NEW DELHI: The Centre on Saturday slammed the findings of an international study that estimated that 11.19 lakh excess deaths occurred in 2020 during the Covid-19 pandemic in India, and that life expectancy among Indian men and women fell.
In a detailed statement, the Union Health Ministry said these findings were based on “untenable and unacceptable” estimates.
“It is strongly asserted that an excess mortality of about 11.9 lakh deaths reported in the Science Advances paper in 2020 over the previous year is a gross and misleading overestimate,” the ministry added.
According to the paper, ‘Large and unequal life expectancy declines during the COVID-19 pandemic in India in 2020’, published in the journal Science Advances, 11.9 lakh excess deaths occurred in 2020 in the country during the pandemic, 17 per cent higher compared to the deaths in 2019.
Their estimate is about eight times higher than the official COVID-19 deaths in India, and 1.5 times the World Health Organisation's estimates, researchers, including those from the University of Oxford, UK, said
Using data of over 7.65 lakh individuals, the study also estimated changes in life expectancy at birth, by gender and social group between 2019 and 2020 in India. The data was taken from the National Family Health Survey-5 (NFHS-5).
According to the study, the life expectancy in women fell by 3.1 years, while it fell by 2.1 years in men, the authors said. Gender inequalities in healthcare and resource distribution within households could be possible reasons, they said. These patterns contrast with those seen in high-income countries, where excess deaths were higher among men than women during the pandemic, the authors pointed out.
The authors claimed that they have followed a standard methodology of analysing National Family Health Survey-5 (NFHS-5) data
But the Ministry said there were “critical flaws” in the methodology.
“The most important flaw is that the authors have taken a subset of households included in the NFHS survey between January and April 2021, compared mortality in these households in 2020 with 2019, and extrapolated the results to the entire country.”
The NFHS sample is representative of the country only when it is considered as a whole. The 23 per cent of households included in this analysis from part of 14 states cannot be considered representative of the country, the statement said.
“The other critical flaw is related to possible selection and reporting biases in the included sample due to the time in which these data were collected, at the peak of the COVID-19 pandemic,” it said.
It is noteworthy that excess mortality during the pandemic means an increase in deaths due to all causes, and cannot be equated with deaths that were directly caused by Covid, it said.
The researchers, while looking at social groups, found that high caste Hindu groups experienced a life expectancy decline of 1.3 years, whereas Muslims and Scheduled Tribes experienced a 5.4-year and 4.1-year drop in their life expectancies.
The pandemic, the study said, exacerbated the disparities already faced by these marginalised caste and religious groups in terms of life expectancy.
Marginalised groups already had lower life expectancy, and the pandemic further increased the gap between the most privileged Indian social groups, and the most marginalised social groups in India," said first author Aashish Gupta, a research fellow at the University of Oxford.
The researchers said deaths in India increased across age groups, most prominently among the youngest and the oldest, whereas drops in life expectancy in high-income countries were largely driven by increased deaths in those aged 60 years and above.
Excess deaths among the youngest could be explained by children in certain areas being more vulnerable to the COVID-19 infection, the authors said.
The indirect effects of the pandemic and lockdowns, including deteriorating economic conditions and disruptions to public health services, also contributed to excess mortality in the youngest age groups, according to the authors.
In a point-by-point rebuttal of the findings, the ministry said the paper erroneously argues for the need for such analyses claiming that vital registration systems in low and middle income countries, including India, is weak.
“This is far from being correct. The Civil Registration System (CRS) in India is highly robust and captures over 99 per cent of deaths. This reporting has constantly increased from 75 per cent in 2015 to over 99 per cent in 2020,” the statement said.
“Notably, all excess deaths in a year in the CRS are not attributable to the pandemic. Excess number is also due to an increasing trend of death registration in CRS (it was 92 per cent in 2019) and a larger population base in the succeeding year,” the statement added.
The erroneous nature of the estimates published by the researchers is further corroborated by data from India’s Sample Registration System (SRS), the it added.
The paper claims that excess mortality was greater in females and in younger age groups (particularly 0-19 year old children), it said.
Data on about 5.3 lakh recorded deaths due to Covid-19, as well as research data from cohorts and registries consistently shows higher mortality due to Covid-19 in males than females (2:1) and in older age groups.
These inconsistent and unexplainable results in the published paper further reduce any confidence in its claims, the statement said.
In conclusion, the all-cause excess mortality in 2020 compared with the previous year in India is markedly less than the 11.9 lakh deaths reported in the paper, the statement said.