A study published in medical journal The Lancet stating that India’s coronavirus mortality rate is higher than official figures is speculative and misinformed, the health ministry claimed on Friday.

The statement was issued a day after the medical journal said in the study that India had the highest number of excess deaths in the world at 40.7 lakh between January 1, 2020, and December 31, 2021.

Excess deaths is the divergence between all-cause deaths reported during pandemic years and in normal years. The numbers are an indicator for undercounting of deaths caused by Covid-19.

In a statement, the health ministry said, “Such predictions are founded on a certain set of inputs either based on real-world scenarios, or approximations of those inputs that are not available.”

It also claimed that such studies often take a “small actual sample” and extrapolate the result to the entire population. “While this may achieve near accurate results for a small homogenous country/region, such techniques have failed repeatedly to give reliable results for a large, diverse population,” the statement added.

It pointed out that the study had taken into account an estimation model of excess mortality that has not been peer-reviewed. This input, according to the health ministry, raises serious concerns about the accuracy of the results of the exercise.

“The pandemic had multiple surges during the period and varied trajectories across different states [sub-state level also] at any point of time,” the government added. “Hence the methodology used by this study is less than robust.”

The health ministry claimed that The Lancet study misses sufficient empirical evidence and does not take into account the pandemic management efforts of the Indian government, such as imposing lockdowns, demarcation of containment zones, testing and contract tracing, among others.

The statement said that the authors have themselves acknowledged that strict pandemic management efforts can lead to negative excess mortality during the pandemic.

The data on Covid-19 deaths is regularly reported in a transparent manner and uploaded on the website of the Union Ministry of Health, the statement said. “Even the backlog in Covid-19 mortality data being submitted by the states at different times is reconciled in the data of Government of India on a regular basis,” it added.

The government said since compensation is paid to families that lost their relatives to Covid-19, therefore “the likelihood of underreporting is less”.

“It is highlighted that quoting issues as sensitive as death, that too during an ongoing global public health crisis like pandemic Covid-19, should be dealt with facts and with the required sensitivity,” the statement said. “This type of speculative reporting has potential to create panic in the community, can misguide people, and should be avoided.”

Multiple reports have pointed out that guidelines have not been followed in cases of deaths caused due to post-Covid complications in India and that crematoria were not maintaining proper records of fatalities.

In June last year, an article published in The Economist on a research by Christopher Leffler of the Virginia Commonwealth University suggested that India’s actual toll could be more than 20 lakh. India’s official toll at that time was 3,67,081.

A month before that, The New York Times had reported that India’s toll could be as high as 6 lakh by conservative estimates, and up to 42 lakh in the worst case scenario. At the time of publishing of the report, India’s official toll was 3.15 lakh.

The Centre had dismissed both the reports.

The Lancet study

The study published in The Lancet on Thursday aimed to estimate excess mortality due to the Covid-19 pandemic in 191 countries and territories, and in 252 sub-national units for some countries. In India, the researchers obtained excess mortality data for 12 states.

“Although reported Covid-19 deaths between Jan[uary] 1, 2020, and Dec[ember] 31, 2021, totalled 5·94 million [59.4 lakh] worldwide, we estimate that 18·2 million [1.82 crore] people died worldwide over that period,” the study noted.

According to the study, eight states in India had mortality rates exceeding 200 deaths per one lakh people – a level only exceeded by 50 other countries in the world. These states were Uttarakhand, Manipur, Maharashtra, Chhattisgarh, Haryana, Himachal Pradesh, Punjab, and Karnataka.

The study also noted that states like Bihar, Uttar Pradesh and Maharashtra had excess deaths higher than South Africa (3,02,000).

The research was conducted by a team at the Institute for Health Metrics and Evaluation, an independent global health research centre at the University of Washington.