(The Wire, August 25, 2020)

Two community physicians with a deep interest in public health, who have earlier published their findings in The Hindu, have said India could be under-reporting its COVID-19 death toll by a factor of 5.29.

To illustrate, they say that the officially recorded COVID-19 death toll on July 31 was 35,747, which amounts to 26 deaths per million. However, the reality, when you include the undercounted COVID-19 deaths, is possibly 188,939 deaths, which amounts to a mortality rate of 138 per million.

In a 50-minute discussion with Karan Thapar for The Wire, Dr. Hemant Shewade and Dr. Giridara Gopal, two community physicians with a deep interest in public health, say that the under-reporting of COVID-19 deaths will get worse as the incidence of COVID-19 spreads beyond metropolitan centres like Delhi, Mumbai and Chennai into tier 2 and tier 3 towns and then, beyond that, into rural India.

As Dr. Gopal, who is also a member of the India COVID Apex Research Team, put it: “This may be more pronounced in rural and semi-urban areas where there is poor access to health facilities and/or qualified medical doctors.”

Doctors Shewade and Gopal explained to The Wire the largest element of under-reported COVID-19 deaths came from “suspected COVID-19 deaths occurring at home or during transit or in non-COVID hospitals”. As they put it: “Outside designated COVID-19 facilities, there could be many instances of suspected COVID-19 being the cause of death which may not be captured.”

However, Shewade and Gopal also said there are many states where COVID-19 deaths happen along with comorbidities but COVID-19 is not mentioned as the cause of death. As they put it: “Some states go to the extent of blindly removing COVID-19 from cause of death wherever a comorbidity is present…hence even among the registered deaths with medical certification, COVID-19 deaths appear to be under-reported.”

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