![]() Most states have also constituted state-level “death audit committees,” which examine all death certificates that mention COVID-19 and then apply further filters to determine which counted as “real” virus deaths. In practice, however, only people who tested positive for COVID-19 and then died soon after in hospital with a clear progression of the disease are counted as COVID-19 deaths, officials from multiple Indian states told me. The Indian government’s official guidance for recording COVID-19 deaths states that if a person dies without being tested for COVID-19-or had tested negative but displayed symptoms typically associated with the virus-their death should be classified as a “suspected or probable COVID-19” death. With a system of this sort, it was inevitable that India would miss counting many COVID-19 deaths, just as it undercounts deaths from other diseases.īut other issues are new and exclusive to the pandemic. ![]() And 4 out of 5 deaths are not medically certified, meaning that the cause of death is not medically established. A third of all people who die receive no medical attention at all after death. In Bihar, a state of 123 million people, just half of all deaths are registered in a given year. India went into the pandemic with a death registration system that recorded only 92 of every 100 deaths. The case fatality rate is a flawed indicator to begin with-and only makes sense in a country that’s doing a half-decent job of counting its COVID-19 dead. ![]() For a long time now, it has been clear that India is not. The trouble is that the case fatality rate is a flawed indicator to begin with-and only makes sense in a country that’s doing a half-decent job of counting its COVID-19 dead. Even now, India’s rate is at 1.3 percent, against 1.79 percent in the United States and 2.74 percent in the United Kingdom. By the end of India’s second wave this April and May, the country’s case fatality rate stood at roughly 1.56 percent, against 2.86 percent in the United States and 9.14 percent in the United Kingdom, according to national data aggregated by Our World in Data. The datapoint at the heart of this contention has been the case fatality rate: the share of reported COVID-19 deaths proportionate to reported cases. This triumphalism was on display in Modi’s now infamous January 2021 speech to the World Economic Forum, in which he said that “India is among those countries which have succeeded in saving the lives of the maximum number of its citizens. Since the beginning of the pandemic, India’s ruling Bharatiya Janata Party (BJP) government has sought to argue that India has handled the pandemic better than most any country, as evidenced by its low COVID-19 mortality rate. In a prepared statement delivered to the media after his visit, the minister’s main point was one that has been central to the Modi government’s messaging on COVID-19: While every death was sad, India had one of the lowest mortality rates in the world. In over a year of leading his country’s pandemic response, the minister has taken few questions from the media, much like his prime minister, Narendra Modi. That morning, India’s health minister, Harsh Vardhan, visited a hospital in the city. The capital of New Delhi was virtually out of space to cremate the COVID-19 dead-the bodies just kept coming in. It was one of the worst ever days of the country’s pandemic experience, just one week out from the peak of its deadly second wave. ![]() ![]() On April 29, India reported over 386,000 new cases of COVID-19 and over 3,500 deaths. ![]()
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