India’s official death toll in 2020 during pandemic underestimated by 8 times: Study

Disadvantaged groups suffered biggest loss in life expectancy, findings show
India’s official death toll in 2020 during pandemic underestimated by 8 times: Study
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India’s death toll in 2020 during the COVID-19 pandemic was likely about eight times higher than the official figures, and 1.5 times higher than the World Health Organization’s estimates, according to a new study.

Life expectancy declined by 2.6 years between 2019 and 2020. COVID-19 hit marginalised groups like Muslims and Scheduled Tribes harder, with bigger declines in life expectancy estimated in 2020 relative to 2019, the study published in the journal Science Advances stated.

Roughly, a third of the global pandemic excess deaths are thought to have occurred in India. 

“Mortality in 2020 is not as high as it was in 2021, doing such an analysis for 2021 would be valuable, if data is available. The year 2020 matters because it set narratives for how well the government responded to the pandemic. Our findings show that in contrast to claims, the impact was large and unequally distributed,” Aashish Gupta, Marie Sklodowska-Curie Fellow at the University of Oxford, told Down To Earth.

The paper analysed data on mortality and socioeconomic characteristics among 765,180 individuals included in India’s fifth National Family Health Survey (NHFS).

The NHFS, Gupta explained, is a unique dataset that is publicly available and has a long history of reliably capturing mortality.

The team analysed the data on projected changes in life expectancy at birth, categorised by sex and social group, between 2019 and 2020.

Within different social groups, life expectancy in Scheduled Castes, Scheduled Tribes, Muslims, Other Backward Classes and high-caste Hindus declined by 2.7, 4.1, 5.4, 1.3 and 1.3 years, respectively, between 2019 and 2020, respectively.

“Marginalised groups already had lower life expectancy, and the pandemic further increased the gap between the most privileged Indian social groups, and the most marginalised social groups in India,” Gupta explained in a statement.  

Gender-wise, women in India suffered greater setbacks during the pandemic, in contrast with global patterns. Among all demographics, women's life expectancy decreased by 3.1 years, while that of men fell by 2.1 years between 2019 and 2020.

“Age patterns of mortality impact among men and women suggest a role of discrimination against girls, a rise in maternal mortality and healthcare disruptions, in addition to COVID mortality, unequal access to health, and unequal distribution of household resources,” Gupta explained.

Another notable trend that surfaced was the disparity in life expectancy reductions. The study observed that in high-income nations, these reductions were mainly due to higher mortality rates among those over 60. Conversely, in India, mortality rates rose across nearly all age groups, with the most significant increases seen in both the youngest and oldest populations.

“Using unique demographic and health survey data, our study highlights the importance of focussing on inequality when measuring mortality and shows that pandemics can worsen, rather than equalise, existing disparities,” Professor Ridhi Kashyap said in a statement. 

These unequal impacts, she added, were particularly noticeable in how the COVID-19 pandemic exacerbated the health impacts of pre-pandemic gender disparities.

The findings underlined the need to concentrate more on disadvantaged groups, including women, marginalised communities, and rural regions, to better comprehend and address future mortality crises.

The researchers aim to analyse these patterns using 2021 data next. They also seek to understand the sub-national variations in the pandemic's effects. 

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