, said in Sydney, referring to intensive care units.
Ninety-five people with Covid-19 are in hospital in the state, 27 of them in intensive care and 11 on ventilators. The state’s five deaths in the latest outbreak take the national toll to 915, with a tally of just over 32,000 infections.
Australia has relied on lockdowns, tough social distancing rules and swift contact tracing to hold infections to a fraction of levels elsewhere, such as Britain and the United States.
However health services are being tested by the virulent Delta variant and low vaccine coverage in Australia, where just over 14 per cent of adults are fully vaccinated.
Although 13 million Australians were under lockdown, the country’s health minister defended its pandemic response as having saved thousands of lives.
"The scope and scale between the rest of the world and Australia are immeasurably different and we shouldn't lose sight of what has been achieved on an extraordinary level," Greg Hunt told reporters.
Indonesia
Millions of Muslims in Indonesia on Tuesday celebrated Eid al-Adha, one of the most important Islamic festivals, as Indonesian president Joko Widodo pledged that tighter coronavirus restrictions would remain in place until infection rates dropped.
Covid-19 cases in Indonesia are currently among the highest in the world due to the rapid spread of the Delta variant, despite the imposition this month of the strictest mobility restrictions so far during the pandemic.
Jokowi, as the president is widely known, advised Indonesians to celebrate Eid al-Adha at home, following strict health protocols. Police and transport authorities have also set up checkpoints to prevent travel in the world’s largest Muslim majority nation.
In a streamed statement on the eve of the holiday, Jokowi said movement restrictions would only be lifted once cases have dropped.
“Imagine if this restriction is loosened and then the cases increase again and the hospitals are unable to contain the patients. This would cause our health facilities to collapse,” he said.
The health system in some areas has been pushed to breaking point by a deluge of patients and on Monday Indonesia reported a record 1,338 coronavirus deaths. – AP/Reuters