Prof. Raj Kishore Panda in Bhubaneswar, June 18, 2021: Over the last 15 months, there are everyday media reports on the rise in the number of covid-19 deaths in the country. As per the official figures the total numbers of Covid-19 deaths as on June 5, 2021 have come to 3.41 lakh. Between March 2020 and June 5, 2021 the country has witnessed a massive rise in Covid-19 mortality – from 10 to 340702. Notwithstanding the rise, it is alleged that official figures of Covid-19 deaths grossly understate the true toll of the pandemic in the country.

Though it can be said that official record does not present full picture of the pandemic death, yet in a country like India with too much socio-cultural factors inhibiting recording of deaths, getting actual number of corona mortality becomes an improbability. It is not Covid-19 deaths but any type of deaths occurring at home in rural areas gets largely omitted from the official counts.

Besides, as per the ICMR requirement a deceased patient must be Covid-19 confirmed through testing to make it to the official count. But where testing is poor, death recording becomes weak. We also find wide variation in testing across states and over time. Against all these circumstances deterring true recording of Covid-19 deaths in the country let me focus some issues concerning the present pandemic deaths which carry enough economic implications for the country and need urgent attention of the Government.

Generally the severity of a disease is evaluated not by the absolute number deaths but by its case fatality rate (CFR) and share in the number of deaths due to all-cause. Taking into account the latest number of Covid-19 deaths to the confirmed cases as on 5th June,2021 the CFR (number of deaths to confirmed cases x 100) works out to 1.19 percent for the country. Comparing with the CFR of most of the countries afflicted by Covid-19 pandemic, India’s CFR is found to be much lower. Besides, between March,2020 and June 05, 2021 the CFR has made a sharp dip from 2 percent to 1.19 percent indicating the that various efforts of the government have yielded positive results and the country has made a big come back in saving people’s lives.

In calculating the share of Covid-19 deaths to all-cause deaths for the country, we find there is severe data limitation. Not only there is unavailability of recent data on all-cause deaths at the all-India level but also available data in this respect are found patchy. As studies reveal in almost all states only a fraction of deaths are registered and this is largely seen in rural deaths. In the present pandemic situation we belief the registration of deaths might have been further reduced as in some cases family members are found unwilling to declare their loved ones have died of Covid-19. Studies also point out that in India two out of three deaths occur at home and deaths at home remain outside the purview of registration.

It is no exaggeration to say that the Covid-19 pandemic has resulted in massive loss of lives unseen in the country’s recent history. But what is more worrisome is that over and above the number of Covid-19 deaths occurred, the pattern of Covid-19 deaths noticed over the period does have greater economic implications for the country. Compared to the high-income countries where Covid-19 related deaths are mostly in the age-group older than 65 years, in India these deaths are found concentrated largely between the age-group of 50-64 years – the economically active age population. Across states we also find wide disparity in the Covid-19 infections and deaths.

Economically important states are found more affected by the disease than poorer states. States like Punjab, Maharashtra, Gujarat and Himachal Pradesh, show higher CFR over the all-India average. In contrast in relatively less well-off states such as Odisha, Assam, Rajasthan and Bihar the CFR lies below all-India average. Among the states Punjab shows the highest case fatality rate of 2.58 percent while Odisha exhibits the lowest percentage (0.36 percent).

Gender-wise covid-19 has hit men harder than women in India. As reported by Ministry of Health in January, 2021 approximately 70 percent of deaths occurred since the outbreak of the pandemic are among men. This is in contrast to developed countries where women are found equally succumbing to Covid-19 as men. Men being considered as the major breadwinners in the Indian families higher mortality among men caused by Covid-19 drags the families down to deeper poverty and destitution.

No doubt the absolute number of Covid -19 deaths estimated by the government might be smaller than the true toll, yet the recorded number is also found inhumanly large. Along with the number of mortality it provides some valuable inputs which have serious economic implications for the economy. Since mortality caused by the pandemic varies across states, multiple strategies rather than uniform strategy specific to each state/ region need to be adopted to curb the spread as well as mortality caused by the pandemic. States like Maharashtra sharing both higher cases and deaths need to be treated differently than states like Punjab and, Chhatisgarh having higher share in deaths. The North-eastern states with less number of deaths but having higher CFR need special action plan to combat the pandemic deaths.

It is to be acknowledged that India’s public health institutions are awfully inadequate to meet the challenges of any epidemic. The present pandemic has thoroughly exposed their inadequacies. The metamorphic development of the country’s public health system is the need of the hour.