Research shows Gujarat saw an estimated 480 per cent rise in deaths in April – the highest such spike recorded in a single month in the world.
Gujarat always strives for the top spot. Since 2001, it has been eyeing the number one position – be it on the export preparedness index, in cotton production, in manufacturing ground nuts, or being the biggest contributor to the tourism industry, most electrified state, or in diamond production. The list doesn’t end. But this obsession bordered on maleficient during the pandemic, a recent research report has revealed.
The state government’s claims of successfully curbing the outbreak of Covid-19 are as tall as the Statue of Unity in the world if findings of a recent study are to be believed.
A study reported by The Telegraph reveals that the number of deaths officially reported were nowhere even close to the real numbers.
The state had, however, grabbed headlines for its effective and far efficient Covid management while others like non-BJP ruled Maharashtra and Kerala struggled and drew flak from the Centre.
Ground reality
Despite the fake rosy picture, citizens knew the harsh reality on the ground. While new media were plastered with heartwrenching visuals of desperate families fighting to save the lives of their loved ones in national capital Delhi, the situation in Gujarat was no different. What was different was that no one reporting it.
In Gujarat, like Delhi, people waited hours for ambulances. If anyone went to a hospital in a private, non 108 ambulance they were not admitted as per a ridiculous state government rule. If they were lucky enough to use influence and get a government 108 ambulance, there were queues. Sometimes eight hours long.
But the world was provided with a different, well-crafted narrative, One that spun tales of how efficiently the Gujarat government was working towards Covid management. However, the reality was that the Gujarat government had completely failed in its handling of the pandemic.
The bodies left behind
The harsh reality is that the excess mortality estimated for only 54 of Gujarat’s 162 municipalities far exceeds the official Covid-19 death count for the entire state, researchers said in a study released on Thursday.
The study reported by The Telegraph has said Gujarat had an estimated 480 per cent (4.8-fold) more deaths than expected in April, when the state’s daily new cases spiked nearly six-fold from 2,400 in early April to 14,000 by month-end.
This is the highest percentage increase in deaths recorded in a single month anywhere in the world, a rise higher than Ecuador’s 411 per cent spike during April 2020 and Peru’s 345 per cent swell during April 2021.
The researchers, who used data from civil death registers, have also estimated that around 16,000 excess deaths occurred in the 54 municipalities between March 2020 and April 2021.
Meanwhile, the Gujarat government’s official tally as of Friday night maintains 10,080 deaths.
India’s health ministry, which relies on the states for Covid-19 mortality data, had until Thursday recorded 10,081 deaths in Gujarat among a nationwide count of over 436,000.
“The vast majority of these excess deaths likely represent direct deaths from Covid-19 in the absence of any other known catastrophe,” the researchers at the Harvard TC Chan School of Public Health, Harvard Medical School and the University of California, Berkeley, have said in their study.
The new study represents the latest effort to estimate excess deaths during the Covid-19 epidemic in India amid contentions by some public health experts that the official death counts appear inconsistent with the body counts during April and May this year.
According to the Telegraph report, the health ministry has challenged the claims of large undercounting of deaths, asserting that while some deaths could have been missed, it has repeatedly asked the states and district authorities to conduct audits to report any missed deaths.
The Harvard-UCB researchers analysed civil register data from 54 Gujarat municipalities – across 24 of the state’s 33 districts — taking the deaths between January 2019 and February 2020 as the baseline mortality data and comparing it to the deaths between March 2020 and April 2021.
The registers record a total of 44,568 deaths in the 54 municipalities since March 2020, with the sharpest increase in deaths during the second wave. This represents around 16,000 excess deaths compared with the baseline count between January 2019 and February 2020.
Between January and April 2021, the registers show 17,882 deaths, a 102 per cent increase over the average for the same months in 2019 and 2020.
“The take-home here is that reliance on death certificates to count mortality from pandemics like this is not sufficient,” emergency medicine specialist Satchit Balsari, an assistant professor at Harvard Medical School and the study’s co-author was quoted as saying in The Telegraph.
The other co-authors are demographer Ayesha Mahmud from the UCB, researchers Rolando Acosta and Caroline Buckee from the Harvard School of Public Health, and Biraj Patnaik from the New Delhi-based National Foundation of India.
“Governments must look for alternative ways to better estimate mortality in the absence of a robust and nuanced death registration system,” Balsari said. “The high excess death estimate also warrants a closer look into who died, when and how, so we can mount appropriate and effective medical responses.”
The health ministry has consistently denied large undercounting of Covid-19 deaths. It has said excess mortality covers deaths from all causes and that attributing them to Covid-19 is “totally misleading”, the report read.
“We have to assume that the vast proportion of excess deaths were due to Covid-19 — there is no other explanation for such large increases as 4.8 times (compared with the same period in) the previous year,” the epidemiologist, who requested not to be named, told Telegraph. A Delhi based epidemiologist told Vibes of India that the Gujarat government owes a public apology to the people of Gujarat for “hiding crucial data and seriousness of the situation”.
“Some excess deaths may be explained through deaths of patients of other critical conditions such as heart attacks who could not get treatment in time because the hospitals were overwhelmed by Covid-19,” the epidemiologist said. “But such deaths cannot explain the observed excess.”
It must be noted that after sudden spike of deaths in Gujarat due to Covid, the state government notified a rule that if any Covid patient dies of cardiac arrest, kidney failure, diabetes or any other ailment, that ailment should be written in the form as cause of death and not Covid.
Last month, researchers at the Centre for Global Health Research, University of Toronto, Canada, had estimated on the basis of three data sources that India’s Covid-19 death counts might range between 2.7 million and 3.4 million, or at least six times the official count.
The former chief economic adviser to the Indian government, Arvind Subramanian, currently at Brown University in the US, and his colleagues too had last month estimated India’s excess deaths at 3.4 million, 4 million or 4.9 million, using three different methodologies.
The health ministry has, however, said India has “a robust system for recording Covid-19 deaths” and while some cases may remain undetected, “missing out on deaths is unlikely”.
“Well-conducted research studies on mortality are usually done after the event when data on mortality are available from reliable sources,” the ministry had said last month.
According to the Telegraph report, a public health specialist said it was puzzling that the excess death estimates for India were primarily emerging from academic institutions outside the country.
“This is data entirely generated by our civil registration system,” the expert said. “Why aren’t Indian academic institutions analysing it?”
Opposition attacks
The Opposition has long accused the BJP government at the Centre of fudging numbers when the Centre allowed large religious gatherings to be held or announced assembly polls in five states in the midst of a raging second eave of coronavirus.
Jignesh Mewani, MLA from Vadgam said: “The research shocked but didn’t surprise me. Rupani’s State government has never bothered about the Human Development Index, 40% malnutrition in the state or the lack of health infrastructure. The government is anti-people. There is a complete disregard for the life of commoners who die innocently. The aim is to win elections and care about nothing else.”
Arjun Modhwadia, senior Congress member said: “It takes two months to set up an oxygen plant, in serious cases, you can set it up in 15 days. The government had nine months to work on the health infrastructure but they did nothing. Their priority is not healthcare. They also delayed the ordering of vaccines from the Serum Institute which lead to a delay in vaccination. During my recent visit to Junagadh, I found how three out of 10 people have died as they got no hospital bed during Covid. This is utterly shameful.”
