The coronavirus pandemic caused more than four million excess deaths in India, a study has found.
Excess deaths are a measure of how many more people are dying than would be expected compared to the previous few years.
Although it is difficult to say how many of these deaths have been caused by Covid-19, they are a measure of the overall impact of the pandemic.
India has officially recorded more than 414,000 Covid-19 deaths so far.
The country is one of the few major economies without an estimate of excess deaths during the pandemic.
Researchers from the US-based Center for Global Development used three different data sources to estimate India’s excess all-cause mortality during the pandemic until 21 June.
They extrapolated death registrations from seven states, accounting for half of India’s population. India conducts yearly mortality surveys but has only published numbers up to 2019.
Second, the researchers applied international estimates of age-specific infection fatality rates – the number of people that die from the virus – to data from two countrywide antibody tests, also called sero surveys.
Third, they looked at India’s consumer survey of 868,000 individuals across 177,000 households which also records whether any member of the family had died in the past four months.
Taken together, the researchers found that excess deaths were estimated to be in the range of 3.4 million to 4.7 million – about 10 times higher than India’s official Covid-19 death toll.
This was also considerably higher than other estimates by epidemiologists, who believed India’s excess deaths were five-to-seven times higher.
Not all these deaths were caused by Covid-19 and an estimation of the actual death toll by the disease would be difficult to give, said Arvind Subramanian, India’s former chief economic adviser and one of the authors of the study.
However, researchers looked at the data on infection rates, based on many sero surveys to get a wide estimate of deaths.
The data implied that four million people had died in the pandemic in India, according to Dr Subramanian.
The researchers said the most “critical take-away, regardless of the sources and estimates”, was that actual deaths during the Covid-19 pandemic were “likely to be far greater than the official count”.
“The true deaths are likely to be in several millions, not hundreds of thousands, making this arguably India’s worst human tragedy since the partition and independence.”