With temperatures rising above 45 degrees Celsius across India this week, you would hope that its government would have learned from last year’s deadly heat waves and prepared the health system appropriately for the next climate-driven crisis. The temperature and humidity levels now seen in South Asia’s pre-monsoon season are already testing the limits of human survival. Further warming of the planet threatens mass deaths this century.
But even attempts to enumerate what is happening are mired in logic. Nearly 100 people have died from heat-related conditions in the country’s two most populous states in recent days. AP It was reported this week, but officials, including physicians, have denied the claims. Indian Express The report states that a hospital superintendent who publicly linked the deaths to heatstroke was removed from his post for making “reckless statements”. Subsequently a doctor who visited the same clinic was quoted as saying that the reasons were unclear. The episode is symbolic of the explosive potential of heat wave deaths in a divisive political climate in a large state like Uttar Pradesh, led by a Bharatiya Janata Party leader. However, more than that, it is symptomatic of the poor state of health services and public data in the country. It apparently has no means of even knowing with certainty how many people are being killed by its severe climate, much less taking measures to help them.
Based on some data, the effect of higher temperatures on India’s population appears to be remarkably modest. The extreme summer season last year, in which the temperature in Delhi reached 49.2 degree Celsius, is widely said to have resulted in only 90 deaths. This figure is an estimate based on media reporting cited in one of the first studies to quantify the impact of climate change on disaster. That study acknowledges that the double-digit number is probably an underestimate: In the city of Ahmedabad alone, the 2010 heat wave caused 1,344 heat-related deaths. However, so far, this is the closest a figure has come.
The Covid pandemic provides insight into why there is a lack of better numbers. Most deaths have multiple causes. When there is a new and political event like a pandemic or a heat wave, people either overestimate or underestimate this factor. For example, if a 65-year-old man with angina has a heart attack on a day when the temperature reaches 45 °C, will the cause be heat or heart disease?
This may distort the data. China changed its standards for attributing coronavirus infections and pressured doctors to name other issues during its outbreak last year, suppressing the reported death toll in each case.
A common solution to that problem involves looking at more deaths – that is, comparing recorded deaths to the number you would expect in a typical year to remove the effects of reporting bias. A study of excess deaths last year found that 4.9 million people had died during the first 18 months of the Covid pandemic in India, compared to the officially recorded 412,000 Covid deaths.
However, even that approach may be insufficient in India, as even the most basic data on mortality rates are very poor.
Nationwide, about 8% of the estimated deaths in 2019 were not recorded, according to an annual government survey, and only 19% of the total were certified by a medical professional, which is considered routine in most countries. In Bihar, a neighboring state of Uttar Pradesh on the lower banks of the Ganges, which has a population larger than that of Japan, only 52% of deaths were recorded and 5.1% were medically certified.
As a result, bias becomes pervasive at every level of information. For example, although women and men die at approximately the same rates, women account for only 40% of the registered mortality – not because of their longevity, but the fact that their relatively low social status means That his death is less likely to be recorded.
Those most at risk from heat waves are the poor, the old and the very young, and those living in isolated rural areas. These are the groups most likely to be omitted from official lists of vital statistics. As a result, measuring excess mortality mostly gives us a picture of how extreme temperatures affect the urban middle class, rather than the entire population.
This information gap can be fatal. Without reliable data, it is impossible to know which populations are most at risk, or where medical and emergency supplies should be sent if hot weather is forecast. India’s health care system may be poor in its cities, but it may be almost non-existent in rural areas. The mortality that is not measured is not taken into account. On a planet that is getting hotter with each passing year, the lack of data in India is fueling a deadly complacency.
David Fickling is a Bloomberg Opinion columnist covering energy and commodities.
©Bloomberg
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Updated: June 22, 2023, 11:47 PM IST