Why India’s pandemic data is vastly undercounted

Trajectory of cases is reminder of how virus can rocket through unvaccinated population

Published:  May 02, 2021 AP

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A relative helps a man sitting in the back of a motorized rickshaw receive oxygen for his COVID-19 symptoms, in Delhi, India, April 25, 2021. India’s devastating second wave of coronavirus infections and deaths is tarnishing Prime Minister Narendra Modi’s aura of political invulnerability. (Atul Loke/The New York Times)Image Credit: NYT

Washington: Even after more than a year of devastating coronavirus surges across the world, the intensity and scale of India’s current crisis stands out, with patients desperate for short supplies of oxygen, pleas for help from overwhelmed hospitals, and images of body bags and funeral pyres.

As daily case counts soar far beyond what other countries have reported, experts caution the official COVID-19 numbers from the world’s second most populous country are likely a massive undercount. But why is India’s data considered inaccurate? Is the data any less accurate than what other nations report? And which numbers give a good indication of the crisis?


India is not counting every coronavirus case, but no nation can. Around the world, official tallies generally report only confirmed cases, not actual infections. Cases are missed because testing is so haphazard and because some people infected by the coronavirus experience mild or even no symptoms.

The more limited the testing, the more cases are being missed. The World Health Organisation says countries should be doing 10 to 30 tests per confirmed case.

India is doing about five tests for every confirmed case, according to Our World in Data, an online research site. The US is doing 17 tests per confirmed case. Finland is doing 57 tests per confirmed case.

“There are still lots of people who are not getting tested,” said Dr. Prabhat Jha of the University of Toronto. “Entire houses are infected. If one person gets tested in the house and reports they’re positive and everyone else in the house starts having symptoms, it’s obvious they have COVID, so why get tested?”

Jha estimates, based on modeling from a previous surge in India, that the true infection numbers could be 10 times higher than the official reports.


Deaths are a better indicator of the shape of the pandemic curve, Jha said, but there are problems with the data here too.

“The biggest gap is what’s going on in rural India,” Jha said. In the countryside, people often die at home without medical attention, and these deaths are vastly underreported. Families bury or cremate their loved ones themselves without any official record. Seventy percent of the nation’s deaths from all causes occur in rural India in any given year.

Counting rural deaths can be done, as Jha’s work with the Million Death Study has shown. The pre-pandemic project used in-person surveys to count deaths in rural India, capturing details of symptoms and circumstances with results of the “verbal autopsies” reviewed and recorded by doctors.https://4922db8fa86d8b892717ebaae167b9ba.safeframe.googlesyndication.com/safeframe/1-0-38/html/container.html

Many low- and middle-income countries have similar undercounts of death data, Jha said, but India could do better.

“It’s a country that’s got a space program. Just counting the dead is a basic function,” he said. “India should be doing much, much better.”


Knowing the size and scope of the outbreak and how it is changing helps governments and health officials plan their responses.

Even with the known problems with the data, the trajectory of COVID-19 cases and deaths in India is an alarming reminder of how the virus can rocket through a largely unvaccinated population when precautions are lifted.

“What happens in India matters to the entire world,” said Dr. Amita Gupta, chair of the Johns Hopkins India Institute in a Facebook conversation Thursday. “We care from a humanitarian perspective, a public health perspective, and a health security perspective.”https://4922db8fa86d8b892717ebaae167b9ba.safeframe.googlesyndication.com/safeframe/1-0-38/html/container.html

Photos: Lifesaving oxygen aid arrives in India as COVID-19 death toll hits new record

Medical equipment was flown into the capital as part of a huge international effort

Published:  May 02, 2021 12:02AFP

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An Uzbekistan aircraft arrives with oxygen concentrators. | New Delhi: More emergency medical aid from foreign donors to alleviate a dire oxygen shortage arrived in India on Sunday, as Covid-19 deaths in the South Asian nation rose to a new record.Image Credit: ANI

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India is setting almost-daily records for new infections and deaths as the virus crisis engulfs overstretched hospitals in cities and spreads into rural regions.Image Credit: AFP

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Oxygen concentrators and cylinders arrive from Romania. | The country of 1.3 billion reported 3,689 deaths on Sunday – the highest single-day rise yet in the pandemic, to take the overall toll to more than 215,000.Image Credit: ANI

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Just under 400,000 infections were added, bringing the total number of cases past 19.5 million.Image Credit: NYT

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Bahrain’s first batch of medical aid of liquid oxygen. | The latest figures came as medical equipment, including oxygen-generation plants, was flown into the capital New Delhi from France and Germany as part of a huge international effort.Image Credit: Reuters

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A patient breathes with the help of oxygen under a tent installed along the roadside in Ghaziabad.Image Credit: AFP

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Medical supplies bound for India. | French ambassador Emmanuel Lenain said his country wanted to show solidarity with India. “The epidemic is still going on in one country. The world won’t be safe until we are all safe. So it’s a matter of urgency,” he said early Sunday following the delivery of eight oxygen-generation plants and dozens of ventilators from France.Image Credit: AP

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COVID-19 patients receive oxygen outside a Gurdwara, a Sikh house of worship, in New Delhi.Image Credit: AP

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Oxygen tanks ready for delivery. | There are growing fears about the surge of the virus in rural regions where health infrastructure is already patchy and limited.Image Credit: AP

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Family members of COVID-19 patients wait to collect cylinders containing medical oxygen after refilling. | Hospitals in Delhi have continued to issue SOS calls for oxygen on social media, with the latest appeal posted by a children’s hospital on Twitter on Sunday. The plea came a day after up to a dozen patients died at a Delhi hospital amid an oxygen shortage, local media reported.Image Credit: PTI

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Cryogenic oxygen containers from Singapore. | India on Saturday opened up its inoculation drive to all adults, but supplies are running low and only online enrolments are allowed for those aged under 45.Image Credit: ANI

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A COVID-19 patient takes oxygen in the van while waiting to get a bed in the hospital.Image Credit: ANI

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Ground staff unloads oxygen concentrators and other COVID-19 relief supplies from Belgium. | Experts have called on the government to allow more flexibility in the vaccine rollout, particularly in poorer rural areas where there is lower internet penetration.Image Credit: ANI

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COVID-19 patients breathe with the help of oxygen provided by a Gurdwara, a place of worship for Sikhs, under a tent installed along the roadside.Image Credit: AFP

source Why India’s pandemic data is vastly undercounted | India – Gulf News

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