The Centre on Thursday said media reports that alleged India vastly undercounted its coronavirus toll were totally fallacious. The health ministry added that the reports wrongly assumed that all the excess deaths were Covid mortalities.

Many health experts believe that India’s official toll of 4.18 lakh so far is an undercount. But, in May the Modi government had dismissed such concerns as “baseless and absolutely false”.

The Centre’s latest response came two days after a study published by the United States-based Center for Global Development showed that the excess deaths in India were estimated to be between 34 lakh and 47 lakh – about 10 times higher than India’s official Covid-19 toll.

Excess deaths are a measure of how many more people are dying than is expected as compared to the previous few years.

“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, genomic constitution of a population, previous exposure levels to other diseases and the associated immunity developed in that population,” said the health ministry’s statement.

The health ministry said India has a “robust and statute-based death registration system”. Some cases could go undetected but missing out on the deaths is unlikely, it said.

The ministry added that it has repeatedly advised states and and Union Territories to record deaths in accordance with guidelines. “States have been advised to conduct thorough audits in their hospitals and report any cases or deaths that could have been missed with a district and date-wise details so as to guide a data-driven decision-making,” it said.

The Centre also pointed to India’s low case fatality rate. “…Even after an unexpected surge observed in the second wave in April-May 2021, the case fatality rate today stands at 1.34%,” it said.

On Tuesday, Union Health Minister Mansukh Mandaviya said in the Rajya Sabha that if there was any underreporting of deaths, it was by the states. He said that the Centre only compiles the data given by the states and publishes them.

The US study on excess deaths

The study used three different data sources to estimate India’s excess deaths during the coronavirus pandemic till June 21.

First, the researchers considered death registrations from seven states that account for half of India’s population – Andhra Pradesh, Bihar, Chhattisgarh, Karnataka, Kerala, Madhya Pradesh, Tamil Nadu and Uttar Pradesh. The study, however, said that there could be problems with this extrapolation of data from the seven states to arrive at an all-India estimate. The study said that it was possible that the Covid-19 mortality in the “rest of India is different from the seven states”.

The second source came from combining Covid seroprevalence data and international estimates of the age-specific mortality rate.

Sero surveys are conducted on a subset of the population to examine for Covid-19 antibodies. The data, called the seroprevalence, is then extrapolated to arrive at an estimate for the whole population.

Third, the researchers studied India’s consumer survey of 8,68,000 citizens across 1,77,000 households which also records whether any member of the family had died in the past four months.

“True deaths are likely to be in the several millions not hundreds of thousands, making this arguably India’s worst human tragedy since partition and independence,” the report, co-authored by India’s former Chief Economic Adviser Arvind Subramanian, said.

Subramanian, however, added that not all these deaths were caused by Covid-19 and an estimation of the actual death toll by the disease would be difficult to give.