India’s Covid-19 death toll may be 4-11 times higher, economic cost is 30% of GDP: Study

India’s Covid-19 death toll may be 4 to 11 times higher than official numbers and translate into whopping economic costs worth 30 per cent of the country’s gross domestic product, a team of health experts and economists has said in a new study.

The researchers from the University of Michigan, Indian Statistical Institute, Kolkata and Delhi School of Economics reported that India might have lost 1.7 to 4.9 million people to Covid-19 as against the Union Health Ministry’s official record of over 400,000.

In addition, the Covid-19 infection cases were under-reported by 25 to 30 times, says the study, which is the latest among a series of research papers that have reported undercounting of Covid cases and deaths in India – a claim that has been consistently refuted by the Union Health Ministry.

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The team led by biostatistician and epidemiologist Bhramar Mukherjee collated existing studies to estimate infection fatality rates - the proportion of the deaths among the total counts of infections - and Covid-19 deaths.

They also used an epidemiologic model to generate their own estimate that yielded 1.4 million deaths by July 1. The calculations from the pooled results on the other hand gave cumulative excess deaths in India to be 1.7 million to 4.9 million, with variations across states.

“Due to the raging discussion and debate regarding India's true Covid-19 mortality, we undertook a comprehensive survey of the existing literature, pooling estimates from multiple studies for the extent of underreporting of deaths and infections. This systematic review suggests that the true death toll may be 4-11 times more than what is reported with considerable variation noted across different studies, regions and time periods,” Mukherjee told DH.

“After synthesizing the estimates India's true Infection Fatality Rate appears to be around 0.4-0.5 per cent. But if you just rely on reported deaths, this number is around 0.1 per cent.”

Also Read | Mumbai sees steady increase in Covid-19 cases

This implies that by June 30, 2021, India may have seen nearly 900 million Covid-19 infections and 1.7-4.9 million Covid deaths when the reported numbers stood at 30.4 million cases and 412,000 odd deaths.

“It is now well-known that only a fraction of SARS-CoV-2 infections are captured, stemming from a large degree of covert infections, access, willingness and availability of testing, and sometimes a desire to maintain public image,” the team reported in the study, which is yet to be peer reviewed but released in an online archive.

The researchers calculated the economic cost of Covid-19 deaths following two separate approaches and found that even on the lower side, the losses would be huge. For instance, the model used by the researchers suggests a Covid toll of 1.4 million, which would translate to a whopping economic cost equivalent to 31 per cent of the GDP.

On the other hand, if the economic loss of 412,000 reported Covid deaths is estimated, it comes down to just 9 per cent of the GDP.

“Aside from the health lens, premature mortality and infectious disease mortality’s consequences for

economic stability and ensuing welfare policy further support the need for continued attention to assessing the mortality burden of Covid-19 within India,” the team reported.

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