In first year of lockdown, more died of other respiratory diseases than COVID-19

The medical certification of cause of death report says that 1,60,618 deaths in 2020 were due to COVID-19 which differs from government’s official toll of 1.49 lakh.

A view of the Governement Kilpauk Medical College Hospital, in Chennai. File | Photo Credit: B. Jothi Ramalingam

The first year of COVID-19 lockdown saw the highest incidences of persons dying of respiratory illnesses in a decade, the 2020 report on medical certification of cause of death (MCCD) compiled by the Registrar General of India (RGI) says. In 2020, as many as 1,81,160 deaths occurred due to respiratory diseases such as pneumonia, asthma and bronchitis, higher than 1,52,311 such deaths reported in 2019. 

The certified deaths are other than those caused by COVID-19 virus, also a respiratory disease that has been separately recorded in the report as “Deaths reported under Codes for Special Purposes (Covid 19 Deaths).” At 1,60,618 deaths, the report said that this newly introduced major group is the third leading cause group recording 8.9 % of the totalmedically certified deaths at national level. The Union Health Ministry, however reported 1.49 lakh COVID-19 deaths in 2020.

The total number of deaths, from all causes, in 2020 was 81.2 lakh.

The recent World Health Organisation’s (WHO) report on excess mortality rate due to Covid-19 notes that India’s official death toll is an undercount. The report pegged India’s excess mortality (people who probably would not have died if there was no pandemic) for 2020 and 2021 at 47.4 lakh. These are the highest, by far, for any country and comprise nearly a third of the 15 million such deaths globally.

The Health Ministry, while questioning and objecting to the methodology used by WHO to arrive at its figures, maintained that India officially estimated 4.8 lakh cumulative deaths linked to COVID-19 as of December 2021, which would mean that the WHO estimate is almost 10 times the government count. As of May, India’s official COVID-19 death toll is 5.2 lakh.

Excess mortality includes deaths associated with COVID-19 directly (due to the disease) or indirectly (due to the pandemic’s impact on health systems and society).

India earlier this month released birth and death registration data from 2020 that reported 4.75 lakh excess deaths from all causes in 2020 over 2019. This Civil Registration System (CRS) data only counts deaths registered and doesn’t break down causes of death. The WHO, on the other hand, has estimated nearly 8.2 lakh excess deaths from all causes

According to the MCCD report. those above 70 years were the worst affected by the respiratory diseases accounting for the highest incidences of deaths- 47,292 deaths or 29.4 % of total registered medically certified deaths. This was followed by 55-64 years reporting 23.9 % deaths, the age group 65-69, having class interval of only 5 years also reported significant number of deaths- 14.5 %, the report said. “The major number of deaths is concentrated in the age group of 45 years and above constituting 82.7 % of total deaths in the group,” the report said.

The report on MCCD-2020, is based upon 18,11,688 total medically certified deaths. As per annual Report on Vital Statistics of India based on Civil Registration System, 2020, the number of registered deaths at national level is 81,15,882. 

The report said that medically certified deaths account for 22.5 % of total registered deaths at national level but after taking into consideration, any kind of medical attention received by the deceased at the time of terminal illness, it increased to 54.6 %.

Around 5.7 % of total medically certified death has been reported in infants.

“Certain Infectious and Parasitic Diseases,” mainly constituted by septicemia and tuberculosis accounted for 7.1% of total medically certified deaths. At 62,759 deaths, septicemia accounted for 3.5 % of the total such deaths while 29,421 people died of tuberculosis.

Maximum number of people died of diseases of circulatory system” comprising diseases of pulmonary circulation and others forms of heart diseases. Nearly 5.8 lakh deaths or 32% deaths were due to pulmonary or hearth diseases.