NEW DELHI: The Indian Council of Medical Research (ICMR) is set to start mortality surveillance across India to assess whether Covid-19 is killing people outside hospitals who may be undetected and untested and to understand true impact of the pandemic, this newspaper has learnt. The surveillance exercise will continue through the pandemic period and will study the weekly death data compiled by Health and Demographic Surveillance System and death statistics of the Registrar General of India. It will capture and compare the mortality data this year with that of the corresponding period last year.
The exercise is being undertaken following recommendation by an expert group on Covid-19 surveillance and epidemiology constituted by the ICMR several weeks ago amid concerns that more people than the reported official figure may have succumbed to the infection. Sources in the ICMR and the research group said the idea was to compare whether excess mortalities are being reported in any part of the country. “Usually 28,000 deaths occur in India every day, but any change in the usual numbers could suggest a link with Covid-19. So we want to see how the death graph is moving during the pandemic period,” said an ICMR official.
“If there is an unusual spike in deaths suddenly, it can be further probed through district surveillance based on talking to the families etc. on the circumstances leading to deaths and estimates can be made whether people are succumbing to Covid-19 without clinical detection.”A member of the expert group said it has been suggested that the HDSS — a longitudinal surveillance system at multiple sites in the country that captures data related to health indicators, nutrition and mortalities — will be used for the purpose.
“It has three major sites in India and several smaller sites that capture crucial data related to health and demography. The plan is that the ICMR will fund a project to keep a close watch on any excess mortalities reported every month,” the official said.Public health experts welcomed the move saying the exercise will not only help capture the excess deaths due to Covid-19 but could also signal if people are dying due to other morbidities.
“Given the fact only about 20 per cent deaths are formally registered, this can be a crucial exercise to understand the true mortality picture due to the infection and disruption in other healthcare services,” said Dr Sanjay K Rai, who teaches community medicine at AIIMS-Delhi.The project is being planned even as WHO, released a technical resource report which said that “a focus on total mortality encourages the measurement of deaths occurring outside of a health facility, which can be the norm in many low- and middle-income countries”.