Systematic review of excess mortality in India during the Covid-19 pandemic with differentiation between model-based and data-based mortality estimates
Background: COVID-19 has proven to be the worst pandemic in the history of mankind. While the pandemic still continues to perplex scientists globally, attempts are being made to quantify the mortality caused by the pandemic. Official COVID-19 figures in India grossly understate the true scale of the...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2022-01-01
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| Series: | Indian Journal of Community Medicine |
| Subjects: | |
| Online Access: | http://www.ijcm.org.in/article.asp?issn=0970-0218;year=2022;volume=47;issue=4;spage=491;epage=494;aulast= |
| _version_ | 1828066187667308544 |
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| author | Subramanian Natarajan Poonam Subramanian |
| author_facet | Subramanian Natarajan Poonam Subramanian |
| author_sort | Subramanian Natarajan |
| collection | DOAJ |
| description | Background: COVID-19 has proven to be the worst pandemic in the history of mankind. While the pandemic still continues to perplex scientists globally, attempts are being made to quantify the mortality caused by the pandemic. Official COVID-19 figures in India grossly understate the true scale of the pandemic in the country. Fatality rates help us understand the severity of a disease, identify at risk populations, and evaluate quality of healthcare. Official COVID-19 mortality figures in India grossly understate the true scale of the pandemic in the country. A COVID-19 death is defined for surveillance purposes as a death resulting from a clinically compatible illness in a probable or confirmed COVID-19 case, unless there is a clear alternative cause of death that cannot be related to COVID-19 disease (e.g., trauma) and excess mortality is defined as the difference in the total number of deaths in a crisis compared to those expected under normal conditions. Materials and Methods: We did a systematic review of multiple papers on PubMed, Medline, Embase, MedRxiV pre print on excess mortality. Differentiation between model based estimated excess mortality and data based excess mortality was studied. Results: All the studies showed that the excess mortality was to the tune of almost three times the official figures. The model based excess mortality assumptions showed higher deaths as compared to the data based one. However, there were a lot of discrepancies in the data provided by various states along with variations observed between the two waves as well. Health survey data suggested higher mortality rate as compared to data compiled from the civil registration system. Additionally, in the second wave, a small but a significant number of deaths occurred due to non availability of oxygen and beds in the hospitals. Conclusions: Official COVID-19 deaths have entirely failed to capture the scale of pandemic excess mortality in India. If most excess deaths were, indeed, from COVID-19 then under ascertainment of COVID-19 deaths has been high, with around 8-10 excess deaths for every recorded COVID-19 death. |
| first_indexed | 2024-04-10T23:27:03Z |
| format | Article |
| id | doaj.art-15d3aa4b2a15411fbfbb604b12585b90 |
| institution | Directory Open Access Journal |
| issn | 0970-0218 1998-3581 |
| language | English |
| last_indexed | 2024-04-10T23:27:03Z |
| publishDate | 2022-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Community Medicine |
| spelling | doaj.art-15d3aa4b2a15411fbfbb604b12585b902023-01-12T11:31:12ZengWolters Kluwer Medknow PublicationsIndian Journal of Community Medicine0970-02181998-35812022-01-0147449149410.4103/ijcm.ijcm_11_22Systematic review of excess mortality in India during the Covid-19 pandemic with differentiation between model-based and data-based mortality estimatesSubramanian NatarajanPoonam SubramanianBackground: COVID-19 has proven to be the worst pandemic in the history of mankind. While the pandemic still continues to perplex scientists globally, attempts are being made to quantify the mortality caused by the pandemic. Official COVID-19 figures in India grossly understate the true scale of the pandemic in the country. Fatality rates help us understand the severity of a disease, identify at risk populations, and evaluate quality of healthcare. Official COVID-19 mortality figures in India grossly understate the true scale of the pandemic in the country. A COVID-19 death is defined for surveillance purposes as a death resulting from a clinically compatible illness in a probable or confirmed COVID-19 case, unless there is a clear alternative cause of death that cannot be related to COVID-19 disease (e.g., trauma) and excess mortality is defined as the difference in the total number of deaths in a crisis compared to those expected under normal conditions. Materials and Methods: We did a systematic review of multiple papers on PubMed, Medline, Embase, MedRxiV pre print on excess mortality. Differentiation between model based estimated excess mortality and data based excess mortality was studied. Results: All the studies showed that the excess mortality was to the tune of almost three times the official figures. The model based excess mortality assumptions showed higher deaths as compared to the data based one. However, there were a lot of discrepancies in the data provided by various states along with variations observed between the two waves as well. Health survey data suggested higher mortality rate as compared to data compiled from the civil registration system. Additionally, in the second wave, a small but a significant number of deaths occurred due to non availability of oxygen and beds in the hospitals. Conclusions: Official COVID-19 deaths have entirely failed to capture the scale of pandemic excess mortality in India. If most excess deaths were, indeed, from COVID-19 then under ascertainment of COVID-19 deaths has been high, with around 8-10 excess deaths for every recorded COVID-19 death.http://www.ijcm.org.in/article.asp?issn=0970-0218;year=2022;volume=47;issue=4;spage=491;epage=494;aulast=covid19deathsexcess mortalityindiamortality |
| spellingShingle | Subramanian Natarajan Poonam Subramanian Systematic review of excess mortality in India during the Covid-19 pandemic with differentiation between model-based and data-based mortality estimates Indian Journal of Community Medicine covid19 deaths excess mortality india mortality |
| title | Systematic review of excess mortality in India during the Covid-19 pandemic with differentiation between model-based and data-based mortality estimates |
| title_full | Systematic review of excess mortality in India during the Covid-19 pandemic with differentiation between model-based and data-based mortality estimates |
| title_fullStr | Systematic review of excess mortality in India during the Covid-19 pandemic with differentiation between model-based and data-based mortality estimates |
| title_full_unstemmed | Systematic review of excess mortality in India during the Covid-19 pandemic with differentiation between model-based and data-based mortality estimates |
| title_short | Systematic review of excess mortality in India during the Covid-19 pandemic with differentiation between model-based and data-based mortality estimates |
| title_sort | systematic review of excess mortality in india during the covid 19 pandemic with differentiation between model based and data based mortality estimates |
| topic | covid19 deaths excess mortality india mortality |
| url | http://www.ijcm.org.in/article.asp?issn=0970-0218;year=2022;volume=47;issue=4;spage=491;epage=494;aulast= |
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