The number of “excess deaths” registered by the Civil Registration System (CRS) in Chhattisgarh during the second wave (April to May 2021) was 43,062, which is 4.85 times the official reported figure of 8,878 COVID-19 deaths for the same period.
If the first three months of 2021 are included, the undercount factor decreases to 3.6 times (34,897 excess deaths and 9,677 official fatalities). Excess deaths were calculated based on the month-wise number of fatalities registered in the State’s online CRS (provisional figures), which The Hindu accessed. The 43,062 “excess deaths” during the second wave were calculated as the difference between 71,142 deaths registered online in April and May 2021 and the average number of deaths in the same period in the pre-pandemic years between 2015 and 2019 (28,080).
The month-wise figures between 2015 and 2019 were sourced from the CRS’ annual reports.
If instead of averages, a year-by-year growth rate of deaths is considered, the State’s 71,142 registered deaths in April-May 2021 were 2.2 times higher than the estimated 31,842 deaths. In this approach, the undercount factor slightly comes down from 4.85 to 4.4. However, estimating the undercount using the averages method would suit Chhattisgarh as the growth in deaths over years is not consistent.
It is important to note that the excess deaths calculated are a conservative estimate given the low death registration levels of the State.
First, only 81.5% of deaths were registered in 2019, lower than 26 of the 36 States/Union Territories. This contrasts with death registration numbers in States such as Tamil Nadu, Karnataka and Kerala which were 100%, according to CRS 2019. Chhattisgarh’s registration numbers are however higher than that of Bihar (51.6%) and Uttar Pradesh (63.3%).
Secondly, the registered deaths in April-May 2021 were based on only 24-32% of the registration units which reported fatalities online during the two months. Whereas the figures from 2015-2019 were based on the CRS annual reports which had collated information from all the registration units. Thus, the actual deaths that occurred in April-May 2021 may be three times higher than reported and so the undercount factor may also increase substantially from 4.8 to about 10.
The registered deaths in the last two months could also be higher because in Chhattisgarh only 76.4% of deaths are registered within 21 days of death, a number that is lower than States like Punjab (98.9%), Himachal Pradesh (92.1%), West Bengal (91.7%), Andhra Pradesh (91.4%), Tamil Nadu (90.9%) among others. This could also increase the number of excess deaths and its multiple over the actual COVID-19 death toll.
By way of comparison, Madhya Pradesh and Andhra Pradesh’s excess deaths were 43 and 31.4 times the official COVID-19 tally for April and May 2021, but online registration of deaths in the two States were 97.65% and 100% according to CRS 2019.
When questioned about the excess deaths and the undercount factor, Chhattisgarh Health Minister T.S. Singh Deo said they are “completely open to any data presented by anyone”.
“We are absolutely open to add anyone who died due to corona but are not in the list. There is no question of suppression,” the Minister said. “Even if the data says that it is [actual deaths] 4 times more than the reported deaths. Even if it is 10 times more, we are open to that,” he added.
However, he said that low levels of deaths registration in the CRS was not possible. “In today’s times I don’t see the possibility of anyone not registering their deaths. There is a lot of awareness in the villages too.”
Mr. Singh Deo said they had been consistently updating the figures whenever the media pointed out. “However a door-to-door survey was not needed”, he said. “Frankly I don’t see a need for that”.
Minister of Planning, Economics and Statistics, Amarjeet Bhagat, said the deaths could be high because of the second wave but could not confirm the exact fatalities.
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Yogesh Jain, who is a public health physician in rural Chhattisgarh and associated with Sangwari, a rural health NGO, expressed surprise at the undercount. “I haven’t heard that undercounting was a common thing in Chhattisgarh. It is unlikely that the undercount in Chhattisgarh is as high as other States.” The government here has no reason to modify the numbers, he said.
Dr. Jain said that during a lockdown the number of deaths in general declined due to restriction of movement. He also said that excess deaths might also be due to other causes such as denial of healthcare, though those might not be the predominant reasons.
The undercount factor during the first wave could not be analysed as the annual CRS report for 2020 has not yet been released and the number of units which reported deaths in the online portal were very low during the period. Also, the undercount factor for 2021 was a smaller multiple (3.6) for a similar reason. The excess death figure and the undercount factor will be revised when data from all registration units get recorded.
(With inputs from Shubhomoy Sikdar)