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Counting the Covid dead is not a mere academic exercise. This effort is crucial to addressing the shortcomings of public health facilities and framing responses to future medical emergencies.The World Health Organisation’s (WHO) report on excess mortality due to Covid-19 has pegged the India figure at nearly 10 times the official toll at 47.4 lakh. As an analysis in this newspaper showed, this raises several questions. India’s death toll of 5.23 lakh so far is, most possibly an undercount, but the WHO’s data suggests that over 90 per cent of deaths in India have gone unreported. Even the base number of expected deaths (in a no-Covid scenario) for the year 2020 which the WHO has used in its report is almost nine lakh more than the average number of deaths recorded each year in India for the last 15 years. Still, the WHO estimates reflect similar numbers by many other agencies and are based on well-established mathematical models. How effective are these in getting close to what actually happened, capturing the several variables of a pandemic given India’s size and diversity — from high urban population-density Kerala to rural settings in other states — will always be open to question.
Counting the Covid dead is not a mere academic exercise. This effort is crucial to addressing the shortcomings of public health facilities and framing responses to future medical emergencies. It is also a vital part of the endeavour to heal the wounds of those who have suffered in the past two years. The Covid compensation exercise, under the watchful gaze of the Supreme Court, will, hopefully, encourage families to report their loss. Accurate information is paramount to the process, especially when, in a sharply polarised discourse, even science is contested. In the first month of the first pandemic year, an oft-quoted study said up to three million Indians could die by mid-April 2020. The author has since then back-tracked and acknowledged that his assumption of mortality rate was a little off the mark. The WHO’s record on Covid hasn’t been much to write home about. Its own study concluded that crucial time was lost in the fight against the virus because the global health agency delayed the announcement of an international emergency. It spent weeks persuading China to allow a team of international scientists to visit Wuhan after the outbreak. It then swung to the other extreme late last year after the relatively-less virulent Omicron began to infect people worldwide. Instead of educating the world about the nature of this new variant, it rang needless alarm bells.
That said, it would be, well, unscientific, to be prickly and attribute sinister motives to the WHO. Barely days ago, its Director-General Tedros Ghebreyesus and Prime Minister Narendra Modi launched the WHO Global Centre for Traditional Medicine in Jamnagar, that will play a key role as a “global repository” of traditional medicine practices across the world. What the WHO’s Covid death estimates underline is the need for India to further strengthen its death recording system, finetune its accuracy and transparency. In fact, the success of India’s vaccination programme has been facilitated by distribution and supply-chain processes on the ground, from the shop-floor to the primary health care centre, backed by a robust digital architecture of reporting and recording. Given the rapid digitalisation of social systems, this should translate to strengthening the Civil Registration System and Sample Registration System as well, the two main tools for recording births and deaths. Let the WHO and experts do their job, the Centre and state governments should do theirs.
This column first appeared in the print edition on May 9, 2022, under the title ‘Who’s counting’.
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