Coronavirus | Spike in excess deaths during pandemic

Excess deaths in Rajasthan are at least five times the official COVID-19 tally

Beneficiaries wait in a queue to receive COVID-19 vaccine dose, during a vaccination drive at Harmada Dispensary, in Jaipur, Rajasthan. File   | Photo Credit: PTI

The number of “excess deaths” registered by the Civil Registration System (CRS) in Rajasthan ever since the COVID-19 pandemic hit (from April 2020 to May 2021) was 45,088, which is 5.4 times the official reported figure of 8,385 deaths for the same period.

Also read: Chhattisgarh’s excess deaths at least 4.8 times COVID-19 toll

This high number was largely due to deaths registered in April 2021 (26,251) and May 2021(49,046). In this period, which coincided with the second COVID-19 wave, the excess deaths were around 39,438, compared to the registered COVID-19 tally of 5,567, leading to an undercount factor of 7.1. The overall COVID-19 tally in Rajasthan so far, as of July 2, is 8,970.

 

Excess deaths in Rajasthan were calculated based on the month-wise number of deaths registered in the Rajasthan Civil Registration System (Pehchan portal) from January 2018 to May 2021, which was accessed by The Hindu. It was ensured that the data analysed did not include duplicate records (~1,100 names out of ~7.92 lakh deaths from 2018 to 2021).

But the State’s registration toll in the CRS report released by the office of the Registrar General & Census Commissioner for 2018 and 2019 were 4,43,173 and 4,51,315 respectively, nearly double the data in the Pehchaan system for the same years – 2,16,370 and 2,19,814 respectively. If the full CRS data for Rajasthan is analysed, the undercount factor may change and could go up further. The excess deaths calculations and undercount factor will be updated if and when the full CRS data for 2020 and 2021 is made available.

Not all “excess deaths” would be related to COVID-19 but a bulk of them are, during the pandemic.

Also read: ‘Excess deaths’ in Kerala 1.6 times official COVID-19 toll

The estimated undercount factor (5.4) and excess deaths for Rajasthan (45,088) were lower compared with the other north Indian State of Madhya Pradesh (1,92,044 and 23.8) in the same period and for which complete data has been made available so far. Excess deaths have also been estimated for Uttar Pradesh, Bihar and Gujarat but these figures are only partial, either for some districts (U.P.) or for a limited period (Bihar and Gujarat).

According to the Civil Registration System report for 2019, Rajasthan registered an estimated 98.6% of all deaths in the State, and thanks to the Pehchan system, there is online registration as well. The report also mentions that 67.3% of all deaths are registered within 21 days of the event in the State, a number that is comparable to Karnataka (67.2%) and Kerala (65.1%) but lower than States like Punjab (98.9%), Himachal Pradesh (92.1%), West Bengal (91.7%), Andhra Pradesh (91.4%), Tamil Nadu (90.9%), Gujarat (87.5%) and Madhya Pradesh (81.6%). This suggests that excess deaths might go up as late registrations are tallied in Rajasthan (similar to Kerala and Karnataka), but at a higher rate compared to States like Tamil Nadu which have quicker registration.

Excess deaths calculations (and therefore, undercount factors) change if the method to calculate it changes based on the years for which averages are considered or if a projection based on linear growth of deaths year on year is used. For Rajasthan, Madhya Pradesh and Andhra Pradesh, excess deaths were calculated based on registrations available only for two pre-pandemic years, 2018 and 2019. Rajasthan’s undercount figure based on partial data is comparable to those for Karnataka and Tamil Nadu. The figures for Karnataka and Kerala fall if the linear growth estimation method is used, indicating that better registration in later years have lowered “excess deaths”. Tamil Nadu’s undercount factors do not change much.

 

Also read: Thiruvananthapuram bucks excess deaths trend

Among districts in Rajasthan, Udaipur (3,949), Nagaur (3,473), Jaipur (3,334) and Jodhpur (2,874) had the highest excess deaths, but the undercount factor for Jaipur and Jodhpur — 1.8 and 2.7, respectively — was lower compared with Nagaur (20.3) and Udaipur (6). Jalore (2,420 excess deaths) had the highest undercount factor — 34.1. All numbers correspond to the April 2020 to May 2021 period. In general, rural and semi-rural districts had a higher undercount factor compared to semi-urban districts like Jaipura and Jodhpur.

 

Speaking to The Hindu, Medical and Health Secretary Siddharth Mahajan mentioned that the State had commissioned a death audit to ascertain mortality figures and that reports were awaited. He said that the State had sought to ramp up measures to identify patients through effective surveillance, even those with influenza-like illnesses during the pandemic, to ensure that they get adequate care and to avoid deaths. He added, “During the lockdowns, non-COVID-19 patients also suffer and our focus will equally be on such patients. Districts are preparing plans to tackle a possible third wave.”

Also read: Karnataka’s excess deaths nearly 6 times official COVID-19 toll

A look at the gender break-up of the deaths in the State from 2018 to 2021 shows that the proportion of deaths among females went up marginally from 36% to 38% during 2021 compared to the previous ones.

 

This was unlike in Tamil Nadu (the only other State for which The Hindu had such data available for the pandemic years), where the proportion of female people among those dead was close to 40% consistently from 2015 to 2021.

(Based on data compiled and aggregated by Pratap Vardhan. Inputs from Vignesh Radhakrishnan and Sumant Sen.)

UPDATE: This article has been corrected to reflect the mismatch in the data accessed via the Pehchan system and the registered deaths in the CRS report 2019. Charts and graphics have been updated accordingly


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This article has been corrected to reflect the mismatch in the data accessed via the Pehchan system and the registered deaths in the CRS report 2019. Charts and graphics have been updated accordingly

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Printable version | Sep 23, 2021 9:35:09 PM | https://www.thehindu.com/news/national/excess-deaths-in-rajasthan-are-five-times-the-official-covid-19-tally/article35118826.ece

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