The Indian Ministry of Health and Family Welfare has criticised the World Health Organisation for taking a “one size fit all” approach to counting COVID-19 deaths, after the Organisation released a report claiming that India experienced 4.7 million deaths as a result of the virus in 2020 and 2021, well below the government’s figure of 475,000.
A statement by the ministry said the “less than accurate” methodology used by the WHO relies on mathematical models and ignores the “authentic” data provided by the Civil Registration System (CRS) by the Registrar General of India (RGI).
The global health body categorises countries in two tiers based on its perceptions of the reliability of the data provided by those countries. It uses mathematical models to estimate the excess mortalities in countries that are placed in the second tier. In this regard, India objected to its placement in Tier II, asserting that it has its own “effective and robust” system. Therefore, it concluded that the WHO report lacks “academic rigour,” adding that “robust and accurate data generated through the Legal Framework of a Member State must be respected, accepted and used.”
Late night musing: WHO claims that India has 171 excess deaths per 100,000 in 2020-21 while China has -2 (ie less deaths than normal) per 100,000. Really? Yes, it’s very possible death toll in India is under-reported like many other countries, BUT CHINA at -2?? Give us a break! pic.twitter.com/561T3H6ZoI
— Rajdeep Sardesai (@sardesairajdeep) May 5, 2022
The health ministry argued that India is a large country with a diverse population of over 1.3 billion people. Therefore, it posited that the WHO’s use of a uniform model for the entire country cannot be considered accurate, declaring, “It is a known fact that modelling, more often than not, can lead to over-estimation and on few occasions, these estimates may stretch to the limits of absurdity.”
It claimed that these models wrongly relied on “non-official sources of data”, such as “websites and media reports,” which point to the fact that the report was “ statistically unsound and scientifically questionable.”
Expanding on this counter-argument, a source cited by Indian Express questioned whether the predictions were made based on a particular time period or a limited region. He said, “If mortality from Kerala or Maharashtra is extrapolated for the whole country, it would be wrong because those two states saw high mortality throughout the year. Or, if data from the peak of the second wave is extrapolated for the entire country over the two years, it will give an unusually high number.”
According to Vinod Kumar Paul, a senior health official, the data collected by Indian authorities was “absolute, correct and counted numbers.” He added, “There is a public narrative in the media, based on various modelling estimates, that India’s COVID-19 deaths are many times the reported figure - that’s not the case in reality.”
JUST OUT - New WHO estimates of global excess mortality: 14.9 million people, of whom 88% were older than 60.
— Philip Schellekens (@fibke) May 5, 2022
Excess mortality captures the true & total impact of the pandemic, but many countries lack the data
WHO fills that gap with sound and conservative estimates
🧵
1/ https://t.co/rxKjHbCjrh pic.twitter.com/pa1pl6fv9C
Excess mortality is the difference between the actual death toll and what would have otherwise been the death toll if the pandemic had not occurred. In this regard, the WHO determined that the Indian government’s own record of how many deaths occurred could not be trusted. Therefore, it employed its own mathematical model to estimate what the actual death toll was.
The WHO’s report thus concluded that there were 14.9 million excess deaths across the globe in 2020 and 2021 as a result of COVID-19. This is almost three times the official cumulative amount provided by governments, which have claimed that there were 5.4 million excess mortalities.
Apart from the deaths due to the contraction of COVID-19, the WHO also took into account deaths caused by indirect results of the outbreak, such as the inability to access medical treatment as healthcare facilities became inundated with COVID-19 patients. Furthermore, it considered the deaths averted due to the pandemic, such as the drop in traffic accidents due to lockdowns.
Excess mortality includes:
— World Health Organization (WHO) (@WHO) May 5, 2022
1️⃣ deaths due to #COVID19 itself
2️⃣ deaths due to the pandemic’s impact – attributable to other health conditions for which people were unable to access prevention & treatment because health systems were overburdened by the pandemic https://t.co/qTCVY8L5wa
The report assessed the excess deaths based on several factors. For instance, the report analysed the relation between excess deaths and the income of the country and concluded that lower-middle-income countries accounted for 53% of the excess mortalities. Meanwhile, high-income, upper-middle-income, and low-income countries respectively accounted for 15%, 28%, and 4% of the excess deaths.
In addition, the WHO report concluded that men (57%) accounted for a far higher percentage of the deaths than women (43%).
On the basis of geographical location, the report concluded that 84% of the excess deaths occurred in Southeast Asia, Europe, and the Americas. Moreover, 68% of these took place in just ten countries, including India, Brazil, Russia, Indonesia, the United States, Mexico, and Peru. In fact, the report claimed that around half of the unreported deaths were in India.
The total number of deaths associated with #COVID19 worldwide from 2020-2021 may be closer to 14.9 million: New estimates by WHO & @UNDESA.
— World Health Organization (WHO) (@WHO) May 5, 2022
That’s 9.5 million more deaths than reported https://t.co/qDvaA6t5KZ #HealthData pic.twitter.com/ZjABJzlgiZ
According to Samira Asma, the Assistant Director-General for Data, Analytics and Delivery at the WHO, excess mortality is a critical factor in understanding the impact of the COVID-19 pandemic, as “shifts in mortality trends provide decision-makers information to guide policies to reduce mortality and effectively prevent future crises.”
Following the publication of the report, WHO Chief Tedros Adhanom Ghebreyesus said, “These sobering data not only point to the impact of the pandemic but also to the need for all countries to invest in more resilient health systems that can sustain essential health services during crises, including stronger health information systems.”