Himachal Pradesh reported 6,081 excess deaths between April 2020 and May 2021, reported The Hindu on Wednesday, citing figures from the state civil registration system. This is 1.9 times more than the official reported toll of 3,127 during the same time period.

The newspaper analysed month-wise data from the Civil Registration System between January 2018 and May 2021 to get this data. The Civil Registration System is a nationwide system of recording all births and deaths, led by the Office of the Registrar General of India and implemented at the state-level by state governments. The CRS is meant to record all deaths from all causes and all locations, whether they were medically certified or not.

Excess deaths is the divergence between all-cause deaths reported this year and in normal years.

While all excess deaths are not likely to be due to Covid-19, a majority of them are expected to be linked to the coronavirus disease during the pandemic. The diversion of healthcare resources for people with Covid-19 meant that many patients with other ailments may have failed to access treatment.

In 2021, Himachal Pradesh recorded an estimated 3,543 more deaths than the official tally of 2,025 deaths from January to May 2021, according to The Hindu.

Between April 2020 and December 2020, there were approximately 2,538 excess deaths compared to the official figure of 922 fatalities related to Covid-19. This was 2.8 times more than the official count. Kangra district registered the highest number of 2,647 excess deaths, which is 2.8 times the official Covid-19 toll of 933.

The Himachal Pradesh Civil Registration System showed that 40,133 and 40,970 fatalities were reported in 2018 and 2019. These figures are close to 96% and 94% of fatalities recorded by the Annual Report on Vital Statistics based on CRS-2019 for the years, according to The Hindu.

Senior medical superintendent at Indira Gandhi Medical College in Shimla, Janak Raj, told The Hindu that the discrepancies in fatalities could be due to “non-hospital” deaths. Raj also pointed out that many did not report Covid-19 as the cause of death due to stigma or because they were unaware that they had contracted the infection.

“There was a sense of fear that if one died of Covid-19, there would be a problem in cremation, besides people will not visit one’s home,” Raj told the newspaper. “There could be instances that with such fear in mind, some people who fell critically ill at home and didn’t visit hospitals for treatment and eventually died.”

Underreporting of Covid-19 deaths

India’s official Covid-19 toll is widely considered to be an underestimate of the actual number of deaths that occurred in the country. To estimate the scale of this, researchers have used data from the Civil Registration System to calculate and understand the difference between deaths registered during the pandemic years – 2020 and 2021 – and other years.

Latest data from the National Health Mission’s Health Management Information System shows that nearly 3 lakh more deaths occurred in May, compared to the same month in 2019. This figure is more than 2.5 times India’s official Covid-19 death count for the same period.

More than 2.5 lakh of the over 4,92,000 adult deaths recorded in May across the country were from “causes not known”. The biggest increases over a similar period in pre-pandemic times were in deaths from “fever” and “respiratory diseases”, both symptoms of coronavirus.

In the past couple of months, similar data on excess deaths has emerged for states such as Haryana, Bihar, Tamil Nadu, Kerala, Assam, Uttar Pradesh, Karnataka, Madhya Pradesh, Andhra Pradesh and Chhattisgarh.

CRS data for Madhya Pradesh accessed by Scroll.in showed that the state saw over 1,60,000 reported deaths in May 2021, or nearly five times the usual number of reported deaths in 2018 and 2019.

Twenty-four districts in Uttar Pradesh recorded 1.97 lakh more deaths between July 2020 and March 2021 than in the corresponding period the previous year. The mortality rate was 110% higher than the same period the previous year.

Andhra Pradesh reported over 1.3 lakh deaths in May, which is nearly five times the usual number of deaths reported in the month.