Death Count In 24 UP Districts 43 Times More Than Official Covid-19 Toll

SAURAV DAS
 
21 Jun 2021 7 min read  Share

Excess deaths in UP districts with highest official caseload were between 10 to 335 times higher than the government’s Covid-19 death toll over nine months to 31 March 2021, we found after analysing mortality data, obtained under the right-to-information law.

Uttar Pradesh Chief Minister Yogi Adityanath gets his Covid-19 vaccination/TWITTER

New Delhi: The number of people who died in 24 Uttar Pradesh (UP) districts over nine months to 31 March 2021 was, cumulatively, 43 times higher than the total official Covid-19 death toll reported from these districts over this period, according to mortality data for India’s most-populous state.

The 24 districts—of 75 in UP—we chose reported the highest number of Covid-19 cases over the months of June, July, August, and October 2020 when the first wave struck, as per various media reports (here, here, & here) and government data tracked by Covid19india.org

The excess deaths in these districts were between 10 to 335 times higher than the reported Covid-19 death toll between 1 July 2020 and 31 March 2021. The Bharatiya Janata Party has said UP’s chief minister Ajay Singh Bisht, popularly known as Yogi Adityanath “effectively managed” his state’s Covid-19 situation.

All the excess deaths cannot be attributed to Covid-19, and a diversion of health resources could cause other deaths to rise. But the vast divergence in average general deaths and excess deaths over a part of the pandemic calls into question UP’s official Covid-19 death toll of 4,537 by the end of March 2021.

Documents this reporter obtained for Article 14 under the Right to Information Act, 2005, revealed that during the no-pandemic period between 1 July 2019 and 31 March 2020 these 24 districts registered around 178,000 deaths. Over the same period in 2020-2021, deaths increased by 110% to 375,000, an excess of 197,000.


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Twenty districts, including Muzzaffarnagar, Sitapur, Harboi, Chandauli, and Budaun, registered a 2% to 48% drop in deaths when compared to 2019-20. Given the delay in death registration in UP, gaps in registration, and the fact that data for many districts were still being collated, the final figures will likely change. 

If anything, the death toll will increase.

Why Our Count Is An Underestimate

The official all-cause mortality data we obtained are quite clearly an underestimation for two reasons: they do not take into account the toll from the second wave, which has accounted for about 60% of total pandemic deaths until now; and the mortality data are themselves undercounts.

“The actual deaths due to Covid may be much higher than official figures suggest,” said Gautam Menon, Ph.D, a professor of biophysics at Ashoka University. He noted that most Indians die at home and only about 20% of registered deaths are medically certified for their cause.

Adityanath has been criticised, by the opposition and his own party, for his handling of the pandemic, after an especially deadly second wave of mass deaths—including bodies floating on the Ganga and buried on its banks—that, anecdotally, appeared not to reflect in official data

The mortality data confirmed the undercounting in the districts of Moradabad, Rampur, Meerut, Ghaziabad, Gautam Buddha Nagar, Aligarh, Mathura, Agra, Firozabad, Bareilly, Pilibhit, Kheri, Unnao, Lucknow, Kanpur Dehat, Kanpur Nagar, Jhansi, Pratapgarh, Amethi, Balrampur, Basti, Balia, Ghazipur, and Sonbhadra. 

Article 14 sought comment from Devendra Singh Negi, MD, UP’s director general of medical and health services,  but there was no response to repeated phone calls and emails. We will update this story if he responds.

Journalists have reported an excess of death during the first and second wave of Covid-19 in several states, such as Andhra Pradesh, Madhya Pradesh, Assam, Gujarat, Tamil Nadu, Bihar and in major cities like Hyderabad, Chennai and Kolkata

Attention to corpses floating down the Ganga in UP and the fact that thousands of deaths were unaccounted first came to national and global attention when Dainik Bhaskar reporters travelled a 1,000-km stretch of the river. The official mortality data for UP have not been accessed until now. 

In the eastern UP district of Ghazipur, for instance, near Prime Minister Narendra Modi’s Parliamentary constituency of Varanasi and where bodies were found floating on the Ganga, around 19,700 people died between 1 July 2020 and 31 March 2021, compared to 1,600 over the same time period in 2019-20, an increase of 1,136%. 

That is 18,000 excess deaths compared to the same period in 2019-20 and 197 times more than the officially reported Covid-19 toll, which was 92.


[[https://article-14.com/uploads/2021/06-June/20-Sun/UPGraphic2Ghazipur.jpg]]

All our data are underestimates, as we said, but the CRS statistics are the only reliable data to estimate pandemic death toll. 

4 Of 10 Deaths In UP Not Counted

As in other states, UP’s Civil Registration System (CRS) is supposed to register all births and deaths. But as the Registrar General of India’s (RGI) 2019 report noted that UP registered 63.3% of all estimated deaths. 


In other words, around 4 of every 10 deaths in UP are not counted, and nearly 31% are registered anytime after a month from death. 

The RGI report supports the data we obtained through RTI, showing deaths registered rising even after the first Covid-19 wave subsided towards November 2020. Since there is a lag between deaths and their registration, we assumed the four months from December 2020 to March 2021 enough to account for deaths not registered previously.

“The  social stigma surrounding Covid and a lack of acceptance that someone could die from it has likely led to concealment of the true cause of death,” said Menon, the biophysics professor. “This, along with improper reporting, has shown up in these large numbers of excess deaths. This will likely mean that our mortality estimates for Covid-19 will need to be adjusted upwards substantially.” 

Deaths in India could be 2.2 times higher than official records, said a June 2021 study by Menon and six collaborators. He estimated this multiplier to be  even larger in the second wave.


Death Surge Disaggregated By District 

Excess deaths in the 24 UP districts were considered, as we said, were between 10 to 335 times higher than the official Covid-19 death toll between 1 July 2020 and 31 March 2021. 



[[https://article-14.com/uploads/2021/06-June/20-Sun/UPGraphic324Districts.jpg]]

Here are data for six districts, disaggregated:

  • Balia, close to Ghazipur, registered 7,300 excess deaths, about 120% more than the same period in 2019-20 and 68 times higher than the official Covid-19 death toll of 107.

  • Unnao registered over 10,400 excess deaths, about 134% more than 2019-20, and 117 times more than the official death toll of 90.

  • Kanpur Dehat (rural) registered 4,040 excess deaths, 236% more than 2019-20, and 106 times more than the official toll of 38.

  • In Amethi, about 13,000 more people had died than normal, more than 1700% than 2019-20. The official death toll was 39, or 335 times less.

  • Lucknow district, which hosts the state capital, registered over 30,200 excess deaths, 524% more than 2019-20 and 25 times more than the official death toll of 1,211.

  • Bareilly registered 12,000 excess deaths, 72% more than 2019-20and 73 times more than the official death toll of 166. During the second wave, Union Minister Santosh Gangwar, the BJP MP from Bareilly, wrote a letter to Adityanath, expressing “grave concern” over the State’s pandemic mismanagement.

  • Agra district, where on 12 May 2021 Article 14, anecdotally, found vast underreporting, registered around 10,000 excess deaths, 103% more than 2019-20 and 56 times more than the official death toll of 178.


Apart from the 24 districts, most other districts registered deaths 20% to 150% in excess of 2019-20 and between five to 100 times higher than the official Covid-19 death toll.


[[https://article-14.com/uploads/2021/06-June/20-Sun/UPGraphic4RegisteredDeaths.jpg]]

The Undercounting Of Covid-19 Deaths 

Despite being India’s most populous state, fourth by density of population among large states, and with some of the country’s worst health systems—in 2020, rural UP was 51% short of primary health centres (PHCs) and community health centres (CHCs), among the bottom three states in India, according to government data—the state ranked fifth by number of Covid-19 deaths, which, officially, were 22,081 on 19 June 2021. 

Despite World Health Organisation and Indian Council for Medical Research guidelines recommending a more liberal definition of Covid-19 death, many states have deliberately adopted an “excessively stringent” definition, counting only who tested positive for Covid-19 prior to death and died in hospitals, IndiaSpend reported on 1 July 2020. 

But many have died undiagnosed, untested or uncounted at home, especially in rural areas. The result is that the official death toll, 386,785 on 20 June 2021, is estimated to be between three to 10 times larger.

On 19 June, the Centre in an affidavit to the Supreme Court of India said that all Coronavirus related deaths, regardless of where they take place, should be certified as Covid-19 deaths. It promised action against doctors who “fail to comply” with this rule.

Concerns over large-scale fudging of Covid-19 deaths were echoed by one of India’s top doctors. Randeep Guleria, MD, director of the All India Institute of Medical Sciences, told NDTV India needed a “death audit” to resolve what he called “misclassification” of Covid-related deaths, important to evolve strategies for the battle against Covid-19 and a third wave, which he predicted would hit by August 2021.

CRS data help estimate real death tolls. In all states, district level registrars of births and deaths are required to report the total number of death certificates issued by them to the State’s chief registrar every month. Yet, these data are not publicly accessible. If they were, India could be better prepared. 

Menon, the biophysics professor, said inaccurate Covid-19 death tolls could have “a serious negative effect” on India’s fight against future pandemics. 

“If such unusually low mortality rates are reported by state governments as their official figures, we run the risk that the public will not take messaging regarding the disease seriously enough, especially in the future,” said Menon. “Any data that is collected by the government should be checked for its accuracy, even if it casts the government in a negative light, because such data will feed into public policy and  planning”. 

(Saurav Das is an investigative journalist and a transparency activist.)