The number of “excess deaths” registered by the Civil Registration System (CRS) in Punjab ever since the COVID-19 pandemic hit (from April 2020 to May 2021) was an estimated 47,571, which is 3.3 times the official reported figure of 14,450 COVID-19 deaths for the same period.
The figures were arrived at from the data on deaths registered month-wise in the CRS from January 2015 to June 2021 in Punjab and accessed by The Hindu .
If data for June 2021 were added to the analysis, the excess deaths multiple increased to 3.6. The excess deaths were calculated as the difference between the month-wise total number of registered deaths during the pandemic period and average of deaths registered for the same months during the pre-pandemic period (2018 and 2019).
The excess deaths multiple remained close to 3 during 2020 and the early months of 2021, only increasing due to a surge in mortality during the second wave between April and June in 2021. There were 9,184 recorded COVID-19 deaths in this three-month period, which also registered an estimate of 40,910 excess deaths compared with the corresponding months in 2018 and 2019.
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If a longer period was used for the comparison (2015-2019), the excess deaths went up slightly to 51,316, which is 3.6 times the official COVID-19 toll for the period April 2020 to May 2021. A third method, estimating the registered deaths for 2020 and 2021 based on linear increases in the previous years and calculating the difference from the actual number of deaths, yielded an excess deaths multiple of 2.8, close to the estimates from the other two methods.
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As with the other States, not all excess deaths could be related to COVID-19, but a bulk of them could be during the pandemic. As a World Health Organization report suggests: “COVID-19 excess mortality accounts for both the total number of deaths directly attributed to the virus as well as the indirect impact, such as disruption to essential health services or travel disruptions.”
The estimated excess deaths multiple of 3.3 for the State is lower than that of neighbouring Haryana (7.3), Tamil Nadu (6.4 adjusted to 4.4 if CRS COVID-19 tally is considered), Karnataka (4.3) and much lower than that of Madhya Pradesh (23.8) and Andhra Pradesh (17.9) if the same baseline is considered (deaths registered in 2018 and 2019). The multiple was higher than that of Himachal Pradesh (1.9) and Kerala (<1 based on reconciled COVID-19 death figures) for the same period.
The total number of excess deaths for these States (using the same baseline) for the period April 2020 to May 2021 was 9,10,322 which is 7.7 times the official COVID-19 toll for the same period (1,18,941).
The CRS annual report for Punjab notes that death registration in the State has been near 100% from 2012 onwards. An estimated 98.9% of all deaths were also registered within 21 days of the occurrence, which is the highest compared with the other States, according to the CRS annual report for 2019.
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Raj Bahadur, a professional adviser to the COVID-19 response and procurement committee in Punjab, told The Hindu that the data on the number of deaths in the State were absolutely truthful, and there was not an iota of doubt surrounding them.
“From day one we had been tracking each and every patient and his/her movement every day. Death of any patient, which came to the attention of our team, is on the record, but if anyone was at home and it was not even diagnosed that he/she died of COVID-19, in that case it’s difficult to say anything about such people,” Dr. Bahadur said.
“On the presumption of excess deaths, I would like to say with utmost conviction that the death data, which we have collected from medical colleges, district hospitals or private hospitals, should be considered as the actual death data. It is not possible for me to tell that people who are lying in the home died because of COVID or not ... If they have not come to hospitals for any reason — be it fear or any other reason — I am not confident that such numbers should be added to COVID1-9 deaths,” Dr. Bahadur said.
“The data on deaths from Punjab are absolutely correct,” he added.
Dr. Bahadur said in Punjab audits of all the deaths had started when the pandemic began. “An expert group has been conducting an audit of all deaths, it’s an ongoing process,” he said.
He added that even during the lockdowns, the registration system was not affected in any way.
( With graphics support from Vignesh Radhakrishnan )