Given robust system of reporting, missing out on Covid deaths unlikely: Government

NEW DELHI: Recent media reports claiming that India's Covid-19 death data is "vastly undercounted" have been debunked by the government on Thursday. The Centre said the reports assume that all excess mortality figures are Covid deaths, which is not based on facts and is "totally fallacious".
The union health ministry explains, India's robust death registration system makes it highly unlikely to miss out on deaths even as some cases could go undetected as per the principles of infectious disease management.
In the news reports, quoting findings from some recent studies, the US and European countries' age-specific infection fatality rates have been used to calculate excess deaths in India based on seropositivity.
"The extrapolation of deaths has been done on an audacious assumption that the likelihood of any given infected person dying is the same across countries, dismissing the interplay between various direct and indirect factors such as race, ethnicity, the genomic constitution of a population, previous exposure levels to other diseases and the associated immunity developed in that population," the statement said.
Furthermore, seroprevalence studies are not only used to guide strategy and measures to further prevent the spread of infection to the vulnerable population but are also used as another basis to extrapolate deaths.
The studies also have another potential concern that the antibody titers may diminish over time, leading to underestimation of true prevalence and corresponding overestimation of infection fatality rate.
"Further, the reports assume that all the excess mortality figures are Covid-19 deaths, which is not based on facts and totally fallacious. Excess mortality is a term used to describe an all-cause mortality figure and attributing these deaths to Covid-19 is completely misleading," the statement said.
India has a thorough contact-tracing strategy. All the primary contacts, whether symptomatic or asymptomatic, are tested for Covid-19. The true detected cases are the ones that test positive with RT-PCR, which is the gold standard of the Covid-19 test.
In addition to the contacts, given the vast availability of more than 2,700 testing laboratories in the country, anyone who wants to get tested is able to get the test done. This, coupled with awareness campaigns about the symptoms and access to medical care, has ensured people could reach out to hospitals in case of need.
Given the robust and statute-based death registration system in India, missing out on the deaths is unlikely.
This could also be seen in the case fatality rate, which, as of 31st December 2020, stood at 1.45 percent and even after an unexpected surge observed in the second wave in April-May 2021, the case fatality rate today stands at 1.34 percent, it said.
Moreover, the reporting of daily new cases and deaths in India follows a bottom-up approach, where districts report the number of cases and deaths to the state governments and to the Union Ministry on a continuous basis, the statement said.
As early as May 2020, to avoid inconsistency or confusion in the number of deaths being reported, the Indian Council of Medical Research (ICMR) issued 'Guidance for the appropriate recording of Covid-19 related deaths in India' for correct recording of all deaths by States/UTs as recommended by the WHO for mortality coding.
In his statement in Rajya Sabha, Union Health Minister Mansukh Mandaviya has refuted allegations of hiding Covid-19 deaths and said that the central government only compiles and publishes data sent by the state governments, the statement said.
The union health ministry has been repeatedly advising states and UTs for the recording of deaths in accordance with guidelines.
The health ministry has also regularly emphasized the need for a robust reporting mechanism for monitoring district-wise cases and deaths on a daily basis.
States have been advised to conduct thorough audits in their hospitals and report any cases or deaths that could have been missed with district and date-wise details so as to guide data-driven decision-making.
As the health systems focus shifted towards effective management of cases requiring medical aid during the second wave, correct recording of cases could have been compromised as is evident in some states like Maharashtra, Bihar, and Madhya Pradesh.
All the births and deaths in a country are registered under the statute-based Civil Registration System (CRS) ensures all the births and deaths in the country get registered.
The CRS ensures that no deaths are missed out, no matter how time-consuming the process, as it involves several elements like data collection, cleaning, collating, as well as publishing numbers. For the expanse and amplitude of the activity, the numbers are usually published a year later, the statement said.
(with inputs from agencies)