Thread by @shreegireesh

#Thread: On WHO Covid excess death projections and the Union government's dubious arguments against it.

A recently released WHO report has concluded that India's Covid-19 death count is nearly 10 times the official toll. The government has tried to discredit the data -- saying the new estimates “may stretch to the limits of absurdity.”

The government, and some media outlets, have said the data on deaths registered with the Central Registration System (CRS) proves that WHO's projections are way out of line.

Is it? The government is selling us a lemon, I contend. It's doing so by contradicting its own stance on how the CRS maps and collects death-related data from villages and towns into a centralised digital database.

Deaths are first recorded in registers at the municipality and gram panchayat level. Sometimes digitally. And often at gram panchayats in manually filled registers.

From the original death registers, it takes time for the data to be fed up the chain in the central registry that the govt is now using as its defence.

It takes nearly two years before the data is collated nationwide and put out in reports like the one released earlier this week

In fact, the Centre has used this lag as an excuse to criticise any independent analysis of mortality data during the pandemic.

Example: pib.gov.in/PressReleasePa…

We @reporters_co decided to go to the primary source of the information - the original death registers.

.@tapasya_umm, @nit_set & I spent over 3 months parsing through death registers gathered from 68 of Gujarat's 170 municipalities -- where deaths are first recorded. We collected copies of hand-filled registers between January 2019 and April 2021, running into thousands of pages.

Here's what we found:In the 68 municipalities -- 6% of Gujarat's population -- 16,892 more people died from all causes between March 2020 and April 2021 compared to the same period in 2019. The official death toll for the state stood at 10,075 when we published our report.

An estimate of how devastating the second wave was: In April 2021 alone, there were 10,238 excess deaths in the 6% of population under review, which is more than the official statewide COVID-19 death tally for the entire pandemic.

In Surendranagar, a district with 17,56,268 people, the official Covid death toll of the entire district stood at 136. But death registers show that in one municipality, which holds 14% of the district’s population, there were 1,210 excess deaths between March and April 2021.

I could go on and on, one municipality after other. One district to another. We have now mapped more than 100 municipalities of Gujarat and more than 70 districts across the country for excess death data (not projections, but absolute data).

We corroborated some of this data with ground reporting, too. We collected data from crematoriums and kabristaans and matched that data with the corresponding municipality's official death registers.

Now, lets look at the government's attempts at discrediting WHO's estimates and how some media outlets toed a similar line.

Coinciding with the WHO report, govt put out its own CRS (Civil Registration System) report for 2020. The CRS report is a compilation of births and deaths registered in the country in a year.

Keyword: 'Registered'. The CRS report is not a count of the actual deaths.

One of the key features of CRS reports is level of registration of deaths in the country. This gives you the number of deaths registered for every 100 that actually died. The 2020 CRS report is missing this crucial info. Here's the level of registration seen in 2019:

The data on level of registration helps you get to the 'estimated deaths' figure. Since the 2020 CRS report has skipped level of death registration, it has no estimated death count.

Interestingly, the government has claimed that death registration in 2020 stood at 99.9%.

This figure is from the PIB press release. NOT the official CRS report. When @ThePrintIndia reached out to officials to ask them about the missing level of death registration data, the unnamed sources said the 99.9% figure was "internally shared" in the Health Ministry

The CRS report itself, meanwhile raises questions about the true extent of under reporting of deaths. At least two states, Telangana and Uttar Pradesh, blamed pandemic-related disruptions for not being able to capture death figures accurately.

In the absence of level of death registration data, it's not possible to arrive at an estimated count of how many Indians actually died. As this level drops -- meaning the number of dead whose deaths were registered is low -- the estimated death count rises.

Some media outlets, picking up arguments first put forth by govt officials, have also got it wrong. For example...

The Indian Express questioning WHO estimates quotes the 99.9% figure mentioned in govt PR (not the official report) and uses the estimated death count based on this claim to analyse trends.

It says that since WHO estimated 8.3 lakh Covid deaths in 2020, there would be only 73 lakh non-Covid deaths. It then says India's annual death count since 2007 has never been below 80 lakh. This apparently makes the 8.3 lakh Covid death estimates for 2020 implausible.

This analysis, just to remind you, is based on a government claim. A claim even it did not feel confident enough about to include in its official report. Put it out in a press release instead.

You can read our Gujarat Covid death data story here:
thewire.in/health/gujarat…

@tapasya_umm, @harshithamanwan and @journomayank also analysed the excess deaths in three other Indian states: Rajasthan, Jharkhand and Andhra Pradesh

science.thewire.in/health/covid-r…

This took time and a lot of effort. But got us a little closer to truth.

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