Tamil Nadu, Bihar, Maharashtra, Karnataka and Gujarat have the highest number of deaths due to COVID-19
Tamil Nadu, Bihar, Maharashtra, Karnataka and Gujarat have the highest number of deaths due to COVID-19
Affecting around 52 crore people, the COVID-19 pandemic has hit every nook and corner of the world, contributing to over 15 crore deaths from January 1, 2020 to December 31, 2021. Latest World Health Organization (WHO) Estimates,
The pandemic has hit India too, at a time when cases per day rose to over 90,000 during the first wave period starting March 2020. Worldwide efforts are made to fit the datasets available to mathematically model and estimate excess. Mortality due to COVID-19 because of the originality of mortality estimates for public health decision-making.
guess by the Lancet India has been ranked first in the number of cumulative additional deaths due to COVID-19 at 41 lakh, based on vital registration system data from 12 states.
WHO’s estimate is also around 47 lakh for the period between January 1, 2020 and December 31, 2021.
objection to mathematical model
However, the Indian government has objected to the use of mathematical models by the WHO in estimating higher mortality rates when authentic data is available in the country. The criticism is based on placing India in the second class countries for which mathematical modeling is done and poor statistical method is used.
While India has argued against the WHO citing the availability of Comprehensive Citizen Registration System (CRS) data, sources within the country are questioning the shortcomings of critical registration and classification of COVID-19.
The advisory nature of the guidelines on classification of COVID deaths by the Indian Council of Medical Research (ICMR) has led to confusion among states as to what counts as a COVID-19 death and what does not.
In this background, we have attempted to provide an empirical estimate of the high mortality rate due to COVID-19 during the period between January 1, 2020 and December 31, 2020, using information from several authoritative data sources. We have used the number of deaths registered in the year 2019 and 2020 from the CRS, the population estimates for the years 2016 and 2021 by the Registrar General of India (RGI), the Crude Death Rate (CDR) for 2019 from the Sample Registration System (SRS) Estimate. ,
We estimated the proportion of deaths recorded in 2019 using the CRS 2019 and SRS 2019 death data and the 2019 mid-year population.
Furthermore, we applied the same figures for the proportion of recorded deaths assuming that it did not change significantly in the year 2020. The total deaths for the year 2020 are calculated using the number of registered CRS 2020 deaths for India and larger states and the percentage of deaths recorded during this period. 2019
The estimated mid-year population for 2020 and the total estimated deaths for the same year are used to estimate the CDR for 2020, while the 2019 CDR is derived from SRS 2019. The difference between the CDRs of 2020 and 2019 reflects the growth. directly or indirectly responsible for epidemics in mortality. Excess death is termed as the difference between the estimated number of deaths in 2020 and the expected deaths for the same year (applying the 2019 CDR to the 2020 population).
Effects of the first COVID wave
As per our estimates, India has seen an excess of 0.5 deaths per thousand population during the first wave of the pandemic (CDR of 6.0 in 2019 to 6.5 in 2020). The highest difference is found in the state of Delhi, which saw the highest death rate of 3.8 deaths per thousand population during this period, followed by Tamil Nadu (2.9), Andhra Pradesh (2.3), Karnataka (2.1), and Gujarat (2.0). is the location.
The lowest difference in CDR between 2019 and 2020 was found in Telangana (-0.5 i.e. negative change), Uttar Pradesh (0.05 less deaths per 1000 population), followed by Uttarakhand (0.02). The negative change in CDR in these states may be due to less reporting of deaths compared to the previous year. Kerala did not report any change in the CDR indicating no significant change in the mortality rate as compared to the year 2019.
number of states
Our calculations estimate that during 2020, in India 7 lakh in relation to 2019, Tamil Nadu (2.2 lakh), Bihar (1.5 lakh), Maharashtra (1.4 lakh), Karnataka (1.4 lakh), Gujarat (1.3 lakh) and India There have been more deaths. Andhra Pradesh (1.2 lakh) has the highest number of deaths.
During the same year, the official number of COVID-19 deaths in India stood at 1.5 lakh, which was almost 4.7 times lower than our estimate of additional mortality.
The estimated excessive deaths in this period can be directly or indirectly attributed to a number of causes associated with the pandemic. Of course, COVID-19 is the major killer, but not alone.
Delayed treatment of severe morbidity conditions has had its share of high mortality rates worldwide.
emergency services affected
Studies have shown that services for tuberculosis, cancer, heart disease, diabetes etc. have been disrupted and the associated mortality has increased abnormally.
According to the Global Tuberculosis Report (WHO, 2021), the biggest shortfall in diagnosing and reporting tuberculosis is seen in Asian countries, with India leading the way. Additionally, the pandemic has indirectly affected maternal and child health care by delaying access to emergency services.
Apart from these, other factors including long distance migration, mass poverty, hunger etc. can also contribute to more deaths. Once the CRS 2021 report is released, we will be in a better position to provide robust and accurate estimates of additional deaths during the second wave and to conclude to what extent the WHO’s estimates are accurate.
Nandlal Mishra is a PhD Scholar at the International Institute for Population Sciences, Mumbai. Devikrishna is a postgraduate student at NB International Institute for Population Sciences, Mumbai