The Union Health Ministry has dismissed reports suggesting an increased number of deaths in India in 2020 during the COVID-19 pandemic. The Ministry asserts that the study published in Science Advances relies on flawed and unacceptable estimates.
The Ministry stated, “It is strongly asserted that an excess mortality of about 11.9 lakh deaths reported in the Science Advances paper in 2020 over the previous year is a gross and misleading overestimate. It is noteworthy that excess mortality during the pandemic means an increase in deaths due to all causes and cannot be equated with deaths that were directly caused by COVID-19.”
The Ministry claims the paper presents results on age and sex that contradict research and program data on COVID-19 in India. The paper claims excess mortality was higher among females and younger age groups (especially 0-19-year-old children). However, data on approximately 5.3 lakh recorded deaths due to COVID-19, along with research data from cohorts and registries, consistently show higher mortality in males than females (2:1) and in older age groups (several fold higher in those over 60 than in 0-15-year-old children). These inconsistencies and unexplainable results undermine the paper’s credibility.
In a statement issued on Saturday, the Ministry emphasized, “The excess mortality reported in the Science Advances paper in 2020 over the previous year is a gross and misleading overestimate. The study is erroneous, and the methodology followed by the authors has critical flaws; the claims are inconsistent and unexplainable. The all-cause excess mortality in 2020 compared with the previous year in India is markedly less than the 11.9 lakh deaths reported in the Science Advances paper.”
The Ministry added that discrepancies between the study’s findings and established COVID-19 mortality patterns further erode its credibility. “The study fails to acknowledge India’s robust Civil Registration System (CRS), which recorded a substantial increase in death registrations (over 99%) in 2020, not solely attributable to the pandemic,” the Ministry asserted.
The authors of the study claim to follow standard methodology by analyzing the National Family Health Survey-5 (NFHS-5), but the Ministry pointed out significant flaws in this approach. The authors took a subset of households from the NFHS-5 survey between January and April 2021, compared mortality in these households in 2020 with 2019, and extrapolated the results to the entire country.
“The NFHS sample is representative of the country only when considered as a whole. The 23% of households included in this analysis from part of 14 States cannot be considered representative of the country. The other critical flaw is related to possible selection and reporting biases in the included sample due to the time in which these data were collected, at the peak of the COVID-19 pandemic,” the Ministry explained, adding that the paper is methodologically flawed and presents results that are untenable and unacceptable.
The Ministry elaborated that the paper erroneously argues for the need for such analyses by claiming that the vital registration system in low and middle-income countries, including India, is weak. The Ministry countered this assertion, stating, “The CRS in India is highly robust and captures over 99% of deaths. This reporting has constantly increased from 75% in 2015 to over 99% in 2020. Data from this system shows death registration increased by 4.74 lakh in the year 2020 compared to 2019. There was a similar increase of 4.86 lakh and 6.90 lakh in death registration in the years 2018 and 2019 over the respective previous years. Notably, all excess deaths in a year in the CRS are not attributable to the pandemic. The excess number is also due to an increasing trend of death registration in CRS (it was 92% in 2019) and a larger population base in the succeeding year.”
The Union Health Ministry disputes the findings of the Science Advances paper, arguing that its estimates of excess mortality during the COVID-19 pandemic in 2020 are grossly overestimated and methodologically flawed. The Ministry maintains that the robust CRS data contradicts the study’s claims, showing consistent death registration trends and a high capture rate of mortality data in India.