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Synopsis: Instead, of calculating the ‘excess’ death at the national level, Excess death calculated at the District level will provide a more accurate estimation of COVID-19 deaths in India.
- To understand the magnitude of the pandemic there is a need for estimating COVID-19 deaths globally and in India.
- The most commonly used approach is the “excess” death approach. It is the difference between death in Normal years and deaths during the Covid-19 period.
- Further, it includes deaths directly caused by COVID-19. It also includes deaths indirectly caused due to the lack of access to care for other diseases during the pandemic and the lockdown.
- Based on the excess” death approach estimates have been released globally. However, India’s reported deaths contradict Global estimates.
- At present India needs to rely on global estimates rather than India-specific data.
- This is because of poor data availability for COVID-19 excess deaths, India has been classified in category 3 countries by WHO.
- Category 3 constitutes countries where the data on deaths are not available or usable. Hence, they are forced to adopt an indirect approach of using data from other countries.
- So, to have a reliable estimate for India on Covid deaths, India needs to calculate Excess death at the District level by analyzing the data from the Civil Registration System (CRS).
What do the global estimates reveal about the Covid deaths?
As far as now two estimates have been released globally.
- One, the World Mortality Dataset. It is the largest international dataset of all-cause mortality in 89 countries. According to this dataset, researchers conclude that excess mortality exceeds the number of reported COVID-19 deaths in these countries by over 1.6 times.
- Two, The Institute for Health Metrics and Evaluation (IHME). According to their findings, global COVID-19 deaths by May 3, 2021 is at 6.93 million. This is two times higher than the reported number of deaths of 3.24 million.
- India accounted for about 10% of them at 6,54,395. This is about three times higher than the reported official figure.
What needs to be done?
India currently has only crude estimates based on the number of extra deaths reported as compared to previous years. To improve the accuracy of Covid death estimation, we need to do the following.
- First, before estimating excess deaths a probable baseline should be defined. One can do it by estimating the mean and standard error based on data for the last five years to provide a probable range for a baseline.
- Second, Civil Registration System (CRS) data of districts with an acceptable quality of registration should be analyzed to estimate the excess deaths in a given period.
- There are enormous differences in the severity and timing of the epidemic. Therefore, the health system’s capacity within India combining data at higher levels is likely to lead to errors in estimation
- Third, for districts that lack an acceptable quality of registration, we could use alternative approaches.
- Finally, the long-term way out for India is to address the data limitations while academics work on refining their statistical approaches.
Source: The Hindu