Covid-19 second surge: Gujarat records 480% excess mortality in April 2021, world’s highest

The official Covid-19 death count of Gujarat from March 2020 to August 16, 2021 is 10,075

Raising fresh questions on India's official Covid-19 death toll, a new study has estimated that the excess mortality in 54 of 162 municipalities in Gujarat since the beginning of the pandemic exceeds the official Covid-19 death count for the entire state.

In April 2021, when the second wave of the epidemic was surging throughout the country, Gujarat reported 480% excess deaths over the state’s average mortality registered in April 2019 and April 2020. The excess death reported in Gujarat was the highest anywhere in the world.

The research carried out by public health experts at the Harvard TH Chan School of Public Health, Boston; University of California, Berkley and National Foundation of India is the latest in a growing list of studies claiming large-scale underreporting of Covid-19 deaths in India – a charge that has been consistently denied by the Union Health Ministry.

Using data from municipal death registers, the Indo-US estimated 16,000 excess deaths across 54 municipalities in Gujarat since March 2020. Most of these deaths – around 9,500 - occurred during the second wave, between January and April 2021. The municipalities represent only 5% of the population of the western state.

The official Covid-19 death count for the whole of Gujarat from March 2020 to August 16, 2021 is 10,075. As of August 26, the toll stands at 10,080.

“The most striking deviation from the baseline is for the month of April 2021, where we estimate 480% more deaths than expected,” the team reported in the study, which is yet to be peer-reviewed and was released on a preprint server. For comparison, in April 2021, Ecuador recorded a 411% increase and Peru recorded a 345% increase in mortality.

In Gujarat, mortality was more among the females and the 40-60 age group, which experienced a greater increase from baseline mortality compared to other demographic groups.

“The vast majority of these excess deaths likely represent direct deaths from Covid-19 in the absence of any other known catastrophe. A small percentage of these would include deaths from the indirect impact of the pandemic and from causes unrelated to the pandemic,” the team said.

Such a large discrepancy between official Covid-19 death counts and excess mortality underscored the need to rectify how official death counts are collated, the researchers said.

Reliance on death certificates as the single source of truth, they observed, was not the best option to establish the truth when access to health systems, testing availability and death certification accuracy are all weak.

Previously, researchers suspected underreporting of Covid-19 deaths in many states. In June, the Patna High Court delivered a judgement with evidence of such underreporting in one district of Bihar.