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Is India Undercounting Its COVID-19 Dead?


Anindita Mitra, 61, seen with her sons Satyajit Mitra, right and Abhijit Mitra, pose with portraits of her husband, Narayan Mitra, at her house in Silchar, India, Sunday, Sept. 13, 2020. (AP Photo/Joy Roy)
Is India Undercounting Its COVID-19 Dead?
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Narayan Mitra died on July 16 in India’s northeastern Assam state. His death came one day after going to the hospital with a high temperature and breathing difficulties. Test results later showed that Mitra had been infected with the coronavirus.

But his name never appeared on any of the official lists of those killed by the coronavirus. Doctors said the virus was an “incidental” influence on his death. They said his death was caused by a neurological disorder.

The Associated Press reports that India’s national government has asked states not to say an underlying condition caused a patient’s death in cases where COVID-19 has been confirmed by tests.

India has recorded more than 5.1 million COVID-19 infections. That is ahead of all other countries except the United States. It has recorded more than 83,000 COVID-related deaths. That is lower than expected considering its number of infections.

India’s Health Ministry said this is evidence of its success in fighting the coronavirus. It has also said the low number of deaths is a reason for easing restrictions and reopening the economy. Prime Minister Narendra Modi ordered a nationwide lockdown in March.

But some experts say the numbers are misleading and that India is not counting many deaths. “We are undercounting deaths by an unknown factor,” said Dr. T. Jacob John, a retired virus expert.

The Health Ministry has dismissed earlier accusations that it undercounts deaths. But it refused to comment this week on whether states were reporting all suspected and confirmed deaths from the virus.

Dr. Prabhat Jha is a disease expert at the University of Toronto in Canada. He said countries should overestimate death numbers -- not underestimate them -- if they want to make progress in fighting the virus.

“It is better to have no estimate than an underestimate,” Jha said.

India’s Health Ministry recommends that states record all suspected virus deaths. That includes cases were the patient likely died of COVID-19 but was not tested for it. But these are only guidelines and many states are not following them.

Mahrashtra is India’s worst affected state, with more than 1 million cases. There, suspected deaths are not recorded, said the state’s health director Dr. Archana Patil.

Other states, like Assam, have created groups of doctors who separate “real virus deaths” from those caused by underlying diseases. In some cities, like New Delhi or Mumbai, these doctor groups sometimes add missed deaths to the count.

Dr. Anup Kumar Barman heads the doctor group in Assam. He said Assam state is not including many deaths where the virus is listed as “incidental” and not the cause of death. Assam state has recorded over 147,000 infections but fewer than 500 deaths. Those numbers are current as of September 16.

In Mitra’s case, he had more signs of his neurological disorder, Barman said. He added that Assam state was following the national guidelines. Mitra was not included as a coronavirus victim because his death was not caused by breathing failure, pneumonia or blood clots, Barman added.

The guidelines list these problems as possible results of the virus, but other problems are possible as well.

P.V. Ramesh used to lead COVID-19 management for Andhra Pradesh state in southern India. He said coronavirus deaths that happen “at home, in transit or while arriving at hospitals don’t get counted.”

The low number of reported deaths has resulted in people thinking the virus is not dangerous, said Dr. Anant Bhan, a public health researcher. This has led people to not take protective measures such as wearing face coverings or keeping social distance, Bhan said.

Workers at crematoriums in the country have reported an increase in receiving bodies — whether from the virus or not.

At a crematorium in the Indian city of Lucknow, worker Bhupesh Soni said 30 bodies were being cremated every day, compared to five or six before the health crisis.

One cremation normally takes about 45 minutes. Soni said there have been days when he has worked for over 20 hours.

“It is an endless flow of bodies,” he said.

I’m Ashley Thompson.

Andiruddha Ghosal and Sheikh Salliq reported this story for the Associated Press. Ashley Thompson adapted it for VOA Learning English. Mario Ritter, Jr. was the editor.

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Words in This Story

neurological –adj. related to the nervous system which includes the spinal cord, nerves and the brain

underlying –adj. something that is the basis or cause of something

pneumonia –n. a serious infection of the lungs

(blood) clot –n. blockage or barrier of dried blood that prevents the flow of blood through its passageways in the body

management –n. overseeing and dealing with the problems of a large task

transit –n. the act of moving from one place to another

crematoriums –n. a place where bodies of the dead are turned to ash

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