Official COVID-19 Deaths And Those From Funerals Are Telling Two Different Stories, Here Is Why

In April alone, there were over 9400 funerals were held in Delhi as per the COVID-19 protocol. That means on average 313 funerals were held across Delhi every day.

According to The Times of India, between April 1 and 30, the nine COVID-designated funeral centres under South Delhi Municipal Corporation oversaw 3,931 cremations and burials, while 14 centres under North Delhi Municipal Corporation witnessed 3,978 COVID funerals. During the same period, the east body recorded 1,523 COVID funerals, leading to a cumulative COVID funeral count to 9,432.

AFP

Mismatch in actual numbers?

But there is a mismatch between the official number of COVID-19 deaths and the number of bodies that were cremated under COVID-19 protocol.

And this is not a problem that has been limited to Delhi but across the country.

In Rajkot in the west of the state, the official death toll between April 1-23 was 154, yet the city's own health officials put it at 723.

AP

And in Bharuch, the official count for the same period was just 23 but there were 600 funerals.

That is because what we see as a COVID-19 death and how the authorities see it is different.

Died from COVID-19 and died with COVID-19

The Indian Council of Medical Research (ICMR) guidelines which were issued in May 2020 stipulate that deaths of people with suspected or probable COVID-19 should be included in mortality data, based on WHO ICD-10 codes for COVID-19-related deaths. But it was advisory and not mandatory, which means that states have used it to undercount COVID-19 deaths.

According to the guidelines, COVID-19 would be recorded as an ¡°underlying cause of death¡± when leading to pneumonia, cardiac injury and clotting in the bloodstream, among others.

AFP

Deaths with inconclusive test results, but in which coronavirus symptoms are present will be recorded as ¡°probable COVID-19¡± fatalities.

Deaths in which tests are awaited with the presence of symptoms will be recorded as suspected deaths, while those testing negative but have symptoms will be mentioned as clinically-epidemiologically diagnosed COVID-19.

Its clinical presentation ranges from mild to severe, and fatality depends on the severity of the illness, associated co-morbid conditions and age of patients.

¡°Patterns of disease and patterns of death can come from only standardised recording of clinical disease history and cause of death, and therefore epidemiological surveillance of disease and death are important.

¡°Robust data is needed from every district and state in India to measure the public health impact of COVID-19 and to plan for timely health interventions and protect communities.

BCCL/representational picture

Patients may present with other pre-existing co-morbid conditions such as asthma, chronic bronchitis, ischemic heart disease, cancer and diabetes mellitus. These conditions increase the risk of developing respiratory infections, and may lead to complications and severe disease in a COVID-19 positive patient.

¡°These conditions are not considered as underlying cause of death as they have not directly caused death due to COVID-19. Also, a patient may have many co-morbid conditions but only those that have contributed to death should be recorded,¡± the guidance document stated.

In all such cases, the funerals have to be performed as per COVID-19 protocol, irrespective of the classification the death falls under.

AFP

Also missing from the official tally is those who die of the lack of oxygen in hospitals and waiting for beds outside.

"Our estimate is 50 percent of Covid-19 deaths are not registered by the government," Jitender Singh Shanty, in charge of one of Delhi's 26 crematoriums, told AFP.