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COVID-19 pandemic in India The COVID-19 pandemic in India is a part of the worldwide pandemic of coronavirus disease 2019 () caused by severe acute respiratory syndrome coronavirus 2 (). As of , according to Indian government figures, India has the second-highest n ...
.
COVID-19 Coronavirus disease 2019 (COVID-19) is a contagious disease caused by a virus, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The first known case was COVID-19 pandemic in Hubei, identified in Wuhan, China, in December ...
cases, deaths, recoveries, and other statistics are shown in nationwide and
regional In geography, regions, otherwise referred to as zones, lands or territories, are areas that are broadly divided by physical characteristics (physical geography), human impact characteristics (human geography), and the interaction of humanity and t ...
maps and graphs.


Classifying COVID-19 deaths

The
Indian Council of Medical Research The Indian Council of Medical Research (ICMR), the apex body in India for the formulation, coordination and promotion of biomedical research, is one of the oldest and largest medical research bodies in the world. The ICMR is funded by the Gove ...
(ICMR) governs classification of a COVID-19 related death in India. ICMR in turn follows WHO guidelines, recording COVID-19 deaths as U07.1 as per
International Classification of Diseases The International Classification of Diseases (ICD) is a globally used diagnostic tool for epidemiology, health management and clinical purposes. The ICD is maintained by the World Health Organization (WHO), which is the directing and coordinating ...
. The National Centre for Disease Informatics and Research, ICMR, released a document titled "Guidance for appropriate recording of COVID-19 related deaths in India". In March 2020, the first two COVID-19 infected people to die in India officially died due to their co-morbidities and not COVID-19. Around India, people dying of their co-morbidities are not be considered as a COVID-19 death, "if a comorbid patient dies then a committee of experts decides the primary and secondary causes of death ..If that committee identifies the main cause of death as heart attack, then even if the patient was infected, such a death is not counted as being caused by Covid." Testing of dead bodies to COVID-19 is being done according to ICMR guidelines and government orders. On 17 May 2020, the Delhi government changed COVID-19 testing policy by stopping tests of dead bodies.


National serological surveys

India's first national serological (seroprevalence) survey was conducted by ICMR during May–June 2020; 0.73% sero-positivity was observed. The results were published on 10 September 2021 on the website of the ''
Indian Journal of Medical Research The ''Indian Journal of Medical Research'' is a peer-reviewed online open-access medical journal, available as a print-on-demand compilation. It is published by Medknow Publications on behalf of the Indian Council of Medical Research. Since 1977, ...
''. However the survey and subsequent press releases and the final publication saw a number of discrepancies. ICMR also clarified that the observed sero-positivity did not represent the entire population. While ICMR came out with a 49% sero-positivity rate for
Ahmedabad Ahmedabad ( ; Gujarati: Amdavad ) is the most populous city in the Indian state of Gujarat. It is the administrative headquarters of the Ahmedabad district and the seat of the Gujarat High Court. Ahmedabad's population of 5,570,585 (per t ...
, the
Ahmedabad Municipal Corporation The Amdavad Municipal Corporation, or the AMC, established in July 1950 under the Bombay Provincial Corporation Act (1949), is responsible for the civic infrastructure and administration of the city of Ahmedabad. History On 21 April 1831, the ...
conducted its own survey and came out with an average sero-positivity of 17.61%. The second serological survey, published in ''
The Lancet ''The Lancet'' is a weekly peer-reviewed general medical journal and one of the oldest of its kind. It is also the world's highest-impact academic journal. It was founded in England in 1823. The journal publishes original research articles, ...
'', was conducted in August–September 2020; 6.6% sero-positivity was observed, i.e. for every case detected, about 15 went undetected. India's third national serological survey conducted in December 2020 and January 2021 revealed that only 3.5% of the total infections had been "detected" or "recorded". In other words, for every case detected, about 30 went undetected.


Reconciliation of data

Reconciled and backlogged data includes both deaths and number of tests. States and union territories that have reconciled deaths include Tamil Nadu, Bihar, Andhra Pradesh, Uttarakhand, West Bengal, Goa and Delhi. 7.6 million tests have been reconciled. Until 21 July 2021, Maharashtra had reconciled deaths 14 times.


Maps


Interactive maps


Charts


Total confirmed cases, active cases, recoveries and deaths


Daily new cases


Daily new deaths


Daily new recoveries


Daily new cases vs active cases


Confirmed cases by regions


Confirmed deaths by regions


Case fatality rate

The trend of
case fatality rate In epidemiology, case fatality rate (CFR) – or sometimes more accurately case-fatality risk – is the proportion of people diagnosed with a certain disease, who end up dying of it. Unlike a disease's mortality rate, the CFR does not take int ...
for COVID-19 from 12 March, the day first death in the country was recorded.


Total samples tested


Daily samples tested


Positive sampling rate


Plot of new samples tested per day vs new confirmed positive per day


Issues


Background


Global mortality excess

According to the
World Health Organization The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. The WHO Constitution states its main objective as "the attainment by all peoples of the highest possible level of h ...
the global mortality excess for COVID-19 is significant, "while 1,813,188 COVID-19 deaths were reported in 2020... WHO estimates suggest an excess mortality of at least 3,000,000." The worldwide average for underreporting COVID-19 deaths in cities is 30%.


Legacy issues

In India the accuracy of counting its dead is further complicated by its system of tracking deaths in its population in general. In 2018, about 86%% of the deaths in the country were ar
registered
while medical certificates are given to around 22% of the deaths. Recently released reports by the Civil Registration suggest that death registration has improved further in 2019. Still, there are inaccuracies in the medical certificates. Death registration also varies. In 2019 the
National Family Health Survey The National Family Health Survey (NFHS) is an India-wide survey conducted by Ministry of Health and Family Welfare, Government of India, with the International Institute for Population Sciences serving as the nodal agency. History In 1992-93, t ...
registration of deaths varied from 37% (Bihar) to 100% (Goa).


India's low COVID-19 death count

India's low death count has puzzled experts such as microbiologist Gagandeep Kang and epidemiologist Prabhat Jha. Epidemiologist Ramanan Laxminarayan points to India's relatively young population and uneven disease surveillance as reasons for the low death count. Anurag Agrawal, director of the
Institute of Genomics and Integrative Biology CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB) is a scientific research institute devoted primarily to biological research. It is a part of Council of Scientific and Industrial Research (CSIR), India. The institute was founded i ...
, points to genetics and air pollution in India as a factor for the low death count.


Accuracy

In April 2021 the
Gujarat High Court The Gujarat High Court is the High Court of the state of Gujarat. It was established on 1 May 1960 under the ''Bombay Re-organisation Act, 1960'' after the state of Gujarat split from Bombay State. The seat of the court is Ahmedabad. The prese ...
and the
Telangana High Court The Telangana High Court is the High Court for the Indian state of Telangana. Founded by the 7th Nizam Mir Osman Ali Khan, initially, it was set up as High Court of Hyderabad for the then Princely State of Hyderabad Deccan and later renamed ...
both commented on the need of states to provide accurate data with respect to the pandemic. In May 2021, Prime Minister Modi made a comment related to death counts, "states should be encouraged to report their numbers transparently without any pressure of high numbers showing adversely on their efforts".


Undercounting

Undercounting of cases and deaths during the COVID-19 pandemic in India is not unique to the country. Journalists, mathematicians, epidemiologists, statisticians, and scientists have attempted, according to their expertise, to arrive at a truer number of the actual cases and deaths. The aim of this is to ultimately improve national and international responses to the pandemic. Journalists have spent time at burial-grounds and crematoriums and counted in-person the number of burials and cremations. These manual counts have been compared to government figures and have been found significantly different. India's national serological surveys also point to large numbers (ratios of one is to thirty) of cases remaining undetected. The scale of under-reporting from one place to another can be very large. The undercounting may or may not be intentional. Rather undercounting may occur due to unreported COVID-19 cases, inefficiencies in the data collection system, inability to adapt to pandemic like situation and people not reporting deaths. *Undercounting of total cases and death figures was reported during the first wave in 2020. The discrepancies were detected by comparing official death counts released by the governments to the number of deaths reported in obituaries, at crematoria and burial grounds, etc. Some states were reported to have not added suspected cases to the final count contrary to WHO guidelines. *Starting April 2021, reporters of the Gujarati newspaper ''Sandesh'' based in seven cities in Gujarat including
Ahmedabad Ahmedabad ( ; Gujarati: Amdavad ) is the most populous city in the Indian state of Gujarat. It is the administrative headquarters of the Ahmedabad district and the seat of the Gujarat High Court. Ahmedabad's population of 5,570,585 (per t ...
and
Gandhinagar Gandhinagar (, ) is the capital of the state of Gujarat in India. Gandhinagar is located approximately 23 km north of Ahmedabad, on the west central point of the Industrial corridor between Delhi, the political capital of India, and Mu ...
went to mortuaries, hospitals and cremation sites and recorded what they saw. On 16 April, reporters in Ahmedabad counted over 200 bodies; the next day the governments official count was 25. For a number of days ''Sandesh'' reporters did this. The newspaper publishes the findings on a regular basis. ''
The Hindu ''The Hindu'' is an Indian English-language daily newspaper owned by The Hindu Group, headquartered in Chennai, Tamil Nadu. It began as a weekly in 1878 and became a daily in 1889. It is one of the Indian newspapers of record and the secon ...
'' also pointed to similar discrepancies. * On 15 April 2021, a report in '' Dainik Bhaskar's'' Bhopal edition stated that the official number of COVID-19 deaths in
Bhopal Bhopal (; ) is the capital city of the Indian state of Madhya Pradesh and the administrative headquarters of both Bhopal district and Bhopal division. It is known as the ''City of Lakes'' due to its various natural and artificial lakes. It i ...
during the last 5 days were 21, however cremations had taken place for 356 COVID-19 cases. ''
India Today ''India Today'' is a weekly Indian English-language news magazine published by Living Media India Limited. It is the most widely circulated magazine in India, with a readership of close to 8 million. In 2014, ''India Today'' launched a new onl ...
'' and ''
The New York Times ''The New York Times'' (''the Times'', ''NYT'', or the Gray Lady) is a daily newspaper based in New York City with a worldwide readership reported in 2020 to comprise a declining 840,000 paid print subscribers, and a growing 6 million paid ...
'' found similar discrepancies in Bhopal in April. *On 24 April 2021, data scientist Bhramar Mukherjee said "From all the modeling we’ve done, we believe the true number of deaths is two to five times what is being reported." *In April 2021, the ''Observer'' collected data from
Muzaffarnagar Muzaffarnagar is a city under Muzaffarnagar District in the Indian State of Uttar Pradesh. It is situated midway on the Delhi - Haridwar/Dehradun National Highway (NH 58) and is also well connected with the national railway network. It is kno ...
, Uttar Pradesh and found large differences in the official count and the numbers given by frontline workers. * On 18 May 2021 ''
Dainik Bhaskar ''Dainik Bhaskar ''is India's largest Hindi-language daily newspaper owned by the Dainik Bhaskar Group. According to Audit Bureau of Circulations, it is ranked 3rd in the world by circulation and is the largest newspaper in India by circula ...
'' published a story which was the outcome of a collaborative effort of 30 of its reporters. The story reported at least 2000 bodies along a 1140 km stretch of the
River Ganga The Ganges ( ) (in India: Ganga ( ); in Bangladesh: Padma ( )). "The Ganges Basin, known in India as the Ganga and in Bangladesh as the Padma, is an international river to which India, Bangladesh, Nepal and China are the riparian states." is ...
. On 15 May, ''
Reuters Reuters ( ) is a news agency owned by Thomson Reuters Corporation. It employs around 2,500 journalists and 600 photojournalists in about 200 locations worldwide. Reuters is one of the largest news agencies in the world. The agency was estab ...
'' reported that they had accessed an official confirmation that COVID-19 deaths were being dumped in rivers. * On 13 May 2021, the
Institute for Health Metrics and Evaluation The Institute for Health Metrics and Evaluation (IHME) is a research institute working in the area of global health statistics and impact evaluation at the University of Washington in Seattle. The Institute is headed by Christopher J.L. Murray ...
placed India's total deaths at 736,811 while the reported number of cases were 248,016. * On 25 May 2021, ''
The New York Times ''The New York Times'' (''the Times'', ''NYT'', or the Gray Lady) is a daily newspaper based in New York City with a worldwide readership reported in 2020 to comprise a declining 840,000 paid print subscribers, and a growing 6 million paid ...
'' has estimated a number from double the official figure, to over 1 million. The worst-case scenario according to NYT was 4.2 million deaths; 13.7 times India's official figure in the same time period. * On 12 June 2021, ''
The Economist ''The Economist'' is a British weekly newspaper printed in demitab format and published digitally. It focuses on current affairs, international business, politics, technology, and culture. Based in London, the newspaper is owned by The Econo ...
'' reported that Christopher Leffler of
Virginia Commonwealth University Virginia Commonwealth University (VCU) is a public research university in Richmond, Virginia. VCU was founded in 1838 as the medical department of Hampden–Sydney College, becoming the Medical College of Virginia in 1854. In 1968, the Virgini ...
analyses data on excess mortality from different parts of India, showing a rough estimate of between 1.8 million and 2.4 million total death since the start of the pandemic. Indian polling organization
CVoter Centre for Voting Opinion & Trends in Election Research, or CVoter, is an Indian international polling agency headquartered in Delhi, India. History Yashwant Deshmukh is the director and founding editor of CVoter. Clients CVoter India states ...
, which conducted surveys throughout the pandemic, calculated that the likely death toll from COVID-19 by mid-May 2021 was around 1.83 million.


Overcounting

Following reports of under-counting in May 2021, ''
ThePrint The Print is an Indian online newspaper, owned by Printline Media Pvt Ltd. It was launched by journalist Shekhar Gupta in August 2017. History Printline Media Pvt. Ltd, founded by journalist Shekhar Gupta, was incorporated in New Delhi, India ...
'' published figures that the Delhi government may have started over-counting. Irrespective of either, the accuracy of government figures, irrespective of high or low counts, is brought to question.


References


External links


Guidance for appropriate recording of COVID-19 related deaths in India.
National Centre for Disease Informatics and Research, Indian Council of Medical Research. {{Use dmy dates, date=July 2020 COVID-19 pandemic in India
India India, officially the Republic of India (Hindi: ), is a country in South Asia. It is the seventh-largest country by area, the second-most populous country, and the most populous democracy in the world. Bounded by the Indian Ocean on the so ...