India becomes the home to the world’s worst ongoing COVID-19 outbreak, and it reported over 17.6 million cases since the epidemic outburst last year. However, experts fear that the real number could be over thirty times higher – meaning over half a billion cases. Scientists and health workers serving in India long warned that coronavirus-related deaths are significantly underreported for many reasons, human error, low testing levels, and poor infrastructure in the country.
RED CROSS HELPS INDIA FACE COVID OUTBREAK- VO/SOT TUE0229-The Red Cross is stepping in to help the government of India as the country grapples with a record wave of COVID-19 infections. Tuesday India reported 323,144 new infections for a total of more than 17.6 million cases. pic.twitter.com/deiKSs6LAD
— CBS Newspath (@cbsnewspath) April 28, 2021
Since then, the officials change some things, such as increased testing in the wake of the first wave. However, the actual extent of the 2nd pandemic wave now destroying India is possibly much worse than official numbers suggest. The director of the Center for Disease Dynamics, Economics & Policy (CDDEP) in Delhi, Ramanan Laxminarayan, says that it is clear that both the new infection numbers and mortality numbers are undercounted.
Furthermore, he said that they projected last year that only one in almost thirty infections caught during testing, so the reported number of cases is a serious underestimate of genuine infections. Now the mortality statistics are likely serious underestimates, and what they see actually is many more deaths than what previously reported officially. The health ministry of India declined to comment about the claims of underreporting when CNN reached him about the facts.
Death toll May Touch 13000 per Day
As the first wave of the COVID-19 started to receding tide in September 2020, the Indian administration pointed to its low death rate as a mark of its success in combating the pandemic and support its decision to lift some coronavirus-related restrictions. Narendra Modi, the Indian Prime Minister, celebrated the low numbers as back the confidence of the nation. He also foresaw that the whole country would appear victorious in the fight against the outbreak.
The fight I still going. According to an estimate from the University of Washington’s Institute for Health Metrics & Evaluations, the daily death toll of India now likely to continue rising until mid-May. According to the predictions, the death toll could peak at over thirteen thousand daily – more than four times the present daily death toll.
Insufficient COVID-19 Tests
The testing capacity of India increased dramatically since the first wave. Furthermore, the chief scientist for the World Health Organization, Dr. Soumya Swaminathan, said that this time around the year, India was testing less than half a million people daily – now, they are doing close to two million tests per day.
The current testing rate is still not sufficient because the national average positivity rate is almost fifteen percent – in some cities such as Delhi, it is up to thirty percent or higher. It means that several people out there are infected and not detected just because of the testing capacity.
According to a professor of epidemiology and biostatistics at the University of Michigan, Bhramar Mukherjee, there are some reasons for the insufficient testing. The most understandable is that symptomless patients – also called silent infections – may simply never know about their infection. Additionally, there are various case reporting structures all over different states and cities of India, and testing may be less accessible in rural areas.
Mukherjee says that all countries, to some extent, faced this issue of accurately classifying coronavirus-related deaths, but in India, the issue is quite severe. However, serology surveys reflect that these people are at least twenty or thirty times greater than what previously reported. When applied to the recent figures as of 27th April, that estimate could increase the total number of cases of India to over 529 million.
Undercounting Deaths in India amid Coronavirus
Even before the COVID-19 pandemic, India was undercounting its overall dead numbers. The underfunded public health infrastructure of the country means that even on regular days, only eighty-six percent of deaths countrywide registered in government systems. Moreover, officials gave the cause of death to only twenty-two percent of all registered mortalities, certified by a doctor, according to Dr. Hemant Shewade, the community medicine specialist.
Furthermore, many people in India die at home or in other areas, except in a hospital, so doctors normally are not present to describe the cause of death – an issue that has just expanded in the 2nd wave, with hospitals out of space. Coronavirus patients are now increasingly dying at home, in waiting rooms, idling ambulances, and outside overwhelmed clinics.
There are logistical issues, too, such as missing information in the national database or any other human error. Furthermore, these issues are even more noticeable in rural areas of the country. As of 27th April, India reported around one lac ninety-eight thousand COVID-19 deaths. On the other side, Mukherjee estimates coronavirus fatalities may underreport by a factor between 2 and 3 – meaning the actual death toll may be close to 990000.