There is no getting past the pandemic till we credibly count COVID-19 deaths

Indian statisticians and modellers are equal to any in the world. The government could easily set up a panel of experts to arrive at an independent and credible estimate of the country’s pandemic toll

The World Health Organization (WHO) recently released a report that estimated global deaths from COVID-19 across 2020-2021. It suggested that about 14.9 million deaths could be attributed to the pandemic worldwide during that period, further estimating that about 4.7 million of these deaths were in India alone. For comparison, the official Indian COVID-19 toll for that period is 0.48 million, a number smaller than the WHO number by a factor of about 10. 

A number of independent news reports have suggested that there was pressure from the Indian government on the WHO to suppress their estimates. Indeed, once the report appeared, it was immediately criticised by a number of prominent government representatives. A government press release called the report “statistically unsound and scientifically questionable”. 

India’s rejection of the report makes it the only country to do so, out of the 194 member states of the WHO. However, the estimates for India are broadly consistent with estimates from a number of independent groups, all falling in the broad range of 2.2 million to 6 million deaths.

At the core of all such estimates, especially in situations where official numbers might not align with reality, is a quantity called “excess mortality”. This compares estimates of the actual death toll with the number of deaths expected in the same year but without the mortality caused by the pandemic, an obvious counterfactual. There are thus two estimates here — an estimate of the actual number of deaths, and the “counterfactual” estimate. The difference between these is the number of excess deaths that we should attribute to the pandemic.

For the counterfactual estimate, one should extrapolate from the number of deaths in previous pre-pandemic years, but with additional statistical corrections that represent how the population changes from year to year. Somewhat subtly, one must account for the indirect impacts of the disease as well. These should include the fact that fewer deaths from road accidents occur during periods of a lockdown, for example. Accounting for those who died simply because medical treatment was hard to access in the pandemic period, even if from non-COVID-19 causes, is also important.

For the actual death toll, one must rely on official data, if it is believed to be accurate, or estimate the number by other means, as the WHO did for India.

The government’s issue with the WHO report involves both these separate estimates. It argues that the model used by the WHO to estimate deaths in the counterfactual scenario is flawed. Further, it suggests that the way in which the actual deaths are calculated — from a combination of official reports, numbers from external non-government websites and news reports — is questionable.